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Health IT | News, Analysis, Insights - HIT Consultant

Optimizing Revenue Cycle Management – What Will It Take to Get There?

by Stacy Leidwinger, VP of Product, Nuance’s Document Imaging Division 09/04/2018 Leave a Comment

The U.S. healthcare system is undergoing a major transformation, from many freestanding hospitals and individual practices to fewer large, integrated healthcare systems. One motivating factor is the promise of greater efficiencies when it comes to delivering more holistic patient care and improving core operational processes. Revenue cycle management is one process that’s primed for improvement. Poor billing practices can cost hospitals millions of dollars due to lost reimbursement or the imposition of fines, which can undermine patient care quality and erode the operational advantages that expansions and mergers were intended to create. What are the ongoing trends making revenue cycle management so challenging? Disjointed front-end and back-end processes – Revenue cycle management is traditionally separated into front- and back-end functions. The front-end is patient-facing and includes administration, intake documents and the confirmation of coverage eligibility, while the back-end includes payer coordination, claims reimbursement, denial communications and ultimately, collection. With patients assuming more responsibility for out-of-pocket expenses, the first step to improving the revenue cycle is maximizing patient collections. The best chance for this lies in collecting payments as early as possible in the patient interaction. According to one recent survey, 85 percent of healthcare organizations say that collecting payments from patients after they have left the facility is a difficult task. Hospitals need to commence billing processes immediately at patient admission, which requires better integration between front- and back-end workflows. Electronic or digitally-based workflows are intrinsically more efficient and secure than paper-based workflows since they don’t rely on paper passing hands and because there is less risk of document misplacement. IT and Toolset Limitations – Successful revenue cycle management has traditionally depended on a strong supporting healthcare IT infrastructure as well as a solid base of highly fluent administrative knowledge workers, who understand the intricacies of working with various types of payers. Unfortunately, many hospitals do not have the resources to invest in the dedicated on-site infrastructure needed to expedite revenue collection and claims management. Hospitals should also train staff members to code and submit claims as accurately and efficiently as possible. The lack of training is often the difference between a fast, efficient claims reimbursement and a potentially time-consuming kick-back. It is also important for knowledge workers to have “DIY” capabilities when it comes to directly hand-picking their own workflow functions to secure the capabilities they need quickly. Back-end staff may include an electronic signature capability in their workflow, which allows supervisors to verify the authenticity of a claim and sign-off, even if they are traveling or on a mobile device. If software tool is available as part of a larger, pre-approved menu, this will also reduce the threat of “shadow IT” - when staff use technology without IT being aware. Lack of automation – Paper remains ubiquitous in the healthcare enterprise, particularly in the admissions process. Better revenue cycle management requires faster, more efficient digitization of paper-based documents. It is particularly important to quickly incorporate insurance details contained in these documents into streamlined digital workflows. Revenue cycle management can be made more efficient by automating manual data entry. Document conversion and classification can easily convert paper documents to digital form in bulk and route the data to appropriate electronic files and personnel for processing. Advances in machine learning soon will enable scanners to “read” and identify characteristics specific to certain documents. For example, the technology could identify an insurance policy, and route the information appropriately while streamlining the entire claims submission process. Poor provider/payer collaboration – Forward-thinking hospitals are creating new types of streamlined payment processes whose workflows are similar to those integrating front- and back-end claims processing. Tailored workflows can address the unique requirements of individual payers, enabling information exchange and critical communications through a highly secure, digital process. For example, different payers may use a different chain of command or steps for reimbursement approvals. Workflows can be created and modified to adhere to acknowledge this. These provider/payer frameworks also provide end-to-end visibility across the claim lifecycle, allowing providers to take appropriate action to improve collection processes – for instance, identifying and addressing late reimbursements. Increased automation plays a role here as well by alerting knowledge workers when a particular claim reimbursement is complete, or automatically flagging problems and their source. While the challenges of improving revenue cycle management are abundant, and many organizations aren’t sure where to begin, certain threads are common. These include the need for tighter workflow integration (both within an organization and between payers and providers) and greater empowerment of knowledge workers through automation and simplified workflows. Effective revenue cycle management is critical to the success of the healthcare enterprise in its mission to promote high standards of patient care and satisfaction and operational excellence. Most organizations have room for improvement, and the capabilities described here are a good starting point. Stacy Leidwinger, VP of Product, leads the team driving product innovation within Nuance’s Document Imaging Division. She oversees the product roadmap and all phases of the product lifecycle with the goal of planning, launching and managing best of breed software products.

The U.S. healthcare system is undergoing a major transformation, from many freestanding hospitals and individual practices to fewer large, integrated healthcare systems. One motivating factor is the promise of greater efficiencies when it comes to delivering more holistic patient care and improving core operational processes.Revenue cycle management is one process that’s primed for improvement. Poor billing practices can cost hospitals millions of dollars due to lost reimbursement or the
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MEDITECH Integrates Prescription Drug Monitoring Programs (PDMP) Within Expanse EHR

by Jasmine Pennic 08/30/2018 Leave a Comment

MEDITECH Integrates Prescription Drug Monitoring Programs (PDMP) Within Expanse EHR

EHR provider MEDITECH, today announced it is integrating one-tap access to state-regulated electronic Prescription Drug Monitoring Programs (PDMP) that track controlled substance prescriptions, from directly within the MEDITECH Expanse EHR.MEDITECH Expanse EHR Integration DetailsAvailable from DrFirst, the PDMP database link allows prescribers to view controlled substance histories effortlessly from multiple PDMPs simultaneously as allowed by cooperating states, within the EHR prior to
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Innovaccer Launches EHR-Agnostic Physician Engagement Solution

by Fred Pennic 08/30/2018 Leave a Comment

Innovaccer Launches EHR-agnostic Physician Engagement Solution

The role of physicians is instrumental in the rapidly-transforming healthcare. There have been many strategic initiatives or restructured payment models- but the physicians have almost always been disconnected. Physicians are either overburdened with the data around them or have limited real-time visibility into the analyzed data.Limited access to the right data at the right time has dramatically increased the number of burned out physicians in the country. Additionally, the time-taking tasks of
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4 Ways Healthcare IT Can Save Rural Hospitals

by Irv Lichtenwald , CEO of Medsphere Systems Corporation 08/29/2018 Leave a Comment

Rural Healthcare

In business, disruption is often seen as a good thing, e.g., digital photography disrupting Eastman Kodak’s business so significantly that the company has scrambled in recent years just to stay afloat, the thing they once did better than anyone now largely irrelevant.So, disruption is negative for employees of old technology companies, but it’s a boon for workers in cutting-edge businesses and generally for consumers as well. Those who benefit greatly outnumber those who don’t.And disruption
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M*Modal Integrates AI Platform with Epic EHR to Support Clinical Workflows

by Jasmine Pennic 08/29/2018 Leave a Comment

M*Modal Integrates AI Platform with Epic EHR to Support Clinical Workflows

M*Modal integration with Epic EHR supports virtual assistants and nursing applications for an advanced workflow in EpicM*Modal, a provider of clinical documentation and Speech Understanding solutions, announced that it is integrating its artificial intelligence (AI) powered platform with the Epic EHR to support clinical workflows. Creating time to care through smarter, more unified workflows, M*Modal® speech and AI enabled solutions are designed to significantly improve the productivity of the
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Healthcare Data Integration Startup Bridge Connector Raises $5.5M, Following $4.5M Seed Round

by Jasmine Pennic 08/28/2018 Leave a Comment

Bridge Connector Raises $4.5M for Healthcare Data Integration Platform

Bridge Connector, a healthcare data integration platform as a service (iPaaS) that delivers streamlined integration solutions for healthcare organizations, today announced it has raised $5.5 million in Series A funding led by Axioma Ventures LLC, following a $4.5M seed round in May 2018. The latest round brings the company’s total investment to $10M in funding. The health IT startup plans to use the funding to help further expand Bridge Connector’s sales, marketing, and client-services efforts,
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MUSC and Siemens Healthineers Form Strategic Value-based Care Partnership

by Jasmine Pennic 08/27/2018 Leave a Comment

Philips Lands 8 Year, $36M Deal with MUSC Health to Transform Patient Monitoring

The Medical University of South Carolina (MUSC) and Siemens Healthineers have formed a first-of-its-kind strategic partnership to advance the quality of care in South Carolina. The value-based care partnership will capitalize on the coupling of MUSC’s clinical care, research and education expertise with Siemens Healthineers’ engineering innovations and workflow-improvement capabilities.The partnership with a focus on driving performance excellence at MUSC and generating significant clinical and
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Does the Fax Machine Still Have A Place in Modern Healthcare?

by Brad Spannbauer, Sr. Product Manager at j2 Global 08/27/2018 Leave a Comment

TigerText Wants to Eliminate the Ancient Pager & Fax in Healthcare

Fax machines have been a common fixture in medical practices across the country since they reached peak popularity in the late 1980s; the convenience, reliability, and security of faxing meant it was, and still is, the communication medium of choice for the majority of healthcare organizations. But, technology has come a very long way in past 30 or so years, and expectations have changed - what was deemed to be convenient, reliable, or secure two or three decades ago, might not be anymore. So,
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Bipartisan, Bicameral Leaders Urge Effective Administration of 340B Drug Pricing Program

by Fred Pennic 08/27/2018 Leave a Comment

Bipartisan, Bicameral Leaders Urge Effective Administration of 340B Drug Pricing Program

House Energy and Commerce Committee Chairman Greg Walden (R-OR), Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ), Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN), and Senate HELP Committee Ranking Member Patty Murray (D-WA) sent a letter to the Health Resources and Services Administration (HRSA) regarding the fact that they have not used their rulemaking authority to implement regulations to better administer the 340B Drug
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M*Modal Advances AI Applications to Support Next-Generation EHR Workflows for Clients

by Jasmine Pennic 08/27/2018 Leave a Comment

M*Modal Will Receive Approval to Emerge From Chapter 11

M*Modal, a provider of clinical documentation and Speech Understanding™ solutions, today announced that it continues to drive speech and AI innovation for health systems to support next-generation EHR workflows and reduce the administrative burden on doctors. These solutions work independently or are deeply embedded in the EHR by leveraging M*Modal technology to improve the quality of patient care and the clinical note. The following are a few of the many foremost healthcare organizations that
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