Advanced Revenue Cycle Analytics: An Overview

AdobeStock_118992462According to a recent article on the Healthcare Finance website, hospitals are losing an average of $22 million in missed revenue capture. There are a couple of negative market trends that lead to these unprecedented numbers.

  • Payers have increased their level of scrutiny over claims
  • Patient cost obligations are at an all-time high
  • Increased physician responsibility on documentation
  • Poorly integrated revenue cycle operations

All of this pressure from payers, patients, and from the industry as a whole is a lot to keep up with. It is easy to make mistakes when there is so much to juggle, and for hospitals, that looks like a lot of missed charges. That means there is a lot of revenue being left on the table—$22 million for the average hospital.

All of this missed revenue begs the question, what can be done? How do you fight against these negative market forces? There are some things outside of your control, like the scrutiny of payers, and the rising patient cost obligations. However, there are ways hospitals and practices can improve their workflows to create a more efficient and cost-effective revenue cycle.

Using an electronic charge capture system, whether it is through your EMR or through White Plume’s AccelaCAPTURE, greatly decreases your risk of missing charges. This is the first step. The second step is to run claims through a custom-rules engine, like AccelaSMART. AccelaSMART is regularly updated with industry and payer rules, but you can also build custom rules based on the needs of your practice or hospital. This is an easy way to prevent missing those often overlooked charges. Just build a custom rule for it. 

Finally, in order to improve your revenue cycle, first you need insight to see where there are opportunities for improvement. This is where actionable analytics are beneficial. You can take a look at which charges are missed most often, or what codes are being corrected the most. Which of your coders can process the most encounters per hour? With AccelaSMART, we are able to offer these in-depth analytics. These are some of the key metrics that will help guide you towards making changes for a better revenue cycle.

Hospitals may be losing large amounts of cash due to the current negative market trends, but it doesn’t have to be that way. Take steps today to improve your revenue cycle and get paid full reimbursements.