As the nation’s leading technology-driven revenue cycle management (RCM) services organization helping home-based care providers reach their financial goals, Prochant is always looking into solutions for the modern healthcare office. Many providers we work with across the country are struggling with staffing shortages and rising labor costs, so new, smarter workflow solutions have become a necessity for increasing process through-put and reducing errors.
Modern workflow solutions like automation, patient portals, and decision support systems are great for managing your office and helping your staff save time. Another solution Prochant’s Chief Revenue Officer Joey Graham, a self-proclaimed “child of the home care industry,” has suggested is intelligent work queues for your RCM team.
Is your team working on the right tasks or patient files at the right time, ensuring that balls aren’t dropped (like timely filing)? Or, are they “cherry-picking” their daily work, leaving more difficult issues for another day? Also, are you able to funnel the right work to the right team member based on their knowledge and experience? This is where intelligent work queues come in.
Intelligent work queues direct work to the right person at the right time. Think about a hospital ER waiting room. When you enter, a nurse performs triage, determining how critical your injury is and how quickly you need to be seen. When it comes to intelligent work queues, the patients in the lobby are the “work,” and the nurse is the allocation system that understands the complex rules and funnels the work to the right clinician at the right time.
A technology-based allocation system leverages complex rules to direct work to the right RCM team member, when it’s the right time to do that work. These systems can also leverage technology like artificial intelligence and machine learning to refine rules, creating a continuous improvement loop. When it comes to deciding which staff member should be handling, for example, modifier denials or medical necessity denials, a work queue can help move the process along. Using automated rule sets, you can prioritize work based on process, payer/product/branch, complexity, timing, and value. All of this logic is loaded into the Allocation System.
In our visual work queue example, the Allocation System can then use everything it knows to funnel out work based on levels of competency. For example, the allocation system can have easy work funneled to an entry-level team member, what we call level one competency (L1 Queue) and can have the most complex work funneled to an experienced team member, or level three competency (L3 Queue). So for instance, modifier denials could go to a level one person, but a medical necessity denials requiring an appeal might go to the level three person.
Prochant has created an intelligent RCM work queuing system much like in our example here. This allows us to avoid multiple touches by ensuring there are no middle-men, and work is sent straight to the correct staff member. Save time and prevent miscommunication from happening with intelligent work queues in your office.
Want to explore modern billing and reimbursement solutions? Reach out to Prochant’s Chief Revenue Officer Joey Graham directly at (980) 999-4293 or email firstname.lastname@example.org to see how Prochant can help simplify your business.
Prochant has DME/HME and pharmacy clients from all over the country and handles front-end and back-end billing functions. Our scalable solutions, years of experience, and advanced technology provide best-in-class results to the healthcare community. Headquartered in Charlotte, North Carolina, our client base includes national HME and pharmacy providers and health systems.