Optimize Physician Reimbursement with Comprehensive, Technology-Enabled RCM Services
Whitepaper | Matt Michaels
senior vice president and general manager, Physician Revenue Cycle Management, Change Healthcare
Matt Michaels leads the Physician RCM business and the SmartLab™ program. He has more than 20 years of experience helping providers drive efficiency, scalability, and quality of business administration.
Automation and Analytics Key to Overcoming Today’s Cash Flow Challenges
Physician groups face numerous challenges when it comes to sustaining strong, predictable cash flow. Reimbursement rates are flat or falling and payment models are becoming more complex, with frequent changes in payer rules. Organizations that code and bill internally often struggle to track the latest payer guidance, resulting in payment disruptions, delays, and denials.
Cash flow has also been disrupted by COVID-19, which has reduced ambulatory volume and increased pressure on already overextended coding and billing staff. Staff likewise must learn and implement new coding and billing requirements for COVID-19-related procedures and telehealth services.
But recruiting and retaining the most qualified individuals in an historically tight labor market has become increasingly difficult and costly.
Revenue cycle leaders also are struggling to meet the growing demands placed on their IT infrastructure amid rising costs associated with maintaining and updating legacy platforms. At the same time, most groups possess neither the financial expertise nor bandwidth necessary to identify and address systemic revenue cycle performance issues.
End-to-End Revenue Cycle Support
With cash flow sinking and costs on the rise, practices need to fundamentally reassess their revenue cycle management and consider new approaches that can leverage automation, incorporate advanced analytics, and improve patient collections to help ensure they’re reliably and consistently collecting every dollar they’re entitled to.
Using a combination of highly trained personnel and advanced technology, today’s most effective outsourced revenue cycle solutions deliver high-cash revenue realization at a competitive cost. By combining specialty-specific coding and billing expertise with a range of automation tools, analytics, and patient experience enhancements, these solutions help independent, hospital-employed, and hospital-affiliated practices thrive in today’s unforgiving economic environment.
A Comprehensive Solution
Change Healthcare targets the core functions of the revenue cycle with unmatched, technology-enabled services designed to drive performance improvements across the clinical, operational, and financial domains. Capabilities include:
- Compliance risk mitigation, enhanced charge capture, and improved coding accuracy.
- Denials analysis and management with payer contracting/dispute support.
- Patient liability management, including digital patient follow-up/engagement solutions and analytics-based insurance discovery.
- Billing and insurance follow-up through claim status monitoring, root cause analysis, payment accuracy, and credit/debit balance management.
- On-demand reporting and feedback processes that help create transparency between clinical workflows and financial impacts.
Advanced Analytics Can Help Improve Visibility
A hybrid combination of automation and specialty-specific coding expertise is the foundation for more accurate claims. But to fully optimize revenue cycle performance, these capabilities should be matched with improved visibility into key operational and financial areas.
Reporting and tracking key performance indicators (KPIs) enables practices to quickly identify trends, problems, and opportunities and make adjustments in near-real time. These predictive analytic and forecasting capabilities are especially important in the current environment because they can help ensure business resilience and continuity.
Outsourced revenue cycle providers should be able to pull KPIs at the outset of an engagement to make preliminary assessments about existing performance and to produce accurate return-on-investment projections. And once engaged, a vendor must be able to track key indicators, including charges, collections, bad debt, days in AR, and collection rate.
Beyond providing daily, weekly, and monthly snapshots of these and other indicators, reporting should be customized to ensure clients are meeting their specific goals and benchmarks and identifying denial root causes. Vendors should also provide guidance to help fix ongoing issues.
Improved Patient Collections
In today’s hyper-connected world, consumers increasingly demand the same level of digital convenience in healthcare that they enjoy in other aspects of daily life. Yet providers’ ability to deploy user-friendly financial solutions often fall short of what patients expect.
An effective patient-facing solution bridges the digital gap with an end-to-end, patient-centered approach to communications, billing, and payment. For example, our suite of fully integrated solutions create a seamless billing, payment, and patient communications platform. That means greater transparency and convenience for the patient and optimal cash flow for you.
Our communications and payment solutions provide fast, effective statement and invoice processing, as well as print, mail, and digital communications support.
By consolidating all steps in the billing and payment process, you can collect more, get paid faster, reduce collection costs, and lower patient write-offs.
And by using the patient’s preferred communications channel (mobile, telephone, email, mail) to deliver the right message at the right time, our solutions help facilitate patient collections while improving the patient experience.
Unmatched Revenue Cycle Capabilities
New challenges are combining to undermine collections and threaten physician groups’ financial sustainability. In response, practices must adopt a comprehensive approach that can address a range of issues across the clinical, operational, and financial spectrum.
Change Healthcare’s revenue cycle solutions are uniquely positioned in the industry to deliver these kinds of capabilities.
Contact us today at 844-798-3017 or visit our website to learn more about how we can work together to transform your revenue cycle.