If you’re a healthcare provider still processing most claims manually, you know first-hand the challenges this presents. First, you deal with a lot of paper—from spreadsheets to claims forms to sticky notes— just to keep track of what you billed, what got paid, and what got denied. Second, you spend a lot of time communicating with the payers to track down claims, follow up on payments, and reissue remittances. Automating these processes sounds good, but what kind of results can you really expect?
It’s a question the revenue cycle team at Adult & Child Mental Health Clinic considered as they managed a largely paper-based workflow. When Lucy Koehl joined the team as director of revenue cycle management, she led the effort to evaluate automated revenue cycle solutions, including one which she had worked with previously—Availity.
After a comprehensive review of different automated solutions, the team selected Availity, and the results have been impressive. Previously, the only claims Adult & Child submitted electronically were Medicare and Medicaid. Today, almost 90 percent are electronic. Here’s how this improved revenue cycle performance:
Improved error tracking and reporting
Among the biggest advantages the revenue cycle team experienced with Availity was the ability to track and report on claims more quickly and to correct errors before they went to the payer. Within four months of implementing the solution, Adult & Child’s claims error rate dropped from 5.02 percent to just 1.35 percent.
Streamlined front-desk processes
With better insight into claims data, Adult & Child’s revenue cycle team recognized that many denials could be traced back to processes at the point of service. In fact, eligibility problems caused 65 percent of claims errors—many of which took 35-40 days after the claim was submitted to identify. Armed with data, the revenue cycle and front-desk teams worked together to ensure all staff knew how to capture the right information from patients.
Optimized billing process
For operational reasons, Adult & Child has to wait seven days post-service before billing. This wait time, combined with the existing manual workflow, meant that they were only able to bill once a week, which put their average days of service at 19.31. After implementing Availity and realizing the benefits of automation, the revenue cycle team saw an opportunity to increase billing to twice a week, which reduced their days in service by almost 40 percent to 11.71 days.
What results can you see from an automated claims processing solution? Find out more about Availity Revenue Cycle Management.