Health Technology, Digital Healthcare
Article | September 8, 2023
Across the spectrum of healthcare delivery – payor, provider, vendor, consumer, there is a land rush underway to embrace consumer-centric care. With tools like value-based care, chronic disease management, retail services, analytics, and remote patient monitoring, healthcare organizations are pivoting towards capabilities that provide a deeper understanding of patient behaviors and address the whole patient and not just the condition.
Read More
Health Technology, Digital Healthcare
Article | September 7, 2023
Dialysis providers face many of the same financial and operational pressures that affect other provider organizations, including flat or reduced reimbursements, chronic staffing shortages, and increasingly complex insurance requirements. Dialysis centers, nephrologists, and renal pharmacies also grapple with the impact of a growing shift in dialysis care to the home setting.
End-to-End Automation Can Reduce Denials, Improve Cash Flow
The good news is that despite these challenges, dialysis providers can sustain strong cash flow, reduce costs, and mitigate denials by applying advanced technology to the revenue cycle.
Here are six ways technology can help strengthen the dialysis center revenue cycle in the today’s difficult operating environment:
Identify undisclosed insurance coverage
Because patients often present as self-pay even though coverage exists, determining their true insurance status can be challenging. Yet failure to identify existing insurance can result in significant write-offs.
That’s why renal providers need technology solutions that can uncover patient coverage information before care is provided. Change Healthcare’s Coverage InsightTMsolution provides an expansive network and search-and-matching capabilities necessary to identify and confirm patient coverages at the outset of care.
The solution uses machine learning algorithms—coupled with access to vast stores of available third-party-data—to develop robust patient profiles, which can then be linked to potential funding sources. Notably, it identifies a variety of indicators, including high probability of disability, income levels and financial status, insurance sources, and other actionable information to help you verify coverage and recover revenue.
We can help identify undisclosed coverage for end-stage renal disease (ESRD) patients through Medicare/Medicaid, Disability/SSI, third-party liability, commercial insurance, state and county programs, social programs, and charity.
Expedite seamless prior authorizations
Streamlining the prior authorization process is essential to help ensure optimal reimbursement for renal care rendered, particularly with commercial insurance and Medicare. But traditional prior authorization processes are frequently time-consuming and labor-intensive and can delay necessary care.
Our Clearance Authorization software addresses the chronic problem of prior authorizations with automated functionality that can determine if prior authorization is required and on file with the payer. The solution also will automatically check medical necessity requirements at the time of registration and electronically submit requests to integrated payers.
Change Healthcare’s Connected Authorization Services go a step further by deploying pre-authorization experts to handle routine authorizations quickly using intelligent technology while working complex cases by exception to improve authorization efficiency and accuracy.
Speed adjudication with electronic attachments
As claims management processes have grown more numerous and complex, providers have struggled to ensure that the correct information is provided to the payer at the appropriate time. The result can be delayed, denied, or rejected claims.
Assurance Attach AssistTMcontributes to faster reimbursement and reductions in denials, organizational expense, and administrative burden by automating the attachments process to meet payers’ increased demands for additional documentation. Attachments are automatically delivered and matched to the appropriate claim, and once the claim is released, claim and attachment status can be easily tracked.
Expedite claims workflow for recurring services
Creating claims for ongoing ESRD care requires repeatedly documenting the same details on each claim. Revenue Performance Advisor, an end-to-end medical billing platform, provides automation that allows dialysis staff to save time by quickly replicating unchanged data from prior visits while updating date-of-service and other information to expedite claims processing.
Revenue Performance Advisor also includes eligibility and benefits verification and automated claims scrubbing that flags incomplete or incorrect claims prior to submission, resulting in a first-pass clean claim rate of 98%.
Accelerate your Medicare claim cash flow
Medicare is one of the largest payers of dialysis services, so ensuring a problem-free and expedited Medicare claims submission process is essential to strong cash flow.
Our Assurance Medicare Direct EntryTMsolution provides a single system for the real-time submission and processing of Medicare claims. It can help expedite reimbursement, reduce AR days, and speed your Medicare primary claim cash flow by at least one full business day.
Assurance Medicare Direct Entry also checks your Medicare claims for eligibility errors using the CMS eligibility transaction system (HETS). Claims needing attention are flagged and posted in Assurance Reimbursement Management for editing. You can quickly correct errors within the system before transmitting the claim directly to Medicare for validation and payment processing.
Optimize patient liability
Making it easy for patients to receive, understand, and pay their portion of the medical bill is key to ensuring a healthy revenue cycle, mitigating the need for collection services, and improving patient goodwill.
With our Patient Billing and Statements solution, Change Healthcare serves as your strategic communications partner, delivering multi-channel, personalized print and digital statements to help expedite patient payment collection.
The solution is designed to provide fast, effective statement and invoice processing, printing, and mailing—cutting your costs and getting you paid sooner. Our advanced statement printing allows you to bypass conventional and time-consuming folding, stuffing, and stamping.
SmartPayTMconsolidates each step of the billing and payment process into one place, enabling you to collect more patient payments, get paid faster, reduce your collection costs, and lower patient write-offs. With multiple payment channels, including online, mobile, telephone and via mail, SmartPay helps expedite patient payments before, during, and after the encounter.
A single, trusted partner
Change Healthcare’s deep knowledge of the renal care landscape and our development of disruptive technologies to overcome traditional revenue cycle barriers can help dialysis centers achieve unprecedented revenue cycle excellence.
And unlike many point solutions that only address a specific revenue cycle issue, Change Healthcare’s technologies are part of a comprehensive approach delivered through a single, trusted vendor. That translates into improved process integration and continuity, as well as simpler overall accountability.
Read More
Healthtech Security
Article | November 29, 2023
The medical field has undergone a significant amount of change during the past few years, and it’s clear that healthcare consumers are seeking digital experiences. Meeting this need by providing virtual care options can not only remove barriers to quality healthcare but also reduce stress on the healthcare system.
At the same time, how can medical providers offer digital care options, and how can doing so drive revenue growth?
Allow online scheduling to increase appointment volume
If you have ever spent hours on hold, you know how frustrating it can be. In the same way, if patients are left on hold for too long, they will most likely disconnect before a member of the team can assist them. This is why it’s crucial to allow patients to schedule their care online. Patients expect to attend medical appointments at a time that is convenient for them, which means they want to schedule those appointments at a time that is convenient for them as well. They do not want to spend time waiting on hold, only for someone on the other end of the phone to offer them appointments that do not work for them.
The solution would be for medical providers to invest in a digital phone solution that can maintain a virtual waiting room. These virtual waiting rooms allow patients to maintain their place in line, such as receiving a callback, making it easier for them to schedule appointments. Of course, an online booking option can be helpful as well. Most patients want to schedule their appointments when they are not at work, and an online booking option allows them to do so regardless of their business hours.
Don’t forget to consider the type of booking software you use as well. If you select booking software that will automatically sync with your scheduling system in the office, you can take a significant amount of stress off your front office staff.
Digital communication options are crucial
Tebra’s recent Patient Perspectives report indicates that the majority of patients (55%) want to be able to reach their medical providers quickly to get answers to their questions, even when they do not have an appointment scheduled. If you have two-way messaging software, you can streamline the flow between your patients and providers, which may reduce the number of appointments your patients need to book.
For example, patients can ask for prescription refills, run specific numbers by their medical providers, and get quick answers to questions about symptoms they might be experiencing. Not only does this support patients and nurture their loyalty, but it also alleviates unnecessary appointments from inundating providers’ schedules.
Take advantage of telehealth for additional revenue
Before the start of the COVID-19 pandemic, very few patients took advantage of telehealth. Now, nearly a quarter (about 25%) of all patients indicate that they have used telehealth during the past year, and many patients prefer this option.
The reality is that telehealth can remove barriers that would otherwise make it hard for patients to access care. They don't have to worry about taking time off work, arranging for child care, or driving a long distance to meet with a doctor.
While telehealth will never fully replace in-person visits, it can be an excellent option for cold and flu symptoms, mental health issues, and routine check-ins. By offering telehealth to your patients, you can make it much easier for them to access the care they need.
Modernize your revenue channels by taking advantage of digital healthcare
It’s obvious that the medical world is changing quickly, and digital aspects of care are here to stay. To ensure your practice can adequately meet your patients’ needs, take full advantage of everything in this article and ensure you have reliable digital care options. You can develop multiple revenue streams for your medical practice or system while maintaining high patient satisfaction rates and without adding to your workload.
Read More
Article | December 8, 2020
The one clear consensus that has emerged from this doubt and anxiety-filled time is that our society will be forever changed by COVID-19. In the recent days, we have seen a general movement toward telecommuting and digital solutions to accommodate the drastic changes caused by this global pandemic. The healthcare industry, which is arguably impacted the most, is no exception to this trend. But while the movement to digital healthcare started well before the outbreak, it has been a slow journey, fraught with many regulations that have slowed its market penetration.
With the current system so overwhelmed, a transition from the face-to-face model of care to a digital model has become vitally necessary, forcing it to happen sooner rather than later. Places that have already embraced the digitalization of healthcare practices have demonstrated the benefits of updating the old-fashioned model. A digital approach to healthcare can have unlimited applications, from telemedicine to a digital system for tracking available hospital beds. All of these applications not only save time but also potentially peoples’ lives by eliminating unnecessary contact between infected and healthy patients as well as their caregivers.
Read More