How Technology Can Solve Payment Integrity Challenges

Payment integrity has become an essential part of the process for healthcare organizations, but it’s traditionally been given a lower priority in resources. As Healthcare Tech Outlook noted, organizations often devote their IT and analytics resources to specific concrete areas, such as billing or claims. If your organization focuses more on payment integrity as an umbrella to ensure that the overall revenue cycle management of your organization runs smoothly, technology and analytics can significantly improve your projected data and bottom line.

Payment Integrity and Your Revenue Cycle Management

For your organization, payment integrity focuses on creating an environment where claims are paid, on time, without denial. That, of course, is in the ideal world. Your staff will likely roll their eyes at the idea of diminished red tape, no denials, and timely patient payments. But this is exactly what payment integrity solutions can help your organization realize. And the ability to gather data and use analytics in a fine tuned predictive manner has arrived.

If you look at the reasons why patient payments are most often hindered, you’ll note some hard and concrete facts. Knowing, for example, that patients are delaying payment because it’s not affordable can help your organization better counsel patients to set up payment arrangements they can meet in advance. With technology, the analytics are available so that your team can review the exact causes of disruption in your own organization to develop productive solutions.

Ways Technology Can Improve Your Current Processes

In the past, billing and claims were often viewed as time sensitive. They still are, but the focus was often on filing quickly in order to avoid a lengthy wait for payment. The focus on time might mean making mistakes or missing information that might cause claims to be denied, which in turn would actually lengthen the workload and process. As Healthcare Finance discussed, the claims payment system is complicated. With a better grasp on your data and analytics, your organization can attack these responsibilities efficiently and accurately – translating to less time and fewer denials. Here are some benefits you can attain with the proper technology backing up your payment integrity process.

  • Automation. Traditional payment integrity often meant a manual lookup of data. The technology wasn’t universal across all of the departments or areas data needed to be cultivated from for each patient. With the right IT solutions in place, your organization can streamline these processes so that all of the information included in the database is accurate and easily accessible and essential responsibilities can be automated to diminish employee error.
  • Claims Proofing. One area where many organizations see a loss in revenue is in the claims process. Filing incomplete claims or claims with errors can mean a denial, more man hours, and in the worst case, might mean a loss of payment entirely. With the right technological solutions, users can be alerted to missing information so that claims can’t be filed unless they’re properly completed.
  • Patient Satisfaction Improvement. One essential key for your organization is in patient satisfaction. By offering services to help your patients better understand their claims and verify their projected responsibility in advance, you can better meet their needs.

The first step in improving your payment integrity process is in evaluating the current protocol to see where the strengths and weaknesses are in your approach. Often you’ll find small changes in how you gather or use your data can make a dramatic improvement in a short span of time.

2018-07-04T20:54:33+00:00 August 29th, 2017|CAVO Payer|
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