Traditional analytics start by looking at the wrong end of the revenue cycle: bill holds, rejected and denied claims. But over 1/3 of the information needed for a claim is created before the patient sees the physician. So we’ve created a very logical solution: Patient Access Performance Analytics.
It provides verified demographic, financial, and clinical data on the communities you serve. This solution monitors every phase of a patient’s progress through the cycle of care, from pre-registration to admissions, outpatient registration, discharge, and all the way through billing activities and even transfer. It automatically applies standard and custom rules that isolate errors and omissions at every stage, and helps users take corrective action. With daily scorecards, alerts, and notification, managers can transition from management by sampling on a few facesheets to management by exception on every account. Then they can develop training programs that greatly improve the clean claim rate.
Over 1/3 of the information needed for a claim is created before the patient sees the physician. So we’ve created a proactive approach to healthcare consumer access.
Typically, admissions staff work hard, but aren’t given a real context of how their performance affects patients and the organization. Patient Access Performance Analytics changes that for the better. It makes admissions staff a key contributor to the operational and financial success of the enterprise. Staff understands the root causes of errors, sees why admissions data integrity is important, and gets detailed worklists that help them move the revenue cycle upstream.
An admissions worker sees a day-to-day trend of job performance, and learns that clean claims were down to 73% in mid-October from their yearly average of 86%. Our analytics have already determined that the problem was caused by three repeated errors, and have given her a prescriptive remedy that is putting her clean claims back to a good level.
Clerical staff typically have an intuitive understanding of the Pareto Principle, but this visualization makes it crystal clear that the great majority of unclean claims are being created by the same three errors, repeated many times.
Our analytics don’t just pinpoint the root cause of a problem and leave the user wondering, “Now what?” We deliver specific, prioritized worklists that help users do exactly what is needed to fix immediate problems, and how to eliminate the root causes, so they will never appear again.
This advanced new visualization gives managers and staff a deeper understanding of cause and effect. By adding motion to the data, we help users see how resolving errors up front has a positive effect that flows through the system, so they understand the full impact of accuracy.