Seven Ways Technology Can Help Dialysis Centers Strengthen Their Revenue Cycle
Dialysis providers face many of the same financial and operational pressures that affect other provider organizations, including flat or reduced reimbursements, chronic staffing shortages, and increasingly complex insurance requirements. Dialysis centers, nephrologists, and renal pharmacies also grapple with the impact of a growing shift in dialysis care to the home setting.
End-to-End Automation Can Reduce Denials, Improve Cash Flow
The good news is that despite these challenges, dialysis providers can sustain strong cash flow, reduce costs, and mitigate denials by applying advanced technology to the revenue cycle.
Here are six ways technology can help strengthen the dialysis center revenue cycle in the today’s difficult operating environment:
Identify undisclosed insurance coverage
Determining a patient’s genuine insurance status might be difficult because they frequently arrive as self-pay even though they have coverage. However, there could be huge write-offs if current insurance is not identified.
To find out about patient coverage before starting care, renal providers require digital solutions. The Coverage InsightTM solution from Change Healthcare offers a sizable network and the search-and-matching capabilities essential to find and validate patient coverages before treatment even begins.
In order to create strong patient profiles that may be connected to potential financing sources, the system leverages machine learning algorithms in conjunction with access to huge amounts of publicly available third-party data. The fact that it identifies a number of indicators, such as those with a high likelihood of disability, income levels and financial situations, insurance providers, and other useful data to assist you in confirming coverage, is noteworthy.
Expedite seamless prior authorizations
To secure the best possible reimbursement for renal treatment provided, particularly with commercial insurance and Medicare, streamlining the prior authorization procedure is crucial. Traditional prior permission procedures, however, might delay required care since they are usually labor- and time-intensive.
With automatic capability that can identify whether previous authorization is necessary and on file with the payer, our Clearance Authorization software handles the recurring issue of prior authorizations. Additionally, the system will automatically verify the registration process’s medical necessity standards and instantly send requests to linked payers.
In addition, Change Healthcare’s Connected Authorization Services take authorization efficiency and accuracy a step further by employing pre-authorization specialists to process regular authorizations swiftly utilizing intelligent technology while handling challenging instances by exception.
Speed adjudication with electronic attachments
Providers have battled to make sure that the right information is sent to the payer at the right time as claims management procedures have multiplied and become more intricate. Claim delays, denials, or rejections may be the outcome.
By automating the attachments process to fulfil payers’ rising expectations for more paperwork, Assurance Attach Assists helps to accelerate reimbursement and reduce denials, organizational expenditure, and administrative strain. When a claim is released, attachments are instantly provided and linked to the relevant claim, and the status of both can be easily tracked.
Expedite claims workflow for recurring services
The same information must be repeatedly documented on each claim when creating claims for continuing ESRD care. An end-to-end medical billing technology called Revenue Performance Advisor offers automation that helps dialysis staff save time by swiftly duplicating data from earlier visits while also updating the date-of-service and other details to speed up claims processing.
A first-pass clean claim rate of 98% is achieved through Revenue Performance Advisor’s inclusion of eligibility and benefits verification as well as automatic claims scrubbing that flags incomplete or wrong claims prior to submission.
Accelerate your Medicare claim cash flow
Medicare is one of the largest payers of dialysis services, so ensuring a problem-free and expedited Medicare claims submission process is essential to strong cash flow.
Our Assurance Medicare Direct EntryTM solution provides a single system for the real-time submission and processing of Medicare claims. It can help expedite reimbursement, reduce AR days, and speed your Medicare primary claim cash flow by at least one full business day.
Optimize patient liability
Making it easy for patients to receive, understand, and pay their portion of the medical bill is key to ensuring a healthy revenue cycle, mitigating the need for collection services, and improving patient goodwill.
With our Patient Billing and Statements solution, Change Healthcare serves as your strategic communications partner, delivering multi-channel, personalized print and digital statements to help expedite patient payment collection.
A single, trusted partner
Change Healthcare’s deep knowledge of the renal care landscape and our development of disruptive technologies to overcome traditional revenue cycle barriers can help dialysis centers achieve unprecedented revenue cycle excellence.
And unlike many point solutions that only address a specific revenue cycle issue, Change Healthcare’s technologies are part of a comprehensive approach delivered through a single, trusted vendor. That translates into improved process integration and continuity, as well as simpler overall accountability.