Technology has already begun transforming dozens of key sectors, and all aspects of the revenue cycle are no exception. Your healthcare organization must closely monitor the state of technology solutions in denials management so that you can modernize your practice's revenue cycle management (RCM) accordingly. Here’s what you need to know.
Using technology in your denials management refers to the use of a tech solution to complete workflows that were traditionally performed manually. Technologies like Rivet are revolutionizing healthcare by augmenting complex processes, improving accuracy, increasing your team's efficiency, and reducing your A/R days.
Denials management tools should be viewed as a resource that can augment the capabilities of your team members. They can get more done in less time while focusing on complex tasks, such as reviewing denials and submitting appeals to payers.
Traditional billing methods rely heavily on manual data entry and require several layers of human oversight. Despite all of this redundancy, traditional billing and coding remains an error-prone process that can lead to claims denials and lengthy care to cash cycles.
Denials management technology processes data more quickly and accurately. These capabilities lead to significant cost savings and operational efficiency gains.
However, implementing a technology solution requires an initial investment that may present challenges, especially for some practices. You’ll need to integrate the technology with existing systems and train your staff to work alongside the new tech.
However, you shouldn’t let these hurdles discourage you from exploring technology solutions. The benefits greatly outweigh the potential drawbacks and can help you shed inefficient manual billing methods.
Want to learn more about the pitfalls of manual billing methods and how you can augment your workflow with automation? Check out our on-demand webinar on this critical topic.
Using technology to augment your denials management workflows offers advantages such as:
As soon as you provide care to a patient, the revenue clock starts ticking. You need to capture as much of the billed amount as quickly as possible to maintain cash flow stability. That means creating accurate billing codes and getting claims submitted as soon as you can.
Technology accelerates claim submissions and reduces delays caused by human error. In turn, you can speed up the reimbursement process and help mitigate the risk of underpayments.
Download our e-book, “Underpayments in Medical Billing: Revenue’s Silent Killer,” to learn more about how you can use technology to maximize efficiency and put a stop to chronic underpayments.
A tech solution cuts down on coding mistakes and bolsters your entire revenue cycle. You can reduce the risk of denials and capture more revenue during the first submission to payers.
Improving the accuracy of your billing and coding practices is especially important due to the No Surprises Act. It’s your responsibility to provide patients with accurate estimates and bill them in a timely manner.
Automation lowers administrative costs associated with billing, coding, and working denials. Your organization can allocate those additional resources to more important tasks and promote long-term profitability.
Technology systems include built-in features designed to promote compliance and stay up-to-date with evolving regulations. Use these capabilities to maintain compliance and avoid penalties.
Technology solutions aren't perfect. Even highly-advanced systems can struggle with nuanced cases. Incomplete patient data can also lead to errors. Therefore, human oversight must be part of your workflow.
Another challenge of technology is the cost. In addition to the capital requirements, rolling out a technology solution can also be time-consuming and burdensome for your IT team.
Most importantly, human oversight remains essential. Humans must validate the outputs and manage exceptions to maintain high accuracy standards.
AI-powered denials management, medical billing and coding tools use natural language processing (NLP) and machine learning to analyze clinical documentation and assign appropriate codes. This automation generates codes with greater efficiency and accuracy. Coders can focus on more complex cases that require human judgment and experience.
The American Academy of Professional Coders (AAPC) is tackling the artificial intelligence revolution head-on. If you want to elevate your skills and ensure you can thrive in the changing coding environment, check out the Artificial Intelligence (AI) in Medical Coding and Billing Course from AAPC.
Some healthcare practices have successfully implemented AI-driven billing solutions. For instance, an artificial intelligence medical billing solution from NYM Health exhibited a 96% accuracy rate when decoding provider notes and generating billing codes.
Rivet Health is committed to staying at the forefront of industry trends by integrating advanced technologies into its solutions. Our denials management tool can speed your claim appeals — right out of the box. As a strong healthcare denials management system, you'll help your team work denials smarter and create documented, scalable processes to get more done.
Rivet's Revenue Diagnostics tool will help your team gain key insights, such as revenue projection, cash flow, and claim adjudication in visually driven, flexible dashboards to accurately make the smartest moves and the best investments.
Looking to implement a technology to improve your denials management workflows? Schedule a demo with Rivet Health.