VBC is here -
shift gears on your RCM Solution!
A shot of user experience, automation, and some modernization might be the answer for you!
Introduction
US healthcare takes a while to embrace changes. But when it does, a few existing players are toppled from the market. The current transition to Value Based Care (VBC) is a wave that could have similar repercussions for those RCM solution providers that fail to adapt. Those that will survive will need to focus on the user experience they offer, automation of low value-adding activities, modern technologies that are faster, and data-derived intelligence that guides workflows – All that at lower costs! That is going to be the focus of all business leaders that see it coming.
“Mere automation isn’t the answer. With the right processes, it would make them faster for better results.
With inefficient processes, it’ll do the same, just yield terrible results, faster”
Challenges to Overcome...
Maintenance Nightmare
Maintenance Nightmare
Legacy billing systems that are a Pandora’s box of delay in enhancements
Linear Labor Costs
Linear Labor Costs
More billers and AR staff required for every new customer on-boarded
Poor User Experience
Poor User Experience
Multiple clicks and data entry/push which wear the RCM staff down
Lack of Scalability
Lack of Scalability
Solutions suited to single billers, unable to service large-scale floor operations
Evolving Regulations
Evolving Regulations
Changing business models, state/federal/payer regulations requiring persistent systemic changes
Lost Revenues
Lost Revenues
Recoverable revenue lost, due to the lack of enough hands on deck
Flying Blind
Flying Blind
Lack of cognitive automatable intelligence resulting in hunch-based decisions
Rising Training Overheads
Rising Training Overheads
Staff attrition and recurring errors, which spike overhead costs
Avenues to overcome these challenges
There are multiple opportunities that come with RCM solutions, that capitalize on modern technologies. Below are areas where we can make headway for providers and payers.
Pre-registration & Check-in
- Eligibility
- Authorizations
- Patient Demographics Entry
Billing
- Medical Coding
- Charge Entry
- Electronic Claims Submission
- COB
- Patient Billing
AR Management
- Cash Posting
- Follow-ups
- Statement Management
- Denials & Appeals
Analytics & Process Improvement
- Clean Claim Rate
- AR Days
- Denial Rate
How do we help you achieve these?
There is no silver bullet when it comes to RCM. These challenges have scaled up with time, it will take efforts to get past those as well. Here, however, are ways in which we can help you dismantle your problems to help you progress again.
Technology modernization of existing solutions to ease maintenance and introduce flexibility and speed
Redefine & Uplift the User Experience while reengineering existing RCM workflows for better productivity
Data engineering for accurate integration, better data governance and intuitive dashboards using self-service BI
Build unintrusive surface solutions for automated orchestration of billing workflows
Agile response to changing rules, business models, regulations through a reconfiguration of the systems
