patient experiences.
Managing the revenue cycle of healthcare organizations is challenging. Maintaining a healthy margin despite complex reimbursement regulations is making securing payments tough.
Patient expectations are changing as it is no longer about receiving care. It is about a connected, meaningful, and personalized care journey. Hospitals are turning to advanced solutions and cutting-edge analytics to gain financial stability in an environment that offers anything but that.
Over the years, we’ve partnered with hospitals, group practices, and independent physician practices to help them meet their operational and financial goals.
These are lessons we’ve learned from the front-lines. Our biggest wins. Our best clients. And some hard-won lessons that have enabled us to set our clients up for financial success.
Our experts share their insights and strategies.
for a trauma center.
Trauma care centers often struggle with huge volumes of data and information silos. A patient usually goes through 20+ procedures prior to admission. This can make managing patient data difficult and lead to inaccurate or incomplete clinical documentation.
Commercial payers are focusing on clinical validation to reimburse claims. A broken clinical documentation process results in frequent denials and downgrades.
The trauma center was trying to fix their fractured clinical documentation and coding processes to optimize reimbursement and bring down their denial rate. Through automation and E/M coding
expertise SolvEdge was able to help them achieve 99% coding accuracy and improve denial overturn rates. Our proprietary code analysis software helped us to detect quality events and study denial
patterns. And as with all success stories it all began with a
phased roadmap
A data powered coding cycle can not only accelerate but revamp the coding process of organizations.
Client: A hospital group, Ohio.
Services provided: Revenue cycle management, medical coding optimization, clinical documentation improvement.
Results: 60% improvement in net collections. 99% first pass claim acceptance rate.
The hospital was trying to improve their reimbursement percentage of their ED visits.
Their reimbursement rate was sub-optimal and the hospital was trying reduce denials. A revenue cycle audit revealed delays in the processing of medical records and a slow coding cycle.
and days in AR:
We developed training programs for ED physicians to improve clinical
documentation and reduce processing times.
Standardized a 48-hour turnaround for processing medical records.
Offered per-report pricing to contain costs and manage volume fluctuations.
Developed coding-compliant workflows.
Most of the hospital’s claim denials could be tied back to selecting the wrong ED level.
We created guardrails to prevent errors in assigning ED levels.
Minimizing medical records processing time is key to reduce downstream delays in the revenue cycle process.
There are some constants that never change. Across specialties, hospitals and client profiles, there is one big challenge that needs to be addressed. It is adapting to the patient-driven healthcare journey of today.
As patients expect the frictionless and personalized customer journeys they are accustomed to in other industries, the healthcare industry is at an inflection point.
Provider organizations are investing in technology and processes to align with changing expectations.
Through our tailored patient engagement solutions, we enable healthcare organizations to do just that.
With our suite of solutions designed to improve the patient experience and drive better patient outcomes.
Boost HCAHPS scores.
Streamlined and personalized key patient access functions such as appointment scheduling, eligibility verification and the prior
authorization process
Provided convenient patient experiences by implementing a patient-friendly
revenue cycle.
Intuitive, digital engagement solutions helps providers to connect with patients
effortlessly and strengthen the patient-physician equation.
We help providers to rethink their processes through a digital-first lens.
When technology meets expertise a lot can happen. We constantly innovate and push the boundaries of what’s possible. Whether it optimizing the coding cycle of hospitals or curating delightful patient journeys, we build the tools and processes to light the way for change.
Rebuild your revenue cycle with us. We offer full-cycle RCM services.
Request for an audit of your revenue cycle today.