The revenue integrity function within healthcare organizations strives to strike a balance between operational efficiency, regulatory compliance, and revenue optimization. As the current situation around the global COVID-19 pandemic evolves, the role of revenue integrity is more critical than ever to a healthcare organization’s financial health.
The key to an effective revenue integrity program lies in the ability to dig deeply into available data sets to uncover problem areas within the revenue cycle. Analyzing claims and remit data for billing compliance, charge capture, coding accuracy, denials, and other areas can unleash a wealth of knowledge and insights to guide you in establishing more focused training or developing more effective processes. Technology that’s fueled by augmented intelligence can help quickly identify billing anomalies, coding errors, and assist in communicating findings with coders and physicians for corrective action, delivering many critical benefits to power an organization’s revenue integrity initiatives.
Augmented intelligence can also help eliminate problems by continuously monitoring the coding and billing process. Catching errors before claims are submitted can expedite the re-adjudication process, eliminating payment delays and denials. Augmented intelligence can also be used to benchmark important risk areas, learn from similar organizations whose claims data also resides in the “community” data repository, and compare your performance in key areas, which is critical to identifying specific charge capture and denial issues.
Enhancing MDaudit Enterprise with Augmented Intelligence
At Hayes | MDaudit, we are embedding augmented intelligence technology, powered by ThoughtSpot, into the MDaudit Enterprise platform to offer a new module called Revenue Optimizer. The MDaudit Enterprise platform already streamlines your revenue integrity practices with automated workflows, continuous risk monitoring, and anomaly detection that allows you to quickly identify risks, determine the root cause of errors and apply corrective action. Adding this powerful technology will take our revenue integrity platform to a new level, delivering rapid, intelligence-driven insights.
Revenue Optimizer accelerates the process of discovery from your data, while simultaneously enabling you to conduct forward-looking analyses by “remembering” past searches and suggesting other areas of interest that can lead to new insights. Through the use of natural language search, you can enter simple phrases that describe your business questions to quickly get to the data and information you need. The more people that use the system, the more accelerated the learning – which all users can then leverage.
Advancing Healthcare Revenue Integrity
Augmented intelligence is something we are experiencing in all walks of life today – through the Internet of Things (IoT) and our increasingly connected world. Using the same concept to improve the critical revenue integrity function for healthcare organizations is an essential application of this technology. At a time when healthcare organizations are looking to identify, code, bill, and ensure optimal reimbursements for COVID-19 related services, enhancing analytics through augmented intelligence can provide an important boost to efficiency, productivity, and profitability.
Analytics can build a foundation for financial compliance strategies in the ever-evolving healthcare paradigm
In order for organizations to maximize revenue and proactively find opportunities for risk mitigation there must be a strong partnership between financial and compliance departments while leveraging the power of analytics and technology.
To learn more, watch this webinar with the Hayes | MDaudit team (Vasilios Nassiopoulos and Dana Finnegan) to learn how your organization can use the power of MDaudit Enterprise in maximizing revenue and shift towards risk-based auditing practices.
From this webinar you will learn:
How analytics can build a foundation for financial and compliance strategies
Key areas of focus to build a strong revenue integrity program during a pandemic and beyond
Demo on how MDaudit Enterprise can help solve your organizations revenue integrity challenges
Real example of a customer success story and their ROI