How to supercharge your RCM workflow

In today’s fast-paced and ever-evolving healthcare landscape, optimizing and streamlining your revenue cycle management (RCM) workflow has become more crucial than ever. By harnessing the power of cutting-edge technologies, data analytics, and streamlined automation, supercharging your RCM workflow offers a transformative approach that can propel your organization to new heights of success.

Common RCM workflow challenges

Providers face enough hurdles in getting any claim from creation to full payment, so imagine the challenges of processing hundreds or thousands of claims each month. For example, lack of automation reduces revenue as more time and resources are spent per patient. By using automation in revenue cycle management, hospitals can lower their cost-to-collect by 0.25%.

Another obstacle that hinders RCM workflow and threatens revenue is claims denials. In 2022 alone, 11% of all medical claims were denied, which was up from 8% in 2021. This increase in denials causes millions of dollars in lost revenue, which may be caused by not having the proper solutions in place to streamline the revenue cycle and inform financial planning.

Strategies to improve RCM workflow

While there are often challenges with improving your RCM workflow, the right technology can help your organization lower the administrative burden of manual tasks, reduce errors, and improve productivity.

Improve secondary claims submissions

Improving secondary claims submissions is crucial for optimizing your RCM workflow. Delays in submitting secondary claims can lead to uncaptured revenue for services rendered. Using RCM analytics can help solve the issue by making sure primary and secondary claims are submitted on time. The result is a 40% reduction in denials in just 60 days¹  for providers using Inovalon RCM Intelligence.

Reduce days sales outstanding

Focusing on the reduction of Days Sales Outstanding (DSO) also helps with enhancing RCM workflows. One way to do this is to improve patient payment solutions. In fact, 41% of annual healthcare spending could be saved by fully transitioning to electronic transactions online.

Streamlining payment processes with technology such anytime online payment, card-on-file payment plans, text-to-pay, and ApplePay can make it easier for patients to settle their bills, which will improve cash flows.

Improving your RCM workflow with Claims Management Pro

With Inovalon Claims Management Pro, it’s easy to enhance your revenue cycle management processes into an efficient, streamline workflow. This cloud-based software is an all-payer revenue cycle management solution that speeds up reimbursements and strengthens revenue. On average, providers using Claims Management Pro see an average 99% or better clean claims rate², which significantly helps reduce denials. This SaaS solution also simplifies eligibility checks and streamlines claims resolutions.

Schedule a demo to learn more about the power of Claims Management Pro.

Sources:

1. Inovalon internal reporting. Average of customer results, February 2023
2. Inovalon internal reporting, Claims Management Pro, July 2022

Inovalon and design^®, Inovalon^® and the Inovalon ONE® Platform are trademarks of Inovalon, Inc.