3 Steps to Optimize the Revenue Cycle: from Transition to Transformation
How to Drive Savings in Healthcare Payments Today
Now that ICD-10 is delayed until October 1, 2015, according to the CMS (Centers for Medicare & Medicaid Services), healthcare providers who spent millions on training and preparation now must defer the ROI benefits for another 1-2 years. So where can providers see immediate financial benefits as payments transition from paper to electronic? Look to the Revenue Cycle!
Three immediate steps can be taken to streamline revenue cycle processes for healthcare providers which have a sizable, tangible and immediate impact on the bottom line of 2014 financials:
- Build your implementation plan toward the new healthcare EFT standards:
- Reassociation of EFTs to ERAs is a great concept which requires a strong project plan to obtain EDI 835 files.
- Reduce your costs of processing EOBs:
- If the provider is posting EOBs manually, then look to eliminate this unproductive process with EOB Automation technology like OrboGraph P2Post using Opti-Lift™ Technology.
- If the provider is using a third party, breakout unit costs and compare to new technology options. We’ve found that many times the conversion process is not only expensive, but inaccurate, causing costly adjustments downstream! There is a business case.
- Streamline denials and provider correspondence processing:
- Many times providers have backlogs for denied claims and have poor processes in place to handle correspondence letters which are generated from insurers (health plans). New systems can automate this process and present denials next day for resubmission. The positive impact on receivables can reach multi-millions!
The long-term vision of straight-through-processing in healthcare payments is the ultimate transformation from paper-based systems to hands off electronic processing. Because reimbursement and reconciliation are more complex than traditional remittance processing, providers, billers and financial institutions need a transformational platform which drives down unit costs for both paper and electronic transactions.