How do you actually tap into your payments data to improve the revenue cycle?
Healthcare providers and RCMs have payments data galore. Some of it is unrecognized, much of it is untapped. Payments data is much more than EDI claims data and patient billing information (although, that's all very important data). Your data sources also include call data, IVR, text files, IVA, NLP, payment portal traffic and usage analytics, reports and raw data from your patchwork of vendors, paper statement info and more.
Most RCMs and healthcare providers have this data in pieces and different places. It is rare to have this data unified and accessible -- giving you a complete picture of your revenue cycle and payments behavior. Your data can truly show you how your revenue cycle operates and how to optimize collections. If you can harness all of your healthcare payments data, you can transform your operations and improve payments.
It starts with capturing all of your data into a single platform -- an organized, cloud-based, relational database. This creates a common source of truth for your healthcare payments data. When you have your data identified, collected and organized can you truly operationalize your payments data, using it to improve and carve out competitive advantages.
What do I mean by "operationalize" your payments data? Here are six ways Sift partners put their healthcare payments data to use.
- Better reporting. Establish a complete picture of how your payments behave at every cross-section -- facility, provider, procedure, insurance type, payer, etc.
- Payer Monitoring. Thoroughly evaluate payers, plans, contracts and patient populations, equipping you for more strategic negotiations and preparing you to understand/mitigate risks (like an unforeseen pandemic).
- Agent Performance. Track and understand agent productivity and collection success, allowing you to rebalance assignments and work based on performance.
- Resource Optimization. Assess how to best utilize the Human Resource Capital to which you have access.
- AI-Based Workflow Optimizations. Employ AI and machine learning to segment patients and move to a 1:1 patient billing strategy, improving payment outcomes and customer service.
- Develop a proprietary data strategy. Use your data intelligence to become a market leader -- providing better results, best practices, and efficient processes.
Often, at Sift Healthcare, we lead with our AI-based solutions, machine learning and our predictive models. All of which are powerful and of which I'm incredibly proud. But unless data is unified and organized, you can't layer on the fancy AI, and you most definitely can't realize your data's full value.
Creating a common source of truth around healthcare payments data is the foundation of what we do at Sift -- it's what has provided the most value to our clients, expanding their intelligence around their business and identifying where/how they can improve operations and realize greater revenue.