A revenue integrity partner is necessary for building a broader understanding of organizational claims processes and improvement opportunities. A strategic partner can help decrease time to revenue and reduce administrative costs. Finding and onboarding a partner for your revenue integrity program involve both time and resources, making it important to find the right fit from the start. A hospital or health system should always keep in mind three critical components of a revenue integrity partnership.
1. Clinical Expertise
When looking for a revenue integrity partner, experience with both payer and provider perspectives is critical. Additionally, it is crucial to partner with a team with expertise in determining root causes for denials. Comprehensive expertise across multiple hospitals and/or healthcare systems enables more efficient implementation of best practices and will help the implementation process more effectively.
Take a deeper look at the role clinical expertise plays in a successful revenue integrity partner: The Importance of Clinical Expertise in A Revenue Integrity Partner.
At Advent Health Partners, many RNs’ past experiences are from claim reviews of denials by government and commercial payers across a broad spectrum of clinical claims reviews. Our RNs come from various fields, including cardiology, NICU, PICU, oncology, and wound care. With these unique insights, Advent is successful at overturning many complex clinical denials.
2. Technology
Technology that finds and highlights various issues is vital. Many hospitals and health systems have too many moving parts and disparate processes to succeed without applying additional solutions. When a company has the right technology in place, siloed data is no longer an issue, and it can more successfully be pulled together to see trends and more. Real-time, continuous monitoring helps drive performance improvement and minimize errors.
Apello, our claim review and appeal building technology, was designed by clinical and technical nurses, coders, and claims analysts. It efficiently creates effective appeals while immediately decreasing revenue cycle spends and increases productivity by 300+%. The Optics reporting platform gives clients access to valuable reporting information based on data available within their previously inaccessible claims.
Learn more about the advanced technology you should receive from your revenue integrity partner: The Importance of Technology Solutions From Your Revenue Integrity Partner.
3. Client Success
A commitment to open communication via monthly reviews, quarterly meetings, status reports, and more is a critical component of a revenue integrity partner. Demonstrating a proven track record of ROI is essential in helping you create bottom-line improvements.
Advent’s approach to success is to work with a sense of urgency, utilizing subject matter experts, and be transparent through constant communication. With insightful and customizable reports, monthly status updates, quarterly strategic business reviews, root cause analysis and trends, the choice of 3 additional customized reports, and collaborative feedback with mutually determined KPIs, Advent crafts strategies for success through collective, effective revenue integrity consulting.
Dig deeper into the benefits proven client success brings when using a revenue integrity partner: The Importance of Client Success in Your Revenue Integrity Partner.
About Advent Health Partners
Advent’s goal is to drive maximum financial returns and operational insights for clients by helping them to identify three essential components to look for in a revenue integrity partner: clinical expertise, technology, and collaborative partnerships. Advent Health Partners offers advanced technology and reporting through Optics and utilizes skills to bridge industry gaps within clinical reviews, technical and coding reviews, and provides the detailed information and best practices needed to resolve core business issues.
Advent Health Partners works with hospitals and health systems across the country, assisting them with their unique challenges across the claims review spectrum. Advent customizes a recovery and avoidance approach collaboratively with clients, helping to ensure appropriate and timely reimbursements while providing real-time and actionable data through Optics reporting.
If you’re interested in learning more about how Advent Health Partners can help focus on improving clean claims rates and timely and appropriate reimbursements, schedule a consultation today.