If we want to talk about technology, let’s start by looking at the original technology: farming. Early farming used simple tools and animals for plowing and planting. During the Agricultural Revolution, innovations like crop rotation and the seed drill marked the shift from subsistence farming to producing surplus crops for sale. From there, tractors, fertilizers, and better irrigation continued to change the game to make farming hyper-efficient. Over the last decade, rapid technological evolution gave farmers access to new farming technology such as automated tractors, smart irrigation systems, and tools that use AI to predict weather patterns and market trends.
This technological evolution parallels most industries, albeit within a much shorter timeframe (i.e., not since the beginning of time). Mapping this onto the healthcare revenue cycle: We historically maintained patient records and billing information on paper. In the 1980s, we were introduced to the computer, along with basic electronic billing. By the early 2000s, EHRs and RCM software transformed the accuracy of coding and billing and ushered in workflow automation. But in just the last decade, the pace of technology adoption has been staggering what began with simple RPA to handle repetitive tasks like claim submission has evolved into Artificial Intelligence and Machine Learning to predict claim denials, automate coding, and enhance revenue cycle processes through advanced analytics.
Throughout this entire, rapid evolution, our revenue cycle teams have had to continually adapt, quickly mastering new technologies. Besides navigating complex payer requirements, these teams must also manage intricate technology environments. A solid grasp of EHRs is no longer sufficient—numerous additional tools have been introduced, some integrated within EHRs and others existing independently. The pace of evolution within your EHR alone has been so fast, you might not even know what is available now!
To make better decisions about technology requirements and integrations, having a team that works across intersections is crucial. Gone are the days when issues could be chalked up as “just a workflow problem” solved by a Visio diagram. Each solution must balance operational best practices, revenue cycle application expertise, and cutting-edge data/analytics/technology integration.
Consider a report request from a Cancer Center Director seeking to understand the impact of prior authorization delays and denials. Not so simple, it turns out!
- An Application Analyst might ask: What type of impact – financial, clinical, or both? Is the required data to do this captured within the EHR? If not, is there a workflow gap that needs to be addressed?
- A Report Writer might ask: Where is this data stored? Do we clearly understand the requirements? Can the report be obtained through existing self-service data tools? Should this be repeatable?
- A BI Developer might ask: How does the Cancer Center Director want the report to look? How do we surface insights? How do we make the insights actionable? How do we make the insights actionable, not only for leadership but also for staff handling day-to-day authorizations?
- A Revenue Cycle Trainer might ask: Why is the report required in the first place? Do end users understand the EHR workflow for obtaining and documenting prior authorizations, or is additional training required?
- A Technologist might ask: What existing technology are we leveraging within the Cancer Center to efficiently capture prior authorizations? Can we introduce automation?
Coordinating these teams and skillsets across your organization can be difficult – not to mention staying current on some of the required technologies that could be deployed. This is why partnering with a multi-disciplinary technology team is essential.
When considering how to better leverage technology, the question often arises, "Should we build or buy?" But sometimes, the answer could be to "partner." The benefits of partnering with a technology-driven revenue cycle team include:
- Operational Expertise: A technology-focused services partner offers more than just technology; they bring extensive operational experience and expertise in revenue cycle management. By partnering, you can quickly identify gaps in your environment and implement best practices to enhance efficiency.
- Outcomes-Based Approach: While billable hours have their place, your revenue cycle technology partner should be willing to evolve beyond that model and commit to outcomes. This includes ensuring successful technology deployment, maintaining high service levels for support, and achieving KPI improvement through strategic initiatives.
- Data-Driven Performance Improvement: An outcomes-based approach aligns incentives between your organization and your chosen partner. This synergy fosters a performance-driven mindset focused on achieving measurable results and continuous improvement.
- Fluency in Diverse Technologies: Being proficient in a wide range of technologies, especially those specific to healthcare, allows for seamless integration with existing systems and collaboration with preferred technology vendors. This expertise ensures that we can identify and implement the right technology for each use case, promoting purposeful usage without adding unnecessary steps to users' workflows.
- Innovative Staffing Models. Securing the right staff and expertise for strategic projects is a common challenge. A great consulting partner brings the necessary experience and ensures coordinated delivery. This approach minimizes the need to repeatedly orient the partner to your systems, operations, and processes, enabling efficient and effective project execution.
Partnering with a technology-driven revenue cycle team ensures that you can navigate the complexities of modern technology, optimize your processes, and drive continuous improvement. We’ve seen technology move quickly, so embrace the future by combining expertise, innovation, and strategic collaboration to cultivate a more efficient and effective revenue cycle.
