Are you striving to become an all-star in your role along the revenue cycle continuum? Today’s revenue cycle management (RCM) professionals are working harder than ever, and often struggle to see the results of their labor. Realistically, today’s healthcare landscape requires new technology for success.
Defining Revenue Integrity
At MDaudit we define revenue integrity by the following three attributes-
- Billing Compliantly: Ensuring that all billing is accurate and adheres to regulatory standards.
- Optimal Reimbursement and Revenue Recognition: Maximizing the revenue due through compliant billing practices.
- Operational Efficiency: Streamlining processes to enhance productivity and reduce errors.
Today’s RCM professionals are successfully navigating the first two, but often struggle with the third, and this is where technology shines.
Operational Efficiency
A modern-day platform that utilizes artificial intelligence (AI), analytics, and automation is a necessity for today’s RCM professionals to achieve optimal operational efficiency. This platform should offer the following capabilities.
- Collaboration and Data Integration
One key to becoming an all-star in your role is leveraging technology to foster collaboration across teams. This facilitates cross-functional teamwork, allowing compliance, coding teams, central billing offices, payer management, and HIM professionals to work together seamlessly. This united front is essential to combat shrinking reimbursements and maintain optimal outcomes.
- AI and Continuous Risk Monitoring
The right platform will be driven by AI and continuous risk monitoring (CRM) for RCM. This technology ingests data daily, providing insights into denial root causes, provider and coder performance, anomaly detection, and more. These insights empower you to take corrective actions swiftly, improving first-pass pay rates and reducing days in accounts receivable (AR).
- Real-Time Data Insights
This feature allows for self-sufficiency and empowers users to address issues proactively without needing advanced technical skills or dependency on IT and report writers.
Recognize value in your department
Billing Compliance
- Let analytics give you the ability to immediately identify your at-risk provider population for undercoding and overcoding via benchmarking capabilities.
- Enhance your ability to easily pinpoint high-risk DRGs, HCCs, CCs, and MCCs to ensure accurate and compliant coding.
Revenue Cycle/Revenue Integrity
- Easily identify the root causes of denials for more successful appeals.
- Gain a better understanding of payer policies with predictions for medical necessity denials on a pre-bill basis.
Coding and HIM
- Discover essential support for coding and HIM professionals when auditing coders in real time. Through healthy dialogue and rebuttal functionality, coder accuracy will drastically improve and provide opportunities for ongoing education and improvement.
By bringing together all roles along the revenue cycle, a modern-day platform helps organizations form a united front against payer scrutiny and today’s healthcare revenue challenges.
Watch the Webinar
Are you ready to elevate your role and become an all-star in healthcare auditing and revenue optimization? Watch the full webinar recording to learn how MDaudit can help you achieve these goals.
