Challenges

• Manual Data Collection: Revenue and billing data was manually pulled from disparate systems, leading to delayed reporting.

• Complex integration: It is complex and sometimes impossible to integrate disparate data sources.

• Limited Visibility: The lack of real-time analytics made it difficult to identify inefficiencies in the billing cycle.

• Inefficient Billing: High rates of claim denials and delays in payments impacted cash flow.

Solution

• Implemented an RCM Analytics Platform integrated with Purchase, Inventory, EMR, PMS and also from government and 3rd party systems.

• Automated data collection and reporting through real-time dashboards.

• Built custom reports for Key Performance Indicators (KPIs) like denial rates, revenue per patient visit, and claim aging.

Results

• Hundreds of thousands of dollars of more revenue generated by identifying all the missing billing opportunities.

• 25% Reduction in claim denials by identifying common errors in coding.

• Improve Clean Claim % by 60%

• 30% Improvement in collection time.

• Real-time access to performance metrics allowed the client to take corrective actions faster, improving overall operational efficiency and cash flow.

• Also recommends the most profitable options without impacting the patient outcomes.

• Improves Patient satisfaction and outcomes by recommending the regiments with minimum toxicity and side effects.

“The RCM analytics platform provided us with the real-time insights we needed to streamline our revenue cycle and improve our bottom line.”