The vital revenue cycle management (RCM) systems that healthcare organizations depend on are often not fully suited to meet their needs. In an era of constant cybersecurity threats and persistent staffing shortages, new RCM capabilities are essential.
This was a major theme in an executive roundtable sponsored by Office Ally at Becker's 9th Annual Health IT + Digital Health + RCM Conference.
The roundtable was led by two Office Ally leaders: Will Brockman, chief revenue officer, and Brad Royer, chief product officer.
Three key takeaways were:
- Office Ally helps streamline, automate and accelerate RCM.
Traditionally, clearinghouses have been mostly owned by payers. Roundtable participants discussed how payer-controlled clearinghouses can present several challenges, including potential conflicts of interest and cybersecurity gaps (as seen in the significant RCM disruption caused by February's ransomware attack on Change Healthcare).
"Payers have had a lot of power for a very long time, but we are finally starting to see a lot of scrutiny of questionable practices such as denying prior authorization," one attendee said.
Office Ally, an all-payer clearinghouse, is providing an alternative option — aiming to help healthcare organizations simplify RCM and drive efficiency.
"Office Ally has changed that payer-driven model," Mr. Brockman said.
- Clearinghouses should provide built-in intelligence and automation.
This feature will help health systems deal with staffing shortages, which also affect revenue cycle departments.
"There is a significant exit of staff in the RCM space, so how do we ensure that an RCM platform produces the same outcomes independent of who's operating it?" a roundtable attendee commented.
- Organizations should prioritize strong cybersecurity systems when selecting RCM technology.
In an age of constant cybersecurity threats, provider organizations need to ensure that whoever they partner with has the capabilities to thwart cyberattacks and restore service quickly in case of an incident.
"You need to know who you're doing business with because it is an extension of your reputation and your risk," one participant said.