Change Healthcare has unveiled a new version of its Acuity Revenue Cycle Analytics that will enable users to track and gather data across the revenue cycle continuum.
Change’s move to boost revenue cycle solution comes at a time when such products are in high demand, as hospitals strive to grab every dollar and either maintain or grow margins and footprints.
Healthcare organizations are poised to spend more than $90 billion worldwide by 2022, an outlook spike from about $51 billion in 2017, according to a recent Research and Markets report. So it’s not surprising that startups such as Recondo and Payformance introduced new rev cycle tools earlier this year while bigger players such as Cognizant bought Bolder Healthcare Solutions to round out its RCM portfolio earlier this year.
Hospitals use such tools to optimize collections, cut insurance claims denials, expedite the explanation of benefits and improve the quality of information sent to patients. The report said Factors reimbursement cuts, EHR mandates, governmental push to boost the adoption of RCM solutions and revenue loss thanks to billing errors are some of the drivers in the upward moving market. loss of revenue due to billing errors, and process improvements in healthcare organizations.
In introducing its new technology, Change said revenue cycle managers often struggle to optimize processes because they can’t analyze the flow of revenue through every phase of the cycle, denying them the ability to pinpoint challenges. As such, the new program enables providers to access data no matter where it lives in the revenue cycle. Change added a customizable dashboard that facilitates viewing rev cycle performance data, be it historical, near real-time within or across facilities.
“Provider revenue cycle managers get near real-time information and can set customer performance alerts without involving IT resources,” Change said.
The program also connects to the Change Healthcare database, which contains billions of healthcare financial transactions including eligibility, authorization, estimation, claims and remittance data supporting root-cause analysis.
Finally, the technology provides a broader view of the revenue cycle continuum which can allow providers to pinpoint trouble areas and helps providers understand how estimated patient charges compare to actual adjudicated insurance benefits to gauge the accuracy of patient responsibility estimates up front.
“With visibility into eligibility, estimation, pre-authorization, and medical necessity, as well as the relationships between processes that span departments and systems, revenue cycle managers now can make decisions to better manage consumer experiences, promote accurate and timely payment from patients and payers, and improve patient access team management,” the company said.
Other vendors have out with tools that are specialized toward a specific niche of healthcare revenue cycle operations. Payformance Solutions, heeding the much-heralded shift from volume to value-based care, designed and unveiled a cloud- service to connect hospitals and insurance companies in that transition. It includes technical tools for designing, evaluating, building, measuring and negotiating value-based reimbursement requirements that the company said would enable providers and payers to also align their financial goals with improved patient outcomes.
Recondo Technology has unveiled plans for a new revenue cycle management tool that harnesses artificial intelligence and Epic's electronic health record to cut denials and boost POS collections.
The Recondo automated RCM platform for Epic capabilities include: patient demographic verification, real-time eligibility and authorization, benefits normalization alerts management for denial risk reduction, and it and features Recondo's ReconBot technology for authorization initiation and follow-up.
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