Navigating the intricate realm of medical billing workflows and insurance claims requires the perfect blend of expertise, strategy, efficiency, and technology, especially within crucial healthcare channels such as Home Medical Equipment (HME), Durable Medical Equipment (DME), Infusion and Specialty Pharmacies, and Home Health & Hospice. Success in these fields hinges not only on balanced work distribution and robust productivity, but also on innovative solutions that embrace the digital era.
Why healthcare providers are ready for automation in the medical billing workflow?
Prochant recognizes the significance of the recent findings presented in CAQH's 10th annual Index report, which measures the progress made in automating business functions within the healthcare industry. The report reveals promising advancements, indicating that more tasks, including eligibility and benefits verification, are now being performed electronically. This shift toward automation showcases a positive trajectory toward increased efficiency and streamlined processes.
However, the report also emphasizes the substantial opportunity for further savings and improvement within the healthcare industry. CAQH estimates that a complete transition to automating business transactions could result in an impressive annual savings of $25 billion. Such cost reductions would have a profound impact on the industry's financial landscape while driving greater efficiency and innovation.
In addition to the potential for significant savings, the CAQH report sheds light on the rising expenditure associated with business tasks. The data highlights that the healthcare industry spent a staggering $60 billion on these administrative functions in 2022, marking a notable increase of $18 billion compared to the previous year. These figures underscore the pressing need for transformative solutions that can optimize and streamline these costly processes.
As a leading innovator in the revenue cycle management space, Prochant is committed to leveraging advanced technologies and comprehensive strategies to address these challenges head-on. Our goal is to empower healthcare providers by offering end-to-end automation solutions that improve operational efficiency, reduce costs, and enhance overall financial performance. By harnessing the power of automation and AI-driven tools, providers can make significant strides in transitioning to a more streamlined and cost-effective business landscape, ultimately benefiting both the industry and patient care outcomes.
Proper Work Distribution
Process tracking is the practice of allocating the correct amount of labor to complete a specific task. Mapping out your labor for each day helps you monitor backlogs on a day-to-day and cumulative basis. Process tracking inherently informs you as soon as you fall behind, which allows you to adjust accordingly.
Key Performance Indicators (KPIs)
KPIs complement process tracking from a collections viewpoint. These performance metrics help providers understand the effectiveness of their claim collections and indicate which areas of back-office processes need enhancement.
Our robust dashboard provides a wide range of features, tailored to optimize RCM, bolster efficiency, and improve financial performance. It allows users to:
- Monitor and Report: Track business performance and receive timely alerts on emerging issues. Monitor RCM outcomes, KPIs, production, quality, process health, and automation to ensure optimal performance.
- Diagnose: Identify the root cause and severity of issues swiftly and accurately.
- Allocate and Work: Customize work queues based on complex logic such as payor, procedure, and denial codes. Monitor work queues, balance workload, and escalate issues as needed.
- Coach and Engage: Enable users to decide the best course of action for A/R balances, track their progress, and enjoy rewards for their achievements.
- Automation “Virtual Agents”: Streamline simple or repetitive tasks through automation, freeing up your staff to handle more complex responsibilities.
Gamification and Leaderboards
Prochant enhances RCM processes through gamification and leaderboards. By adding engaging challenges to daily tasks, participation increases, and task completion becomes more enjoyable.
Leaderboards provide live updates on employees' production levels, boosting motivation. By integrating leaderboards into the dashboard, employees can monitor their variable or bonus pay in real-time, reducing the likelihood of discrepancies and maintaining high production levels.
Leveraging Prochant's innovative dashboard and operational guidelines can help providers effectively tackle challenges associated with RCM. Over time, our approach results in increased efficiency, improved financial performance, and, crucially, enhanced patient care.
In an increasingly digitized healthcare landscape, Prochant takes a step further with the integration of AI-driven automation tools and analytics in the collections process. Our enterprise-grade technology, specifically tailored for healthcare channels, is designed to significantly reduce your Days Sales Outstanding (DSO) and bad debt. The system accurately processes and responds to complex billing queries in real-time, resulting in quicker reimbursements, fewer claim denials, and a dramatic reduction in bad debt. The AI-driven automation frees your staff from repetitive tasks, enabling them to focus on higher-value activities. Prochant's sophisticated approach to collections is not just about retrieving outstanding payments, it's about revolutionizing the way you manage your revenue cycle for enhanced operational efficiency and improved financial health.
Connect with us today to learn more about how our reimbursement experts can help optimize your revenue cycle management!
Prochant is the only AI-driven reimbursement service provider in the home-based care industry. We deliver focused revenue cycle management (RCM) solutions to healthcare providers with 7 wholly-owned global delivery centers. Our expertise lies in providing end-to-end RCM for home-based care, infusion, and specialty pharmacies, consistently delivering exceptional results to some of the leading healthcare providers in the country. We harness specialized automation technology and deep industry knowledge to streamline the time-consuming and expensive reimbursement process. As a result, we help healthcare providers accelerate their collections, increase revenue, and reduce operational costs while managing risk. Prochant is HITRUST certified, the gold standard for HIPAA security.