As the healthcare industry increasingly turns to technology to solve administrative problems, automated RCM solutions aim to save hospitals significant time, while improving their bottom-line.
By leveraging data and analytics, healthcare providers can streamline tasks such as eligibility and benefits verification, preauthorization, medical necessity and billing and collections, thereby shortening the payment cycle and improving patient satisfaction.
Care providers and RCM systems are focusing on automating the following three areas of the revenue cycle:
1. Cost-estimation process. Medical centers are increasingly unable to provide precise cost-of-care estimates to patients due to cumbersome insurance variables. The cost-estimation process is so time-consuming —and requires such an abundance of coordination between payers, the physician's plan-of-care and the healthcare facility— that many caregivers are forgoing estimations altogether.
"Because [cost-estimation] was not a seamless part of registration, it actually became a negative part of the patient experience," Lisa Rickey, patient access manager at BrazosportRegionalHospital in Texas, told Executive Insight.
Insurance eligibility solutions, capable of using analytics to find insurance coverage, can help hospitals improve their reimbursement rates and provide patients with the cost information they need.
2. Cyber security of information in patient portals. Patient portals enable providers, payers and labs to share patient information conveniently, but portals also introduce security vulnerabilities. RCM service providers are adopting the same security technologies and information-processors as credit and financial industries to protect patient information. RCM is one the fastest-growing health information segments, according to Executive Insight.
3. System integration.A comprehensive RCM solution can help providers better manage the entire patient continuum from registration through recovery. Integrated patient and payment RCM systems can give providers greater control over their revenue processes. By leveraging data and analytics in more powerful ways, staff can reduce time spent in data-entry tasks and increase time spent delivering patient care.