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4 ways to reclaim the claims process

In an era when the healthcare community is working to improve quality of service and delivery and to reduce costs, the reimbursement process is under intense scrutiny. Organizations are asking themselves: How can we simplify the claims process? Are there ways to save time? What can we do to make our claims more accurate to help speed payments? In a series of recent case studies, three clients have shared their experiences using Allscripts Payerpath® Solutions to reclaim their claims processes. Here are four examples: 1) Collect more patient payments Patient payments are the fastest growing portion of many providers’ revenue streams. Unfortunately, according to the American Hospital Association, as much as 5.3% of expenses are written off each year as uncompensated care, representing $42.8 billion in losses. One of the ways Burton Creek Rural Clinic (West Plains, Missouri, U.S.A.) is […]

Readers have responded with interest to our new magazine, Continuum. Created for healthcare professionals, it features industry insights and Allscripts client success stories. In the 2Q 2016 issue, you’ll find articles that address some of healthcare IT’s most pressing questions: How can we help deliver safer medications? Teams of clinicians at Atlantic General Hospital used Allscripts Sunrise™ to standardize and automate several processes, reducing medication errors by 86% over three years. What is FHIR and what does it mean for me? Has FHIR “kindled” your interest? Learn about this emerging interoperability standard through most frequently asked questions. Which capabilities will lead to truly integrated care? Senior Vice President and General Manager of Population Health Martha Thorne describes population health technology and which capabilities will ultimately lead to success. What does it take to provide patient-centered care for people with autism spectrum disorders? […]

Today there are many steps to processing claims, and each one is an opportunity to gain or lose money. Practices are weighing the pros and cons of different approaches to managing their revenue cycle, including relying on experts from outside their organizations. Arbor Family Medicine (Westminster, Colorado, U.S.A.) Office Manager Mikie Gonzales talked about her experience with Allscripts Revenue Cycle Management Services™ (RCMS) in a recent interview: Gonzales discussed some of the myths that surround decisions to bring in a revenue cycle management services partner. Her experiences are similar to other clients and “bust” some of the most common myths: Myth #1 – We’ll lose control of our billing activities. As responsibility for claims – from submission to sorting out denials and beyond – shifts to a services partner, some practices fear that they are also giving up control. However, […]

So, you’ve weighed your options and decided it’s time to replace your revenue cycle management (RCM) solution. You’re not alone. According to a recent survey, about one out of every five healthcare organizations are planning to replace their current system, too. What’s causing this trend? Healthcare organizations are preparing for new value-based reimbursements, while still collecting as much revenue as possible under current fee-for-service methods. Lots of RCM solutions simply aren’t up to the challenge of succeeding with both financial models. At Allscripts, we updated our revenue cycle management solution to help clients meet today’s financial challenges. Our Sunrise Financial ManagerTM solution builds on the successes of Sunrise Patient Financial ManagerTM. We listened closely to clients about what they needed in future revenue cycle management solutions. We made sure that Sunrise Financial Management could: – Switch gears smoothly as they […]

U.S. healthcare providers need to collect every dollar owed to them. As their reimbursement models rapidly evolve, you may be asking, “Is it time to replace our revenue cycle management (RCM) solution?” Experts estimate that if U.S. hospitals do nothing to address the swiftly changing financial environment, they could see a 19% drop in margins over the next 10 years. Based in part on the HIMSS AnalyticsTM index and other observations, we developed a checklist of the core components of a healthy financial system. If your RCM solution can’t do these things, it may be time for a change: 1. Offer web services to patients for convenience – Can your patients pre-register, self-schedule and pay bills online? These online conveniences are becoming more important to consumers and help speed the billing process. 2. Verify insurance eligibility in real-time to reduce risk […]

Our clients have great stories. I love hearing about their outcomes and how they achieved them. Readers on this blog and on ClientConnect have called for more of these accounts, too. We recently shared several strong client stories at our annual client conference, ACE. We highlighted a few with the Allscripts Client Awards.  Blessing Hospital (Quincy, IL) won a 2013 Client Award for excellent financial outcomes. Click here for a video about Blessing Hospital’s outcome Ideas to simplify the hospital’s revenue cycle workflow In 2010 Blessing Hospital began a two-year effort to transform its revenue cycle. By more tightly integrating clinical and financial data, Blessing wanted to improve its ability to deliver quality care in the face of increasing regulation and decreasing reimbursements. A team shadowed staff and carefully documented ways in which Blessing could improve its financial processes. Blessing […]

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Applying analytics to revenue cycle management

In an increasingly complex healthcare environment, physicians must base financial strategies on more than assumptions and anecdotes. They need analytics. Frank Cohen presents a solid case for analytics in a recent Physicians Practice webinar, entitled Analytics Do Nothing for Your Practice’s Health – True or False?. People often use limited information – what they think is true – to make management decisions. This approach can lead to three pitfalls: Failure to observe – assuming you know what the problem is without seeing what is really happening Failure to plan – assuming you know how to fix a problem without first finding out what is causing it Failure to validate – assuming the action you have taken to fix the problem has worked without measuring it Diagnosing financial issues with evidence When physicians first assess patients, they may have some intuitive […]

To control costs and improve results, many medical groups are evaluating a new generation of outsourced revenue cycle management (RCM) solutions. But wading through RCM solution options can be confusing. One obvious measure is the price of the solution. It’s important to evaluate the total cost of ownership to help make the right decision for your practice. Considerations should include the answers to these questions: 1. Will the solution save staff time by automating time-consuming tasks with easy-to-learn software? 2. Will the solution’s analytics give you insights to help you proactively manage the revenue cycle, provider productivity and benchmark performance? 3. If you decide to make a change in the future, is the solution portable? Or will you need to start a new solution from scratch? 4. Will your staff continue to perform certain tasks internally, or will your partner? […]

When Allscripts began the process of designing our new Sunrise Financial Manager (SFM), we had the rarest of opportunities…the chance to start over with hindsight. Our plans included moving SFM to the same technology platform as our clinical solutions. Tapping clinical data as part of the revenue cycle is a smart way to boost cleaner claims and more timely payments. More exciting was the chance to do something really special with the solution. The move to the new platform meant essentially starting with a blank sheet, sketching out what to carry forward and what to leave behind from the existing solution. Our goal: to develop a new patient financial system that dynamically addresses the changing health care landscape, now and in the future. So, we looked to the collective knowledge of the people closest to the realities of managing revenue […]

Do you have the data and insights you need to better manage your practice and improve profitability? Over the years, the business of running a physician practice has become immensely complicated and labor intensive. Health plan rules and government regulations are constantly changing. And while it’s increasingly important to cut costs, increase efficiency and align compensation with productivity, it’s difficult and time consuming for practices to track these and other key success measures, let alone understand how they’re performing versus their peers. To help, today I’m really excited to announce Allscripts Practice Performance, a new business intelligence and comparative analysis tool that responds directly to our customers’ evolving business needs. Leading medical providers have told us they want a new generation of cloud-based solutions that give them actionable business intelligence. Allscripts Practice Performance delivers with a complete analytics and business intelligence solution […]