Following and understanding industry trends is one of the best ways to improve your revenue cycle. By nature, the healthcare industry is constantly evolving. This means that your revenue strategy won’t stand up to the test of time without optimization and development. The best revenue plan is strict, flexible, and keeps up with industry trends. One of the most financially beneficial trends is incorporating revenue cycle analytics into the utilization review process.
Artificial intelligence is becoming increasingly relevant in healthcare, especially from a financial perspective. Learning to leverage AI and other emerging technologies keeps your organization up-to-date and levels up your utilization management strategy.
Leveraging Artificial Intelligence in Analytics
A strict internal UM strategy involves communication from the front to the back end, meticulous documentation, and leveraging analytics. However, your organization must be flexible in being open to new ideas and technologies. Payers are constantly leveraging new technologies and AI; they’re quickly advancing and using more sophisticated algorithms to automate their review process and use more elaborate criteria for claims submission. Because of this flexibility, they are quickly leaving providers behind.
The best practice for providers is to have a denial prevention strategy. To have a prevention strategy that works, it’s necessary to leverage the appropriate technology—for example, using artificial intelligence that can recognize trends in payer behavior or your own organization’s internal processes.
What does appropriate technology look like?
Create customized, actionable insights
Ideally, technology can intake data from multiple data streams or EMRs and aggregate that information into intelligible, customized reports. Automating data collection and combining of your data streams increases data accuracy, ensuring insights aren’t missed or overlooked. Automated data collection is much faster and more precise due to decreased human error. It also frees up your team’s time to focus on other, more financially impactful areas of their roles.
Backed by clinical expertise
Clinical expertise is the root of a successful utilization management strategy. Utilizing technology backed by clinical expertise ensures that it is made for your organization and your specific problems—tailored to your needs to provide insights and deliver the correct decision data. Incorporating clinical expertise into your technology provides real-time access to valuable reporting information based on industry data.
Evolve your technology with your organization
Every quarter, search for new ways to approach utilization reviews more effectively, leading to increased profit. Technology can provide you the ability to identify and track KPIs and other measures of success throughout time. The technology your organization adopts should scale and grow with your organization’s needs and capabilities instead of quickly being out date and becoming a hindrance.
As a best practice, providers should take a technology-forward approach to identify trends in the revenue cycle process. Your technology should be able to measure the quality throughout the process and improve the claim journey. A technology-forward approach enables providers to increase revenue without burdening their staff.
How Advent Can Help
Advent Health Partners provides strategic business intelligence reporting through our Optics reporting platform. Optics gives clients access to valuable, real-time reporting from previously disparate appeal management data. Create intuitive dashboards with Optics’ flexible framework to display insightful information and pave the way to discovering actionable data points to improve appeal management and utilization management programs.
To discover how Advent Health Partners can increase financial recoveries and operational insights for your hospitals or health system, please connect via the button below.