Automating RCM with Three Core Technologies
Regent RCM recently hosted a webinar aimed at helping ambulatory surgery center (ASC) personnel gain more control and efficiency over their revenue cycle. The following post examines the core technology that forms the foundation of billing and collections and how automation contributes to a predictable revenue cycle.
Automating revenue cycle management (RCM) is as much about efficiency as it is analytics. Three core areas of technology that form the foundation of ASC billing and collections include:
- ASC Management Information System (MIS platform)
- Reporting, analytics, and dashboard capabilities
ASC Management Information System (MIS platform)
While Regent RCM can integrate with any Health Level-7 (HL7) compliant MIS platform, in many cases, the team is asked to recommend a software platform. Regent’s primary goal is to identify a platform that fully captures the individual needs of a center; one that can manage billing, scheduling, and inventory management, as well as seamlessly interface with clearinghouse and other software platforms. Bottom line, implementing an MIS that optimizes and automates workflow results in measurable efficiencies, decreased A/R, and improved profitability.
ASC clearinghouse software provides essential process automation including the ability to send claims and receive electronic remittance advice (ERA), provide claims management, eligibility verification, and patient out-of-pocket estimation. ASC staff no longer have to call insurance companies to assess a patient’s eligibility. With the click of a mouse, a user can verify and pull a patient’s eligibility information into the MIS and view it – including deductible, remaining deductible, coinsurance, co-pays, and out-of-pocket maximums. This information may be used to estimate out-of-pocket expenses and establish patient financial responsibility prior to a procedure.
Reporting, analytics, and dashboard capabilities
Reporting and analytics tools offer detailed insights into the way an ASC operates and highlight opportunities to make changes that can improve outcomes. ASCs can access reports and analytics via a real-time dashboard. This dashboard displays both financial and clinical key performance indicators (KPIs) that can be customized with facility-chosen parameters, alerting an ASC about issues in priority areas. Dashboard capabilities are explained in greater detail in a blog post on real time measurement and reporting.