According to a survey from the Healthcare Financial Management Association (HFMA), 82% of health systems are experiencing higher denial rates from payers compared to the pre-pandemic era. So, what does this and other troubling trends mean for healthcare finance leaders? Nearly 60% of chief financial officers (CFOs) are spending more time focusing on cost management and operational issues.

As margins tighten and non-clinical staffing shortages widen, CFOs and other leaders evaluating financial systems must identify options that improve efficiency in the business office. Here are some of the top qualities to look for to enable your financial operations—and cash—to flow more seamlessly.

A single system…

Think about the convenience and simplicity that a platform like Microsoft Teams offers. Instead of using separate applications to exchange messages, meet virtually and share documents, users can execute all of those functions in one place.

Similarly, business office staff members can benefit from a single system that enables them to work through and follow up on items within a standard workflow and without dependencies on third-party products or vendors. By using one integrated system, organizations can eliminate the need for staff members to rebill claims in a different application for follow-up, for example, and reduce the number of windows open on their monitors, providing a more streamlined user experience.

Healthcare organizations that do not rely on third party systems can also avoid waiting for a data feed to update overnight or over the course of several days. This helps staff members get claims out the door faster so your organization can be reimbursed for services rendered sooner.

…that works for your teams

Clinicians have been calling for better user experiences for years, and the industry is now responding to remedy longstanding frustrations with electronic health records (EHRs). As the healthcare labor shortage persists, organizations simply cannot afford to lose skilled workers due to technology-induced burnout.

Likewise, many organizations are feeling the strain of workforce challenges within the business office. Financial staff members want to complete their work without managing unnecessary distractions. Equipping your staff members with an intuitive system that works the way they think and execute workflows can help short-staffed teams work more efficiently and effectively.

Additionally, artificial intelligence (AI) has great potential to streamline healthcare finance. AI is often cited for its ability to perform tedious, repetitious work in place of people—and there are certainly use-cases for that in revenue cycle—but less attention is given to ways AI can complement the human workforce to perform better.

For example, work queues can prioritize tasks based on how much value they bring to the organization, so staff members can focus on completing those tasks instead of searching for what to do next, helping to maximize reimbursement and increase the speed of cashflow. Only 10% of health systems have made investments in AI for revenue cycle functions, so there is a lot of room for performance improvement as this technology expands.

…and brings the right data to the right person

Data is one of the most powerful assets in healthcare, and the business office is no exception. Having the right information where and when your teams need it enables them to make decisions more quickly and decisively. For example, episode management tools that bring relevant information to the forefront can help teams submit clean claims without clicking through multiple areas of the product.

Additionally, it is valuable to have dashboards that summarize revenue cycle data and present notable trends to users based on their individual role. An executive might prefer to see a high-level view of specific metrics the organization wants to track, such as daily revenue, days in accounts receivable (also known as A/R days) and discharged not final billed (DNFB).

Line-level managers, on the other hand, can benefit from the ability to delve into the underlying data comprising the metrics. With Sunrise™, for example, the claim edits dashboard provides trends like top 10 reoccurring edits and the ability to drill down into the data to understand average times for users to resolve an edit. Presenting insights like this can help managers make more informed decisions about where process improvements are needed, benefitting the individual users as well as the overall organization.

Bringing it all together

Having the right features in your revenue cycle management (RCM) system is crucial, and organizations can further elevate their financial performance with the right technology partner. Developers that act as trusted advisors not only can help organizations maximize the value of the system, but also support internal teams by identifying other ways to make the organization more successful.

Getting reimbursed what your organization deserves enables your clinical teams to continue delivering high-quality care—and unlocking operational efficiency in the business office is key to that.

If your organization’s financial system is standing in the way of peak productivity, it’s time to explore other options. Learn about Sunrise™, the alternative you need for the outcomes you want, here.

FREE EBOOK

Sunrise™: The flexible EHR for the outcomes you want

DOWNLOAD