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More money, less hassle: A closer look at the value of advanced payment practices

A high-performing billing office is one that rarely sees denied or rejected claims, makes few mistakes and has a thorough understanding of the payers they work with. It’s one that operates at top efficiency, providing the most possible value to the organization it’s part of.

If your billing office is slow to verify patient eligibility or has a high rate of denied or rejected claims, you’re not getting the most value out of this department. It may be time to introduce advanced payment practices like the use of EHRs and the implementation of intuitive claims management software.

These can transform your billing performance. They position your team for success by giving them the tech-savvy tools they need to create better, faster results.

Here are the top five benefits of using advanced revenue cycle practices.

1. Enjoy faster claims submission and responses

EHRs allow billers to send claims to payers at the click of a few buttons. Compared to the time it takes to fill out a paper form, prepare it to mail and get a response, the benefit of submitting digital claims is clear. You can shorten your claims submission and response time from a few weeks to a few minutes. This significantly speeds up your revenue cycle, allowing you and your team to keep better track of claims and to see them reflected on the books faster.

2. Send claims in batches

Imagine if your billers were able to fill out and send multiple claims at once rather than managing claims one at a time. The batch claim capacity of some advanced payment tools allows them to do just that. This function gives billers the chance to cut their claims management time in half, if not more. It provides the ability to send a group of claims to each payer your organization works with, then adjust and resubmit individual claims as-needed.

3. Access patient history with ease

A few of the reasons why claims get denied may be:

  • There is missing patient information
  • The patient information provided is inaccurate
  • A claim has been sent to the wrong payer

Being able to generate patient history alleviates these problems. Once billers have all necessary patient information in a claims management system, they can easily retrieve it when creating a new claim without worrying if a patient’s name, address or insurance information is accurate. Billers may have to adjust the date to reflect the most recent visit/treatment or add additional services, but these steps are much easier to accomplish with access to patient history than when starting an entire claim from scratch.

4. Set unique rules

Defining unique rules within a claims management system offers two key benefits: it keeps your team up to date with the latest payer requirements and reminds them of your own facility-specific rules. By making payer rules readily available and/or utilizing if/then functions, you’re giving your billing department the resources they need to work smarter rather than harder.

Billers won’t have to hunt down payer information anymore. They’ll be more in tune with the specific needs of each organization you work with and have a deeper understanding of facility-specific expectations.

5. Reduce A/R days

This is where most organizations see the biggest value in using advanced revenue cycle practices. All the benefits listed above have one combined effect: they can largely reduce average A/R days.

Instead of waiting 60-90 days to see payments on the books, you may be waiting as little as 15-30 days. There’s no guarantee that every claim will be a clean claim or that payers will always provide a fast turnaround, but, when your billing department starts operating at top efficiency, it will put pressure on payers to quickly process claims and send payments. The A/R cycle should speed up and the overall financial performance of your organization will greatly improve.

Additional benefits of using advanced claims management practices include:

  • Fewer claims rejections
  • Fewer human errors throughout the revenue cycle
  • More time back in your team’s workday

Together, these benefits add an immense value to your organization. They create a healthier bottom line, a more engaged team and increase patient satisfaction. With advanced revenue cycle practices, everyone wins.

Advance your RCM workflows with Inovalon

Having strong payment processes is important – but it’s only one part of your revenue cycle! Ensure your entire workflow is set up for success from start to finish. Discover how our cloud-based provider RCM solutions can help.

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About the author

Jeremy Swanson, Senior Product Manager