Healthcare Revenue Cycle Software Solutions Articles and Blog

Automate Your RCM Like the Portfolio Companies of Audax, Shore Capital, and TA Associates

Written by Alpha II | Sep 23, 2024 12:40:58 PM

Leading private equity-backed organizations like United Urology, US Dermatology, and Spectrum Vision Partners use automation to fuel rapid growth. Why? Because automating manual processes reduces workloads, enhances accuracy, and improves revenue. Here’s how automation can help your group meet your aggressive onboarding goals.

Find Manual Processes to Automate

Even if you’re using technology to enter charges and scrub claims, do you have the most efficient workflow in place? One group who switched to an automated process initially had physicians enter charges which were then sent to an external claim scrubber that generated a daily error report. The billing team had to manually review the report and return to the PM to make changes. Charges needing correction had to be voided and re-entered as well as having routine errors like missing modifiers or diagnosis codes added. However, once they started addressing issues earlier in the charge process, routine errors were caught and automatically corrected without any intervention from their staff. Ask your staff what processes they spend the most time on and see what technology automates those manual steps.

 

 

Reduce Workload Through Automation

Traditional approaches to the charge review process require extensive and expensive staffing. Automation allows your staff to focus on only charges that require manual review while the routine errors are corrected and sent onto the PM. Reducing manual tasks will also eliminate costly staff overtime and minimize the stressful month-end crunch. Your coding and billing team can redirect efforts on more important revenue-generating tasks, like researching and filing high dollar appeals. When you revise your approach, you can onboard more physicians without having to add more or overburden your existing RCM staff.

 

Enhance Accuracy and Efficiency

When you address data issues before the claim is created, you increase both the accuracy of your charges and the efficiency of your operations. Implementing technology can streamline your manual workflows. For example, having a system that can run after hours allows your staff to enter new charges during the day and increases the number of daily charges. Then charges run through custom rule editing after hours. Clean charges and those with automated changes are sent directly to the PM system and those that require a manual fix are sent to appropriate staff via dedicated work queues. Creating individual electronic tasks eliminates manual note-tracking and results in cleaner claims, improved front/back-office communication, and faster processing times.

 

Improve Revenue

As you onboard new medical groups, your goal remains the same – increase revenue through rapid growth without increased spending. Every time you have a manual process, it results in more money spent. Inaccurate claims increase days in A/R and don’t get paid at the correct rate. Paying staff to review extra reports costs time during the day and less claims are being sent to payers. Spending time reviewing denied claims requires more staff. All of these are expenses that can be reduced with automation. Through technology, you can send more claims, have those claims get paid, with payments processing faster all without paying more for specialized staff. This translates to a more predicable RCM operation.

 

 

RCxRules – Measurable Automation Intelligence

We have developed intelligent tools that replace manual workloads with automated tasks. If you have processes that you’d like to automate, we want to hear about them. We can share insights and solutions learned from top performing PE-backed medical groups.