Tag: SYNERGEN Health

Automating Revenue Cycle Is Helping Providers Cut Down On Administrative Costs Amid a Potentially Looming Recession

Teri Gatchel-Schmidt

By Teri Gatchel-Schmidt, vice president, consulting and business development, SYNERGEN Health.

Almost a quarter of U.S. national health expenditures go toward administrative costs. In revenue cycle, rising costs continue to escalate which negatively impacts the bottom line. There is a silver lining in all of this; as a potential recession looms, these costs can be reduced with automation.

By simplifying daily routine tasks with automated tools like robotic process automation (RPA) and machine learning (ML), nationwide spend could be reduced from 25% of the national healthcare expenditure to 18%.

Automation: The key to improving efficiency

As it stands, manual revenue cycle processes burdens staff with repetitive, mundane tasks, causing staff burnout.  Additionally, the  reimbursement landscape evolves in complexity year after year. Staffing issues also continue to plague health systems, leaving chief financial officers playing defense, with high turnover rates causing a decrease in productivity and an increase in aged receivables.

When it comes down to it, organizations must either add more resources to support the manual way of working – which can prove to be costly and inefficient – or invest in automation. Simply put, revenue cycle is ripe for automation which results in reducing cost-to-collect and creating large-scale cost savings throughout the revenue cycle. When pairing automated technology with best practices to empower operational teams, revenue cycle leaders will streamline workflows to reduce manual work and increase efficiency, all while boosting revenue.

Denial Avoidance

Many providers are not fully aware of just how deeply denied claims can affect their bottom line. According to HFMA, providers lose nearly $5 million on average per year due to claim denials.

With ever-changing reimbursement and collection requirements, providers and their staff need tools  to analyze and prevent denials to reduce the workload required to avoid an increase in denials.Instead of assigning denial management and appeals to staff members, providers should look to automation as a champion for claims and denials management.

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Putting A Price on Transparency: The Patient Payment Challenge for Payers and Providers

Mel Gunawardena

By Mel Gunawardena, managing partner, SYNERGEN Health.

The healthcare revenue cycle is an unnecessarily complex tangle of patients, providers, employers, and insurance companies. Patients and other parties are often frustrated with medical claim submission and reimbursement procedures, which can take months to resolve. This has forced a closer look at ways to increase the transparency of payment structures – offering the potential to address long-standing patient concerns while ensuring a more stable revenue source.

One of consumers’ chief concerns is the final cost of care. Over the last two years, many patients have lost their jobs and health insurance, leaving them highly cost-conscious. Patients require more cost predictability as they continue to navigate the financial impact of the pandemic. Insurance eligibility and payment estimation tools enable providers to generate reliable out-of-pocket costs at the time of scheduling. For cost-conscious consumers, this helps drive better-informed care decisions, provides options of payment plans or financing, and is an opportunity for providers to improve a critical patient experience.

Price transparency has been a long-standing concern for consumers, and recently the federal government and states have taken steps to address the problem. The Price Transparency Rule, established by the Centers for Medicare and Medicaid Services, took effect on January 1, 2019. Still, hospitals reluctant to comply with the rule now face the possibility of a hefty $2 million fine, and with the No Surprises Act set to take effect next year, it’s clear providers must embrace billing transparency, or the government will force them to accept a less-than-ideal option.

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