Background
Netsmart, an electronic health records (EHR) software vendor, delivers intuitive and easy-to-use EHR solutions to behavioral health, care at home, senior living, and social services providers. Their solutions support clients in driving clinical efficiencies and care outcomes by making the complex simple and personalized, so clients can focus on providing whole-person care.
However, Netsmart needed an integrated clearinghouse to help clients seamlessly manage claims and save time in their day. With Inovalon software, Netsmart has delivered the integrations clients needed, helping them simplify their revenue cycle management processes, streamline workflows, and improve financial results.
Improving Patient Access, Even on the Worst Days
When discussing the impact of integrated capabilities, Erica Gregory, SVP and GM of Revenue Cycle Management, Netsmart, shared, “Many of our clients are interacting with patients on their very worst day, and it’s not always easy to gather benefits information. Inovalon enables our clients to get correct and complete information.”
For their clients, enhancing eligibility verification really means improving patient access and the overall patient experience. Having the right technology in place means they can better focus on the patient in front of them, without compromising the details they need to have for claims.
Better Results, Driven by Integrated Capabilities
While the patient impact is the biggest benefit, the value of having an integrated clearinghouse doesn’t stop there. For Netsmart’s clients, built-in reporting allows them to get the most out of their labor and the services they provide.
Our integrated capabilities help ensure billers create clean claims – which means less labor is spent trying to get claims right the first time or on correcting claims, and overall, services get paid faster. “That type of technology has been able to really help clients collect cash and accelerate that in their financials,” says Gregory.
Particularly for Medicare, integrated claims management means that post-acute clients no longer have to work in the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) system. Instead of an outdated green screen, where claims are manually keyed in, clients can now work claims in a modern solution. This interface is connected to their Netsmart EHR, ensuring data is consistent and correct, and feeds back important reporting on their Medicare claims. Gregory adds, “The DDE enablement through the clearinghouse has helped clients accelerate Medicare clean claims, and the reporting for RTPs and ADRs has been very powerful for our clients.”
“The DDE enablement through the clearinghouse has helped clients accelerate Medicare clean claims, and the reporting for RTPs and ADRs has been very powerful for our clients. That type of technology has been able to really help them collect cash and accelerate that in their financials.”
Erica GregorySVP and GM, Revenue Cycle Management, Netsmart
Data-Driven RCM Success
RCM data across all payers and claims helps Netsmart clients improve their financials by increasing visibility to bottlenecks and monitoring workflow trends.
As Gregory shares, “minutes matter,” and more visibility to the revenue cycle means clients can focus in on seemingly small mistakes that are actually costly errors, both from a labor and claims perspective. Reporting allows them to get the most out of their labor force. She continues, “You can only measure what you can report on, so the critical thing with these tools is having easy-to-use dashboards and exportable reports. Inovalon’s reports are very easy to understand.”
In other words, the data users see is primed for action – they can clearly identify delays in their revenue cycle and drill down to how individual associates are performing.
“On any given month, we’re processing up to 18 million claims. So, being able to do exception reporting, to be able to quickly target the issues that we’re having, the bottlenecks we’re experiencing in revenue cycle – that is a key differentiator.”
Erica GregorySVP and GM, Revenue Cycle Management, Netsmart
The Value of the Right Partner
For Netsmart, its Inovalon connections are twofold: powerful software integrations, and dedicated people supporting the partnership every step of the way. Gregory shares:
“I think that people are what make the relationship strong and the Inovalon team really engages with us like they’re one of our team members. We can call our account management team at Inovalon at any hour of the day and they help us get a very quick resolution, whether for payer connection issues or to troubleshoot for our clients. The Inovalon team is incredibly responsive, always available to help us work through a problem.”
Solve Your Integration Needs with Inovalon
With connections across the healthcare continuum and years of experience bringing integrated capabilities to providers in all care settings, our team is ready to deliver on your integration needs.
