Revenue cycle management (RCM) and access leaders face increasing work queues due to growing patient volumes and payer denials.
As the number of timely filing write-offs for normal claims and appeals increases, healthcare organizations can't ignore the impact to the bottom line. What’s more, patients are increasingly dissatisfied with their healthcare billing experience and collections process, making them more likely to delay payments or switch to a different provider that offers more transparent pricing.
During a July webinar hosted by Becker's Hospital Review, two revenue cycle experts from Notable discussed how healthcare organizations can use AI and automation to increase revenue capture and reduce cost to collect
Four key takeaways were:
1.) Healthcare leaders need a new approach to revenue cycle automation. Two-thirds of organizations are turning to automation to ease the burden of revenue cycle work. Historically, however, automation has introduced more challenges than it has resolved. Health systems cede control when they outsource revenue cycle processes. Yet, building automation in-house is often costly. Niche technologies can provide point solutions, but they are also expensive and lead to overburdened IT teams. "The challenge is to determine what should be automated, as well as to identify the overall revenue cycle strategy to deliver ROI," said Philip LaBella, solutions lead for revenue cycle management at Notable.
2.) Notable seamlessly automates the entire revenue cycle. Automating upstream RCM workflows is important since upstream errors lead to as many as 40 percent of back-end denials. By centralizing revenue cycle workflows on a single platform like Notable, health systems can improve response times and handle higher patient volume without hiring more staff. Plus, patients can automatically schedule their appointments giving them greater control over their own care and reducing no-show rates by 35 to 40 percent. "By focusing on the front end, we've seen a 97 percent patient satisfaction rating, a 300 percent increase in copay collections and a 20 percent reduction in authorization write-offs," Mr. LaBella said.
Mid-cycle workflows like clinical charge capture, charge review resolution and claims attachments are also worth automating. Errors and incomplete data cause denials and are time consuming for staff. Health systems that use Notable for revenue cycle automation can see 30 percent reduction in charge review work, which allows employees to focus on higher-dollar and more complex accounts. Back-end automation of denial management, claims status and clinical documentation improvement can also preempt denials and accelerate cash collection. "Our partners report a 30 percent reduction in timely filing write-offs, 10 minutes saved per documentation request and a 25 percent reduction in denial work queue volume," said LaBella.
3.) A truly touchless revenue cycle experience relies on four primary pillars. To automate revenue cycle workflows, Notable leverages artificial intelligence (AI), robotic process automation (RPA), patient engagement and custom configurability. The first pillar is rooted in AI, which instructs bots on what needs to be automated, when and how to take actions based on predetermined rules. Using RPA, bots or “digital assistants” perform those actions in the EHR, just as a human would. Patient engagement is achieved through an intuitively- designed digital experience. When patients understand what they are doing and why -- and what to do next in the process --, they provide more up-to-date information and pay bills faster. Finally, the fourth pillar, custom configurability, is what allows Notable to accommodate unique workflows, and enables administrators to tailor capabilities as the needs of their health system or patient population evolve.
4.) A comprehensive platform for revenue cycle stands apart from point solution offerings. With Notable, workflows can be automated from end to end without staff intervention or substantial IT lift from healthcare organizations. Most RCM leaders find that homegrown solutions are costly to build, point solutions create silos which limit overall ROI, and outsourcing limits control of their revenue cycle. Unlike traditional point solutions that only automate siloed parts of the revenue cycle, Notable's intelligent automation platform is the only platform that provides the broadest set of capabilities for automating any front-end, mid-cycle, or back-end RCM workflow. "In addition to automating discrete back-end RCM workflows, Notable also works to minimize downstream denials by automating front-end and mid-cycle workflows like eligibility verification and documentation -- transforming disjointed revenue cycle management into comprehensive revenue cycle automation," said Muthu Alagappan, chief medical officer at Notable.
Notable recently made their RCM capabilities widely available. To read the full announcement, click here, or request more information
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