Understanding How Clinical Operations Affect Financial Health
As value-based reimbursement models expand, hospitals need technology that can help manage the increasing complexity of the payment and reimbursement landscape. Data analytics plays a key role in identifying documentation and coding challenges and also helps improve clinician engagement and documentation improvement initiatives.
Add to this an enterprise performance management solution, and hospitals will be able to create action and accountability plans to design continuous improvement programs that meet strategic goals.
This white paper will outline the relationship between documentation, coding and reimbursement and show how data analytics and enterprise performance management solutions can identify areas for improvement and bring focus to improvement initiatives. It will also explain how analytics can increase net revenue, reduce audit risk, and enhance ICD-10 readiness.
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Patient Access provides critical real-time analytics information during the patient registration and payment clearance processes. With intuitive dashboards and simple step-by-step checklists, front office staff are able to accurately estimate patient cost, improving pre-service collections and reducing back end denials.
To ensure your financial viability, you need insight into the revenue cycle so you can boost cash collections, reduce bad debt, stop denials, enhance productivity, and guide business strategy. Business Office provides the analytics you need to identify revenue bottlenecks and manage reimbursement trends so you can focus your resources on what matters most: providing quality patient care.
Healthcare reimbursement is changing. By 2020, fee-for-value reimbursement is projected to represent 83% of your revenue—up from 43% today and 14% in 2010. Clinical operations will become vital to your bottom line. It is at the mid-cycle—the point between patient access and the business office—where improvement initiatives will have the greatest impact. Revenue Integrity gives you complete visibility into documentation and coding performance—and that of your peers. So you can quickly spot opportunities to improve revenue capture, minimize audit risk, and measure and monitor the impact of ICD-10 on your revenue.