Staffing challenges are an ongoing challenge in healthcare that impact patient care as well as revenue recovery.
Here’s a key insight Infinx’s Chairman Jaideep Tandon shared on how to approach staffing shortages as an opportunity to improve revenue cycle processes at a recent office hours conversation with Director of Marketing, Kate Tingley.
Kate:
Can you talk a little bit about what the opportunity is here to reevaluate your processes and how you’re doing things in terms of revenue cycle? How would you approach that?
Jaideep:
It shouldn’t be looked at as purely as a staffing challenge, it’s a business challenge that spreads across many business processes.
And at the end of the day, if you’re looking at revenue cycle management, you want to make sure you can minimize your revenue leakage and get maximum bang for your buck. So in any case, you want the least amount of people touching a particular claim as it goes from start to finish, because that’s where you make the most money in it.
And our RCM systems and processes over the years due to the regulatory environment and changing payer guidelines, continue to get more complex each year and few people can understand them.
And this today presents an opportunity for us to take a step back and say, “What’s core to my business as a healthcare provider? And what are best of breed solutions out there that I can deploy, to make sure my revenue cycle operations are running smoothly, and are scalable as my business grows.” And that scalability means you’ve got to rely on outside partners and best-of-breed technology around it.
What we’re seeing in our industry, in our customer base today is they’re recognizing for things like prior authorizations, it’s difficult to be an expert across all geographies, all payers, all the time. And so relying on partners who can take them along the journey is extremely important to them. And they want to focus on maximum utilization, and not get bogged down by administrative tasks.
And these administrative tasks aren’t going away. There is technology coming in to help assist that but they’re going to remain and more likely to get more complex.
So we see a tremendous amount of change coming from our customers in the industry around rethinking how prior authorizations, insurance eligibility and verification, and patient pay estimates are done. All of those are critical things that you can do prior to a claim going out to reduce your revenue leakage.
And the same thing we’re seeing on the accounts receivable management and denials. If you have great analytics to tell you where you really need to focus, you don’t need as many people. You use AI and machine learning again to see how best you can work that A/R inventory and chase the right dollar that is going to return to cash versus just going through a drawn-out process of touching every claim.
So, a tremendous amount of opportunity. I think all of these things can serve as a catalyst to really reinvent the RCM operations of a lot of healthcare providers.
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