AHA recently shared that annually, U.S. hospitals:
- Deliver 3.5M babies
- Provide emergency care to 123M people
- Employ 4.6M healthcare workers ready to provide 24/7 care
- Admit 31M people to hospitals for care
- Provide a healthcare safety net for 26M uninsured individuals
That’s hundreds of millions of people turning to providers and hospital systems for care, treatment, appointments, and emergencies – and with that need for medical assistance comes the administrative burden of tracking patients from scheduling their first appointment to paying their final bill.
Revenue cycle management (RCM) is a strategy healthcare providers use to track day-to-day administrative functions in order to provide top-quality patient care. Healthcare revenue cycle focuses on opportunities to increase revenue and optimize processes by evaluating administrative tasks and time management (such as scheduling, medical coding, claim submission, payment collections, etc.).
As more patient-centric, value-based care models are emerging as a key driver of strategic growth for provider systems, making the patient a priority impacts monetary and non-monetary drivers that lead to innovative solutions and behaviors. A customer-centric approach requires deep understanding and knowledge about customer expectations and perceptions so employees and organizations can be aligned across the business revenue cycle – from the contact center to marketing to product operations to the executive suite.
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Download the Customer Voices in Healthcare Report: The Rise of Customer Centricity Across Healthcare.
Managing Revenue Cycle by Listening at Scale
The healthcare system has many hoops to jump through, which means there are many opportunities to listen, understand what’s working, and locate areas for improvement. When considering revenue cycle, in particular, errors can lead to delays in payment or reimbursements that directly impact patient access to care. The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is also an important indicator on patient perspectives that informs national hospital care standards and is linked to revenue cycle.
Ongoing monitoring and tracking is a critical component of RCM. In today’s healthcare environment there are countless communication channels and sources of data that could offer valuable insights – simply by listening at scale. Consider the following key benefits:
Collect and Analyze Critical Data
Millions of voices with a diverse array of needs makes tracking an important information source for revenue cycle improvements. The more comprehensive and detailed the data, the stronger the foundation is for strategic decision-making. Having a comprehensive view of various data channels improves tracking and gives a clear, holistic view of patient care management. Tech innovations, like artificial intelligence and machine learning are making it possible to listen and analyze large amounts of data. This encompassing data oversight can help in avoiding technical errors, claim denials, and fraud issues while creating an investment strategy that has the greatest impact in patient care.
Identify Root Causes
With a birds-eye view of systems in place for patient care, processes can then be enabled to identify root causes and characteristics associated with areas of success and points of friction. Listening at scale pinpoints where issues originate, such as: disruptive claims processes, claim denials, human coding errors, missing or incorrect patient information, etc. Presenting data clearly and efficiently allows decision-makers to understand gaps in care and provides a path towards resolution. Letting errors and friction points go unresolved or unfound has a direct effect on patient experience and health, as well as potentially lost or wasted revenue.
Systematically Respond to Social Determinants of Health (SDOH)
Factors linked to a lack of socioeconomic resources are commonly attributed to higher readmission rates for patients at hospitals. According to the Centers for Medicare & Medicaid Services, readmission rate is a metric that tracks the percentage of patients that are admitted into the same or another hospital within 30 days of being discharged for the same condition or a complication from care. By focusing on readmission prevention, especially in vulnerable minority populations, investing in health literacy programs helps educate on treatment plans, self-care procedures, medication management, etc. Being able to develop a system that is responsive to the needs of diverse populations can address social determinants that are specific to the surrounding community and provide a higher quality of care.
Employee Onboarding and Training
Staff training is a common pain point for many healthcare organizations. Leaders seek to develop smooth onboarding and continuing education programs to keep staff informed and equipped to manage administrative tasks with ease. Many revenue cycle issues stem from human errors, such as improper coding, missing items in a patient’s account, and insurance eligibility issues that lead to delays in treatment and lost employee time solving the errors. Identifying examples of success and opportunities for improvement to share as part of training sessions have been linked to better return on investment, such as lowering turnover rates and reducing medical errors.
Data-driven outcomes can identify previously unrecognized blind spots within the revenue cycle. Listening at scale gives health systems the ability to address issues at the root cause. This has a profound impact on reducing a hospital system’s administrative burden and, ultimately, a high-quality patient experience.
Tell me more about how Authenticx works with revenue cycle leaders
Revenue cycle leaders need to feel confident in their quality scores and hospital metrics. Particularly across healthcare, there’s a critical need to identify barriers so processes can be improved. Authenticx was founded to surface meaningful insights from unstructured data. We help leaders strategically invest to optimize their quality assurance metrics to improve customer experience and operational effectiveness. Our platform provides automated evaluations that review audio and metadata obtained from IVR systems. With out-of-the-box or fully configurable options, our solution offers a healthcare-specific quality solution.
About Authenticx
Authenticx was founded to analyze and activate customer interaction data at scale. Why? We wanted to reveal transformational opportunities in healthcare. We are on a mission to help humans understand humans. With a combined 100+ years of leadership experience in pharma, payer, and healthcare organizations, we know first-hand the challenges and opportunities that our clients face because we’ve been in your shoes.
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