predictive analytics and insights

How Predictive Analytics Create Long-term Patient Care Improvements

It’s hard to plan long-term care improvements when you’re focused on the immediate needs of the present. Between attending to patient emergencies, making time to see new patients and managing the day-to-day workflow of your skilled nursing facility, there’s practically no time to sit down and anticipate future needs.

This is just one reason why predictive analytics and insights are invaluable in healthcare. While you and your team are busy handling daily responsibilities, advanced systems can work in the background to track your activities as well as patient behaviors. Then, when you have time to make sense of the data gathered, you can identify actionable steps to implement.

These can influence many parts of your day-to-day, but they have one common purpose: to improve the standard of quality care you’re able to offer patients.

Here’s a closer look at ­three of the long-term patient care improvements you can accomplish by utilizing predictive analytics and insights.

1.    Reduce the risk of incidents

Why did one of your patients recently experience a fall? What was it that caused another individual to mistake their medication? How often do these things occur?

These are just a few of the questions that data can help you answer. When you give your staff the capacity to track every detail of an incident, you collectively lower the risk of future incidents. The information recorded highlights areas of care you can improve to better prevent negative patient experiences. It also provides full visibility into incidents that have already occurred, which can help you prioritize which patients now require the most attention.

2.    Increase intake of patients with conditions you specialize in

As beneficial as it is to record and analyze activities within your organization, you also need to keep an eye on what’s happening in your market.

Having market data accessible at your fingertips greatly improves your competitive advantage. It gives you the information you need to target the best potential referral partners – like hospitals who are releasing patients with conditions you specialize in.

Instead of reaching out to hospitals at random, a tool like ABILITY INSIGHT™ Referral Mapper offers detailed reports on local hospital releases and recent admissions by competing post-acute facilities. Analyzing the data allows you to identify the best opportunities in your local market. And by creating targeted partnerships, you’re setting your team up to succeed in the areas of care they’re most familiar with.

3.    Track and monitor quality measures

The final way that predictive data and analytics can improve patient care is by helping you monitor quality measures. As you’re tending to patient needs, intaking new patients and releasing others, predictive analytics and insights can make sense of your day-to-day activities. They’ll generate reports to identify how you can positively impact your quality measures, and help you track that progress over time. With the right tool, you can even benchmark improvements against state norms and competing facilities.

The benefits of analytics aren’t limited to patient care. Once you discover how to capture and make sense of all the data available to you, the opportunities to improve performance – from patient care to workforce management – are endless. Don’t wait any longer to take advantage of this information. Invest in the predictive analytics and insights you need today to offer more successful patient interventions tomorrow.

revenue cycle management

How to Decrease Your Rate of Rejected Claims

Imagine if you went into a patient visit knowing that you wouldn’t receive payment for your work. Would you invest as much time on that patient? Would you hope to see their name on your schedule again?

Compare this scenario with one in which you know for a fact that you’ll receive payment. Most healthcare professionals would choose the latter. However, many hospitals and facilities receive payment rejections on a regular basis. As much as you want to provide every single patient with the best possible treatment, you also need to make sure you’re collecting all the projected revenue associated with your work.

If you’ve been seeing a spike in rejected payments, it’s time to reassess your revenue cycle management efforts. Try using these five tips to help prevent rejected payments.

1. Clean up your documentation and coding process

In a recent HIMSS Media survey, 41 percent of respondents said clinical documentation and coding is a high-risk area for losing revenue, and 43 percent of respondents considered it a medium-risk area.

If you agree, put a stronger emphasis on correct coding. Invest in employee training to ensure that everyone understands the codes your team is working with. Or, try scheduling more people per shift so your team isn’t spread thin and is less likely to make mistakes.

These are just a few ways to improve coding efficiency. If coding errors are affecting your organization, you can’t afford to overlook this issue any longer.

2. Send claims in batches rather than one by one

Sometimes, payment rejections occur because a claim has been submitted to the wrong payer. Additional reasons for rejections include:

  • Inaccurate or missing patient information
  • Inaccurate payer information
  • Terminated coverage
  • Timely filing deadlines
  • No referral on file (for applicable services)

Batches can’t solve all these issues, but they can offset the chances of payment rejections. Working in batches means you can group claims by payer. It reduces the risk of sending claims to the wrong payer and helps you file claims in a timely manner.

Thanks to the digital systems that make working in batches possible, you’re also able to prevent inaccurate or missing patient information as you work through each claim in your batch. Think of your eligibility and claims management system as your second set of eyes. It will tell you if there’s any adjustments you need to make in any claim within a batch. When you have no notifications, you can trust that every claim has all the information it needs to be accepted.

3. Consolidate your claims management

Speaking of eligibility and claims management systems, how many different revenue cycle management tools do you use? Do you have one filing process for Medicare and Medicaid payers, plus a separate way of submitting claims to private payers?

This kind of workflow only increases your risk of rejected payments. On the other hand, using a single portal like ABILITY EASE® All-Payer to communicate with payers makes your RCM more efficient. It increases the accuracy of each claim you make, and helps you catch any mistakes before a claim is submitted.

The result? A faster, cleaner claims management workflow.

4. Track your audits and appeals

Although automated tools can significantly increase claims efficiency, they can’t guarantee first-time acceptances for every single claim. Make sure to track your audits and appeals whenever you find yourself resubmitting claims.

This provides full visibility on all your outstanding payments. It allows you to track financial performance metrics and hold your team accountable to the goals you’ve established. It can also help you adjust your financial strategy if necessary.

5. Save patient data

The final tip to help you decrease rejected payments is to save patient data. This will significantly improve the accuracy of every claim you create, in addition to speeding up eligibility verifications and claims submissions.

Note, this doesn’t mean you should keep storing paper files for all your patients. The better option is to save patient data within your claims management portal. This way, all you have to do to create a new claim is click a few buttons. You can quickly pull the information you need and trust it’s accurate, rather than waste time sifting through piles of paperwork and double-checking everything manually.

There’s no reason to keep letting rejected payments add up, or to spend hours on revenue cycle management. Start using tips above to improve your chances of receiving full payment with a faster, more accurate workflow.

patient satisfaction

The Impact of Patient Satisfaction on Your Revenue Cycle

The value you offer patients has a direct effect on the revenue you collect. This applies to all healthcare organizations, but unfortunately, not all providers understand the impact patient satisfaction can have. The more satisfied your patients are, the better your revenue cycle management performance will be, which affects many other aspects of your business.

Here’s a closer look at how patient satisfaction contributes to financial growth (and losses).

The high costs of low patient satisfaction

Patients want clear pricing and payment expectations. They also want:

  • A deep understanding of their condition
  • Actionable steps they can take to improve their health
  • Simple, stress-free payment processes
  • The option to manage high treatment costs with a payment plan

All these things show patients that they’re genuinely cared for. When providers offer such resources and payment options, patient satisfaction increases. When these aren’t included in treatment, patients are likely to be dissatisfied.

And when satisfaction is low, many aspects of your organization are hindered – including financial performance, market share, and care quality. Dissatisfied patients are less likely to pay their medical bills in full, if at all. There’s very little chance these people return for more services, which is how market share can suffer. Even patients who continue treatment may not be fully engaged, resulting in a decrease in quality care levels as patients stop adhering to their treatment plans.

Luckily, these issues can be avoided by investing more in your patients. There are plenty of ways to increase patient satisfaction while also improving revenue cycle management performance, care quality and much more.

The revenue cycle management benefits of investing more in patients

Providing a more satisfactory patient experience can be as simple as taking the time to explain payment responsibilities or as significant as implementing new tools and processes. Convenient payment technology or an advanced claims management system can help you better serve your patients, your staff and your bottom line.

The following is a closer look at three of the top ways to increase patient satisfaction with improvements to revenue cycle management.

1.     Help patients pay faster – and in full

Price and payments are some of the biggest factors that affect patient satisfaction. While you may not be able to lower your costs, you can make patient payments more accessible and easier to manage with a tool like ABILITY SECUREPAY™.

This allows patients to conveniently pay their fees anywhere, anytime. Patients with ongoing treatment can set up automatic payments and those who see you for one-time services have the choice to pay with a credit or debit card in addition to cash and checks.

These payment practices are very familiar to your patients; they’re tools patients use every day in other aspects of their lives. When patients have the option to pay for medical bills in the same manner, they’re more likely to pay quickly and in full, increasing patient satisfaction and practice revenue.

2.     Decrease billing mistakes

Billing mistakes don’t benefit anyone involved in treatment, yet for most organizations, they’re a common occurrence. These issues slow down your revenue cycle and can lead to lost profits. They’re also a stressor for patients.

If it’s become the norm to see your staff discussing billing mistakes with patients, it’s time to try a new approach. Implement an eligibility and claims management process that creates a satisfactory experience for all. Make it easy for billers to input patient information and track claims. Eliminate the need for your staff to sift through paperwork and the risk that patients’ bills go unpaid by their payers.

This will result in higher patient satisfaction and engagement, a more motivated staff and a healthier revenue cycle.

3.     Prepare for price shopping

One-third of healthcare consumers used the internet or mobile apps during the past year to compare the quality and cost of medical services. They price shopped before seeking treatment, a trend that will continue to rise in the coming years.

Providers need to prepare for this now by improving pricing transparency, strengthening their organization’s brand and increasing patient satisfaction. They need to put a bigger emphasis on value-based care and comprehensive treatment.

These are the details potential patients look for when comparing provider reviews. They keep current patients coming back and new patients coming in to begin treatment. Thinking long-term, an early adjustment to price shopping can mean significant rewards for your organization.

At the end of the day, all the functions of your organization should be rooted in one purpose: serving your patients. If you fail to meet their expectations, revenue performance will be one of the first things to feel the consequences. However, put the above tips to work to make sure your organization is performing well across the board and watch how patient satisfaction skyrockets – and how your entire organization benefits.

infection prevention

Skilled Nursing and Infection Prevention: 3 Strategies to Start Using Right Away

When did your facility last experience an infection outbreak? How many patients did it affect? In the United States, 1 in 3 million serious infections occur in long-term care facilities – and of those, 380,000 cases lead to death each year.

It’s a serious issue that can’t be ignored. But unfortunately, not all long-term care professionals know how to best prevent and control infection outbreaks. Regular cleaning and disinfecting, the use of disposable tools and even basic hygiene, such as flushing and hand-washing, is not enough. Caretakers need to do more to best ensure their residents’ well-being.

Here are three infection prevention strategies to start using right away.

1.    Record and monitor all infections

As much as you need to treat an infection, you should also be tracking every symptom and moment of intervention. This information is invaluable for better preventing similar infections in the future. It can help you identify the root cause of one patient’s infection as well as an outbreak.

But, how you record this data plays a critical role in how helpful it is. Paper files won’t get the job done. These are time-consuming to record, find and analyze. The easier, more efficient way to work is to digitally track all infection information with a tool like ABILITY InfectionWATCH™. Going digital gives you much more visibility to the infection trends affecting your organization. It simplifies how you track and treat each patient’s condition and how you prevent outbreaks from affecting all patients.

2.    Strengthen early detection efforts

One of the best ways to keep an infection from spreading is to identify it early on – either when an already existing infection enters your facility, or when a new infection occurs within the facility.

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Some ways to improve the early detection of infection include:

  • Identify where an infection was acquired
  • Identify the prevalence of healthcare-associated infections (HAIs) and community-associated infections (CAIs)
  • Track cases of antimicrobial resistance
  • Record adverse drug effects
  • Utilize the information of previous outbreaks to identify high-risk trends

Early detection doesn’t just mean being aware of the potential for an infection outbreak in the future. It also means learning from past outbreaks to best minimize this risk.

3.    Prioritize your intervention plans

If one individual contracts an infection on Monday, and another is affected by a different, more serious infection on Tuesday, who do you need to see first on Wednesday?

Infections don’t happen exclusively. Depending on the size of your facility, it may not be that unusual to manage more than one outbreak – and many affected individuals – at a time. If you find yourself administering multiple intervention plans, you need to know how to prioritize them.

This way, there’s no question as to which patients need certain treatments and to what extent their infections should be tracked and monitored. To best prioritize your intervention plans, refer to the records you keep as symptoms arise and infections are identified. Then, continue to use these records to further enhance your infection prevention and control strategies long-term.

patient data

Continuing the Care Cycle: 3 Things You Can Learn from Tracking Patient Data

Patient care is an ongoing effort. Its success relies heavily on regular caretaker interventions, and it’s partially dependent on how invested a patient is in their well-being. Patient data also plays a role in the coordination and effectiveness of care.

When skilled nursing professionals are able to easily understand the recurring trends of their patients’ health, they can better focus their efforts. Over time, care efforts can shift from a reactive process of caring for the symptoms of serious conditions to a proactive approach that can prevent certain symptoms from affecting patients.

This can’t happen if patient data is sitting in silos. The data must be collected, compiled and analyzed for providers to utilize its full potential.

Wondering what you could accomplish with predictive analytics and insights?

Here are three things you can learn from tracking patient data.

1. Your biggest opportunities to improve care quality

Most providers assume they don’t need to track patient data because they already have a thorough understanding of each patient’s condition. This misconception causes them to miss out on the opportunity to greatly enhance the care quality levels of their entire organization.

By compiling the patient data of multiple people with similar conditions and treatments, providers can better understand how well they’re performing across the board. They can confirm which efforts work best and identify where their team has the most opportunities to improve.

Some providers may discover that assessment errors or lack of patient engagement have negatively affected treatment results. Others may be surprised to find that they’re performing below – or perhaps above – their state’s average star ratings. These are valuable pieces of information available via ABILITY CAREWATCH®, and they’re just scratching the surface of what utilizing comprehensive patient data can accomplish.

2. Why readmissions are occurring

Missed opportunities during treatment can lead to more serious conditions for patients and costly consequences for your organization. If you’ve seen a spike in readmissions, it’s time to take a closer look at what’s causing patients to leave your organization and return to a hospital. Assessing the data of a patient’s treatment from start to finish can help you find the turning point of their condition.

Analyzing patient data for a group of individuals, though, is what allows you to spot workflow trends in your organization that need to be improved. One benefits you on a case-by-case basis, while the other can significantly improve the results you’re able to provide all patients. By utilizing the data of all, you can reduce the risk of readmission for many.

3. How much revenue you’re not capturing

In addition to improving quality of care, patient data can boost financial performance. This occurs when you analyze the claims associated with a patient’s treatment records. If all the claims for a treatment haven’t been submitted, accepted and paid in full, revenue is slipping through the cracks.

There’s also a chance that you have untapped revenue in the form of claims that haven’t yet been created for services you’ve completed. This may happen because your billing staff is prioritizing other claims, or maybe, because they’ve overlooked the opportunity to bill for a service altogether. Another possibility is that the supporting documentation you currently have in place isn’t meeting payers’ requirements.

There are many additional reasons why a claim may not have been submitted or paid in full. But, you can’t leave money sitting on the table or allow conditions to worsen. With the right approach, a little bit of extra time spent analyzing patient data can lead to significantly stronger financial performance and more effective patient care efforts.

Healthcare IT

3 Healthcare IT Trends to Watch This Year

It’s easy to see how the relationship between technology and healthcare can benefit providers and patients in theory. But, it’s much harder for healthcare leaders to determine the most effective use of technology. Between the various tools and applications available and ever-changing healthcare IT trends, healthcare leaders are constantly having to adapt.

They must have a deep working knowledge of their organization’s biggest challenges and the technical understanding to recognize the best solution. They need to stay ahead of industry trends and local competitors – and part of that means being the first to adopt new technologies and processes. Sometimes, it also means catching up to where the market currently is.

Whether you’re getting ahead or gaining ground in your market, here are three healthcare IT trends you can’t ignore.

1. Electronic Health Record (EHR) optimization

Healthcare professionals across many disciplines anticipated that EHRs would significantly improve their daily workflows, financial performance and more. While there have been some good results of using EHRs, 40% of providers have seen more challenges than benefits.

Key challenges to note are:

  • Data silos
  • Increased weekly hours worked
  • Lowered professional satisfaction
  • Difficulty sharing information across teams/organizations
  • Lack of financial integration

Now is the time to address these issues. You may start to compile siloed data or invest more in training the staff who regularly work with EHRs. Or, you can transform their workflow to be faster and more accurate.

The concept of storing patient data and sharing this data across teams isn’t exclusive to EHRs. It can be done with various advanced healthcare applications created to simplify eligibility verification, claims management and/or generate predictive analytics. Instead of settling for EHRs as they are, try finding better ways to operate with the help of advanced applications.

2. Cloud migration

As you’re investing more and more into healthcare IT, consider the support you’ll need. No form of technology is perfect. Even the most advanced tools will have glitches, and they’ll need updates and regular monitoring to run smoothly. This can either be the responsibility of an internal tech support team, or it can be taken care of for you off-site.

When you invest in cloud storage, you also invest in a highly-experienced team of IT professionals who know how to best protect and manage your data. This gives you the functionality you need without the expense of maintaining technology on your own. You can enjoy a simple, stress-free cloud interface without worrying about what’s happening on the backend.

3. Manual task automation

This is arguably the most important of all healthcare IT trends on the list. Manual tasks are slow, they increase the risk of making mistakes and they often hinder staff engagement and patient satisfaction. It’s time to support your staff’s efforts by automating some of their tasks.

You may choose to automate anything from eligibility verification to infection monitoring or staff scheduling. There are various ways to turn a manual process into a simple, efficient workflow – all you have to do is identify the biggest areas of opportunity within your organization. The sooner you do this, the more you’ll be able to truly tap into the talent on your team. When staff members spend less time on manual tasks, they create better results as they work together and interact with patients.

Healthcare IT trends will continue to come and go. What works today may not necessarily be the best way of doing things tomorrow, but you need to make sure you’re operating as efficiently as possible. If you’re not caught up with the trends on this list, get to work right away. If you have adjusted to these shifts, don’t settle. Keep looking for ways to further enhance your organization’s performance.

predictive analytics and insights

How Predictive Analytics and Insights Can Improve Market Share

The post-acute care market is becoming more competitive every day. Hospitals’ selectiveness in referral networks is increasing as multiple new providers enter the market. This means your organization needs a stronger competitive strategy in order to maintain market share and continue to grow.

Luckily, predictive analytics and insights can help you easily identify the opportunities in your market. They can position you to gain more referrals whether you’re a new organization or you’ve been a post-acute care provider for many years.

Here are three ways you can leverage analytics to benefit your organization.

1. Closely monitor patient movement

What conditions does your organization specialize in? Which hospital do most of your patients come from? The answers to these questions can establish the foundation for your new and improved referral strategy.

The data available within ABILITY INSIGHT™ Referral Mapper can help focus your strategy on the most viable opportunities. By breaking down patient movement data into DRG-specific groups, you can better understand which referral partnerships would be the most beneficial. You can also track patient movement from a hospital to a competing organization, which may help you identify what your current competitive strategy is missing.

This information is invaluable. It has the potential to make your referral strategy go from a hit and miss to a much more direct, successful approach.

2. Present a stronger case to potential partners

Predictive data and analytics can make the difference between establishing a new referral partnership or losing this opportunity to a competing organization.

When you combine market trends with quantified metrics that reflect your expertise, it’s easier to express why a referral partnership would be mutually beneficial. The data lets you speak to the treatment results you create and how they match up to competitors’ performance in terms of occupancy targets, census ratings and more. And with the shift from a fee-for-service mindset to one of value-based care, results are at the top of potential partners’ minds.

3. Adjust your efforts with in-depth predictive analytics and insights

Being the first to know about new referral trends in your market makes you the first to act. It gives you the chance to reach out to potential partners before other organizations do. This ensures you maintain your competitive advantage – especially if you frequently generate and analyze reports to benchmark your performance.

Running a successful operation includes providing quality patient care and making smart business decisions. Using data to identify referral sources that align with your facility’s strengths is key to the continued growth and success of your business. Discover first-hand how predictive analytics and insights can transform the way you target potential referral partners and serve your audience.

Tips on Introducing Value-Based Quality Care to the Day-to-Day Operations of Your Organization

As healthcare continues to embrace value-based care, it’s increasingly important for organization leaders to be on-trend.

Those who can quickly implement this way of thinking and operating will see an increase in patient engagement as a result of higher quality care. Those who struggle to embrace value-based care will fall behind as consumers turn to other, more attentive providers who can offer better results.

Here are three tips to help your organization succeed in its transition to providing value-based care as opposed to fee-for-service treatment.

1. Streamline front-end operations and payment processes

One of the biggest areas for opportunity with a value-based care model is front-of-house operations. Patients don’t like having to wait for their provider if they show up on time for their appointment. When being admitted into a hospital or skilled nursing facility, it’s not ideal to fill out piles of paperwork, either.

This means you must streamline your front-end operations, no matter the kind of organization you run. Make it easier for patients to provide their eligibility information, and help your staff verify eligibility by investing in the right software.

Advanced verification and claims management tools like ABILITY COMPLETE® can significantly speed up the entire billing process. They’ll provide your team with all the information they need to share with patients. To embrace value-based care even more, ask your team to clearly explain patient eligibility.

Patients who have a better understanding of their coverage and payment responsibilities will show higher levels of engagement. They’re also more likely to pay what they owe on time, especially if you have credit card processing capabilities on site. Other payment processes patients respond well to are online bill pay and automated payments.

2. Focus on comprehensive care and wellness

In addition to front-of-house improvements, you also need to change how you deliver patient care. A diagnosis and prescription won’t cut it anymore. Patients want a much deeper understanding of their health. They want a comprehensive approach to treatment – something that teaches them healthy behaviors they can continue after their treatment is over.

The desire for these long-term solutions is the result of the challenges today’s healthcare consumers face. It’s much harder for them to access care, and the cost of care is a big concern for patients as well. In fact, a recent study states 40% of Americans skipped a recommended medical test or treatment in the last 12 months due to cost.

Additionally, Americans fear the cost of treatment more than the potential illness. When they do seek care, they’re looking for the best, most well-rounded and effective treatment they can find in order to prevent future healthcare costs.

3. Boost revenue with CMS value-based initiatives

If patients avoid healthcare and only engage in comprehensive treatment, what does that mean for providers? CMS is aware that providers may be concerned about losing revenue, so they’re rolling out value-based initiatives to ensure both providers and patients benefit from this transition.

If providers can prove that they’re creating comprehensive health plans and focusing on the long-term well-being of their patients, they’ll receive payment. The qualifications and terms of each CMS plan is unique, but the opportunity is there (or on its way) for providers to increase the level of patient care they provide without hurting their revenue.

The shift toward offering higher-quality care in a more accessible manner has already begun. If your organization has yet to make the necessary adjustments to embrace value-based care, now is the time.

Why We Need Data: Understanding How Healthcare IT Improves the Patient, Provider and Payer Experience

Manual processes increase the risk that a healthcare organization wastes time, makes mistakes and misses out on potential earnings. They can hinder the patient experience and put a strain on relationships with payers.

These are just a few reasons why some healthcare leaders invest in the support of technology. However, of those who use advanced systems and applications, not all are taking advantage of the predictive analytics and insights available.

The key purpose of automated work is to produce faster, better results. This occurs when advanced functions are introduced to an organization’s workflows, but it doesn’t stop there. By learning from the specific metrics and performance reports available in advanced applications, providers can further enhance the treatment experience for themselves, their patients and even for payers.

Here’s a closer look at what happens when healthcare leaders make their workflows data-driven.

Patient satisfaction increases

Delivering a high level of patient satisfaction requires more than medical care. The patient experience begins from the moment an individual schedules their appointment or is admitted. It continues as they interact with admissions, caretakers and billers throughout treatment.

Patient satisfaction may increase or decrease during this time for a variety of reasons. Analyzing data from previous patient interactions positions providers to produce higher levels of satisfaction.

If you were to have your team track care quality levels, infection outbreaks and slips and falls, you’d have a better understanding of the opportunities to increase patient satisfaction – as well as safety and treatment success. You could start working proactively to reduce the likelihood of negative experiences and focus your efforts on going above and beyond to exceed expectations.

Providers’ operational efficiency skyrockets

The use of advanced analytics helps you do more for patients as well as your staff. Imagine if your billers could create and send claims in half the time it takes them now. Or if you could better engage and communicate with your entire team.

With the right tools, you can access the data necessary to improve these things, too. Detailed revenue cycle performance reports can identify the most common mistakes your billers make.

Additionally, data on staff attendance can help you cut overtime costs and avoid burnout. Your scheduling program may even have credential tracking capabilities to help your entire staff stay up to date with required education.

Payers enjoy higher quality scores and better member retention

As patients become more engaged in their treatments and providers deliver higher-quality care, payers’ performance improves. Their quality scores go up thanks to the providers who deliver satisfactory data-driven results. Over time, this results in better member retention for payers and patient retention for providers.

Technology and healthcare are continuously becoming more intertwined. They will continue to enhance the patient experience throughout treatment, but only as providers and payers embrace the advanced tools and analytics available to them. This trend goes hand in hand with the rising importance of value-based care.

What is your organization doing to stay ahead of the curve?

revenue cycle management strategy

Why More Utilization of Data Can Lead to Fewer Denied Claims

Denied claims negatively impact your financial performance, put more stress on your billers and hinder the patient experience. However, most denied claims can be prevented!

There’s no reason to let lost earnings continue to slip through the cracks, or to keep settling for delayed payments. With the right tools, you can immediately start improving your revenue cycle management process.

Not sure what your RCM process is missing? Keep reading to discover how using advanced analytics can increase your claims acceptance rates.

Monitor at-risk revenue

Revenue is at-risk of being lost when you have claims that are approaching the 12-month filing limit and when new claims have inaccurate or incomplete patient/payer information.

It’s hard to catch these things when working manually, but an advanced reporting tool can notify you of all the errors you need to fix. It generates the information you need to better prioritize payer responses and provides the visibility to monitor all at-risk revenue. This results in a major workflow shift from constantly playing catch up and fixing errors, to preventing mistakes in the first place, causing fewer denied claims.

Better understand workflow trends and needs

It’s necessary to monitor and work on previously denied claims in the same way it is to submit new claims. More importantly, there’s valuable data to gather from denied claims.

Pull performance reports on all your denials. The data provided should shed light on recurring billing errors and opportunities to better capture revenue. It will help you make sense of why claims aren’t getting accepted and identify workflow issues that need immediate attention. These insights have the potential to improve your clean claims rate, shorten A/R days and boost your bottom line.

Streamline and simplify performance reports

Performance reports are highly beneficial if used properly. Your team needs to focus their time on taking advantage of the key insights within reports, rather than gathering data and creating reports. They need an advanced reporting tool like ABILITY® EASE All-Payer.

When you simplify the creation of reports, you can dig deeper into what the data is telling you. This allows you to quickly start improving your denial rates, rather than wasting time on report generation.

If you’re constantly catching mistakes after a claim has already been denied – or you’re curious why you’ve lost a certain amount of revenue – start reading between the lines. Utilize the data available to you. Apply it to your workflow, share the insights with your team and strive to keep learning. Over time, your acceptance rates will reflect these efforts.