Revenue Cycle Analytics Software in demand among large healthcare networks that manage dozens of primary care and specialty clinics, ground and air ambulance services, hospitals, and medical transportation services. They report tens of thousands of dollars in net profit per month when improving just a few specialty billing areas. Organizations also admit that the productivity of hospital coders and the number of medical notes with sufficient medical data for correct billing charge capture have significantly increased. What efforts do these healthcare networks take to achieve such sustainable results?
To provide excellent patient care and contain costs, hospital leaders must understand all of the organization’s financial pain points and opportunities for improvement.
However, healthcare organizations may lack the tools to collect and analyze information from their myriad IT systems. Also, hospital coders may need more sufficient data so they can justify billing.
In addition to internal challenges on the path to sustainability, there may also be external ones. Difficult market conditions, unpredictable reimbursement, and pressure from regional competitors.
Revenue Cycle Analytics Software is successfully used in various clinical settings in hospitals and can increase the net profit of the organization. When large healthcare networks rely on modern solutions, they can improve the data and process of charge capture for professional services that the hospital provides to patients. This solves the problem that the charges captured may not reflect the actual services provided, and the organization doesn’t receive money from patients or insurers.
Healthtech vendors provide healthcare organizations with platforms for financial and clinical improvement. A healthcare software development company like Belitsoft creates, customizes, and upgrades analytics solutions, such as Revenue Cycle Analytics Software, to meet the needs of healthtech providers such as cloud migration services, database migration, etc.
Challenges with Professional Billing Charge Capture in Healthcare
With the introduction of ICD-10, healthcare organizations have been in dire need of professional hospital coders, and the demand for them grows today. It is also important for stakeholders that the process of charge capturing on medical expenses for the services rendered is accurate.
Healthcare leaders understand that clinical and operational data analysis is only possible if data is collected and integrated from across the electronic health record (EHR) system and other critical healthcare IT systems.
However, they may depend on a proprietary service or solution and be forced to analyze data outside the organization. One of the downsides to this tactic is outdated template reports that the organization receives weeks after the data is sent, rather than in near real time.
Additionally, the billing process can be very tedious and time-consuming. Professional coders who work manually must print out rounding sheets every morning based on data from the scheduling software separate from the EHR. In these sheets, they look for potential doctor-patient interactions. They then review the EHR data to confirm that the interaction happened and whether the organization can use this data to bill. The side effect of such a process is slow speed and overloaded staff.
To set up a process of data improvement for professional billing, a range of dedicated software solutions are needed: an adaptive late-binding data warehouse with an open architecture that is easy to customize, and tools for revenue cycle analysis.
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Features of Revenue Cycle Analytics Tools for Professional Billing Charge Capture
It takes about a month and a half to deploy Revenue Cycle Analytics with the Billing Analytics Tool and integrate it with EHR and other IT systems. This app automates much of the data collection that hospital coders used to process manually. They can focus on data analysis and make sure that data is collected completely and correctly. Revenue Cycle Analytics Tools help improve data processing such as data capture, provisioning, and analysis in the following ways:
- Collecting data on medical services provided from all available sources.
- Integrating Hospital Account Records (HAR) from EHR.
- Automatically checking how accurately the severity of illness is described so that the clinic receives full payment.
- Validating whether diagnosis and procedure codes are specified per insurance requirements.
- Loading the data into the warehouse.
- Leveraging data for general reports to managers, employees, and other stakeholders.
Organizational Measures to Implement Revenue Cycle Analytics Software
The traditional approach to improving revenue capture, where an organization strictly monitors employees to make them more efficient, finds individuals to blame for common problems, and cuts staff if necessary to save costs, is outdated.
Healthcare organizations should also identify workflow problems and use LEAN Methodology to confirm or disprove assumptions that these problems exist. The essence of the LEAN Approach is to reduce the burden that medical staff and patients experience every day and create such values as satisfaction, safety, morale, etc.
To grow the program beyond the original specialties and eventually roll it out across the entire system the healthcare organization may hire additional professionals. These new team members should be trained in the process and help coders quickly check if a note has already been reviewed.
What Benefits Can Be Got by Using Revenue Cycle Analytics Software
Key benefits include tens of thousands of dollars in net profit per month from improving just a few specialty billing areas and increasing the number of medical notes with sufficient data to accurately bill.
Using the above-mentioned LEAN Methodology allows the organization to detect if hospital coders do too much manual work and free up their time with specialized tools.
They can spend this time analyzing the data and also educate providers on how to properly maintain medical notes.
Automated processes instead of manual labor reduce the cost of data capturing. As a result, coders’ satisfaction with the workflow and efficiency increases significantly.
How a Healthcare Software Development Company Can Assist
An outsourcing company like Belitsoft that specializes in healthcare software development assists top healthcare data analytics companies in building robust data operating systems.
For integrated data platforms developed to collect, store, process, and analyze large volumes of data from various sources (Electronic Medical Records, clinic management systems, laboratory systems, financial systems, etc.), the healthcare software development companies:
- Automate data processing workflows (cleansing, standardization, and normalization)
- Configure scalable data warehouses including adaptive late-binding warehouses
- Set up and implement analytical tools for creating dashboards, reports, and data visualizations
- Ensure a high level of data security and compliance with healthcare regulations such as HIPAA
Integrate machine learning and AI into analytics.
If you are looking for expertise in data analytics, data infrastructure, data platforms, HL7 interfaces, workflow engineering, and development within cloud (AWS, Azure, Google Cloud), hybrid, or on-premises environments, a healthcare software development company like Belitsoft also can serve these needs.
They also help build specialized analytical apps like Revenue Cycle Analytics Software for:
Automating Data Capture
- Collecting data on medical services provided from all available sources.
- Integration of Hospital Account Records (HAR) from EHR.
- Embedding data into the workflow.
Checking Data Quality
- Automatically checking how accurately the severity of illness is described so that the clinic receives full payment.
- Validating whether diagnosis and procedure codes are specified per insurance requirements.
Making Data Analysis
- Detecting unobvious connections and patterns.
- Identifying educational opportunities.
Using Intuitive Visuals
- Visualizing rounding notes in a raw form in near real time for quick identification of the problem ones.
- Leveraging data for general reports to managers, employees, and other stakeholders.
Billing Analytics App doesn’t take long to deploy. It only takes about a month and a half to integrate with EHR and other IT systems. It automates much of the data collection that hospital coders used to process manually. They can focus on data analysis and ensure that data is captured completely and correctly.
- The organization uses programming tools to collect data on medical services provided from all available sources, checks their quality, and integrates them into the workflow.
- The data is loaded into the warehouse and can be visualized and used for general reports to managers, employees, and other stakeholders.
- The organization interprets the data, looks for unobvious connections and patterns in them, and checks for errors or omissions in the data that could affect the insights.
