Handoffs. In healthcare delivery, fumbled handoffs between clinicians across shifts and departments create the greatest chance of adverse events and risks to patient safety. As noted in a peer-reviewed publication in the National Library of Medicine, “the transfer of essential information and the responsibility for care of the patient from one healthcare provider to another is an integral component of communication in healthcare.”
In much the same way, handoffs between front-, middle- and back-office administrative and financial functions also has the potential to cause harm…financial harm. It can cause coding errors, avoidable denials, care delays for missing prior-authorization requirements, and overall reduced staff efficiencies that prevent provider organizations from getting paid as quickly and as fully as possible. Care delays or foregone care — affecting nearly 25% of participants in one survey — and/or surprise billings can also dramatically reduce patient satisfaction and retention…as well as provider reimbursement levels under an increasing number of value-based care (VBC) payment models.
Business intelligence from start to finish
“As with integrated clinical information and functionality, the more that critical revenue cycle management functions are integrated and data can be turned into business intelligence from before the patient even hits the front door, the better the outcome for both the provider practice and patient alike,” said Tammy Taylor, Advantum Health CEO. “That’s the end-to-end approach that Advantum takes in partnering with our clients to cost-effectively optimize their operations and positively impact their cash flow and bottom line.”
The company’s advanced Advantum Ai data analytics solution turns data into business intelligence that delivers actionable information — information that supports real-time insights through all phases of the care-delivery process. Taking a wealth of information on coding, denial avoidance, prior authorization, eligibility and more, Advantum Ai learns from that aggregated data and helps healthcare teams streamline workflows, and improve efficiency from the start of the provider-patient experience through billing and payment.
Key aspects of integrated systems, data and workflows from front to back office
Centralized patient data
A single electronic health record (EHR) system accessible to both front and back office staff helps eliminate the need to manually transfer information between separate systems.
Real-time updates
Changes made in the front office, such as appointment scheduling, are automatically reflected in the back office for billing and insurance verification.
Automated workflows
Tasks such as eligibility checks, pre-authorization requests, and claim submissions can be triggered automatically based on patient data entered in the initial patient contact, be it within the patient portal or when patients present in person at the front desk.
Improved communication
Seamless data sharing helps improve coordination between clinical staff and administrative teams, leading to reduced errors and improved patient care.
Examples of how integration is used:
- Appointment scheduling
Front-office staff can directly access patient medical history and insurance details while scheduling appointments, helping ensure accurate appointment booking.
- Patient registration
Patient demographic information entered at check-in is automatically populated in the billing system, reducing manual data entry and, thus, avoiding another potential for errors, caused by additional human contact with the patient’s record.
- Billing and coding
Clinical staff can electronically submit accurate billing codes directly from the patient chart, streamlining the RCM process.
- Claims management
Billing staff can monitor the status of insurance claims and identify potential issues with billing codes in real time.
The mighty benefits of integrated systems and processes
- Reduced administrative burden
Less manual data entry, streamlined workflows, and automated tasks free up staff time to focus on patient care.
- Enhanced patient experience
Smooth check-in process, faster access to medical records, and improved communication with providers.
- Improved financial performance
Accurate and timely billing, reduced claim denials, and optimum revenue cycle management overall.
Seamless information sharing = efficiency and satisfaction
Integrated front and back office systems help enable provider organizations to leverage seamless sharing of pertinent patient information between administrative (front office), clinical, and financial (back office) functions. This leads to streamlined workflows, improved data accuracy, and efficient and cost-effective management of patient-care delivery. From scheduling appointments to delivering high-quality care and optimizing and speeding billing and collections, the integration of information systems delivers cost-effective, best-practice care delivery that optimizes and speeds provider payments and contributes to a positive patient experience.
For more information on how Advantum Health’s integrated, advanced technology used by our expert RCM team can help you optimize all administrative and financial aspects across your operations, contact us.