May 22, 2023 Asmita PillewanOperations , Business ,
The healthcare industry is facing a multitude of daunting challenges, including increased healthcare costs, the high burden of chronic diseases, complex billing processes, and the disruptive effects of a global pandemic. To ensure continuous cash flow, providers have to optimize the revenue cycle. By leveraging the power of Hyperautomation in RCM, healthcare providers can achieve optimal financial success and operational efficiency while providing quality care at the same time. With this all-encompassing framework, hyperautomated RCM enables a more streamlined and automated environment that not only improves patient experience but also delivers long-term advantages for all stakeholders within the healthcare industry.
Revenue cycle management (RCM) is a process by which providers get reimbursed for the services they have provided to patients. Errors in the process lead to the denial of claims resulting in revenue loss. Healthcare expenditures in the US reached nearly $4 trillion each year, with a large portion dedicated to administration. A streamlined RCM process can create a more efficient workplace and lead to significant savings. Denial of claims and write-offs can drain resources, but a proper RCM structure can cover up to 67% of denials and prevent up to 90% of them, resulting in an additional $5 million in revenue annually for US hospitals, as reported by Becker's Hospital CFO Report.
Due to the shift from volume-based care to value-based care, providers have higher pressure to maintain the quality of care and document it to get paid for the same. According to the latest study, the US healthcare industry spends $2.1 billion annually on imperfect and unreliable manual tasks. The automation of revenue cycle management provides a unified solution, to reduce manual intervention and time required for administrative processes. It also helps to decrease errors due to which the clean claim rate is elevated, and revenue is maximized. An efficient revenue cycle management offers a variety of benefits to optimize cash flow and enable providers to focus on care delivery instead of administrative functions.
From streamlining healthcare provider tasks, recommending appropriate ICD codes to monitor billing processes, and even scheduling patient appointments, automated solutions have helped healthcare organizations succeed more efficiently than ever before. According to KPMG World Report (2020), 41% of the respondents believe digital healthcare solutions improve electronic records management, and 90% voted for an improved patient experience.
Some of the ways hyperautomation uplifts traditional RCM processes are discussed below:
An optimized revenue cycle management ensures the survival and sustainability of provider organizations. It is an end-to-end process that consists of a complete journey from a patient encounter with a physician to claim remittance. Revenue cycle management encompasses different milestones which play a vital role in optimal revenue generation for healthcare providers.
You will be able to understand it better if you look at these use cases:
The adoption of AI and automation technologies has rapidly increased in healthcare organizations, resulting in significant ROI. According to a study by CAQH, revenue cycle automation saves $17.6 billion annually in administrative costs. Additionally, electronic claims submissions could save 22 minutes per claim compared to manual processing. Healthcare organizations can now rely on advanced automation for reliable income and swift collections.
Step into the future of healthcare automation with JK Tech's innovative revenue cycle management solutions. Our team offers a comprehensive strategy to help the healthcare industry maximize potential - creating perfect harmony between operations and security while increasing speed and efficiency. JK Tech’s innovation and focused approach to solve business problem by leveraging hyperautomation helps to ease the burden of administrative tasks and bridge the gap between providers and payers. We offer an array of solutions and services around different components of RCM like patient registration, eligibility verification, prior-authorization, medical coding, charge capture, superbill generation, EDI processing, claims denial management. We maximize utilization of data and technology to make the processes efficient and maximize revenues while also enabling providers to give effective care delivery.
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