Healthcare leaders understand the value of data-driven decision-making in today’s industry – it’s essential for improving patient outcomes and lowering administrative costs. To make quality decisions, leaders heavily rely on quality data in real time.
But what if you were told that you are sitting on a gold mine of data that could lead to incredible cost savings? An often-underutilized resource is called the Remittance Advice (RA), and it includes valuable data on payments, adjustments, deductibles, denials, and more. The value of this information has only grown with the rise of electronic remittance advice (ERA) being utilized in the industry. This electronic format allows for advanced reporting capabilities, bringing significant new insights to providers’ fingertips that can help significantly lower administrative burdens.
Even some of the largest, most technologically advanced health systems in the US are still struggling to keep up with and make effective use of all this information. Though many revenue cycle management solutions come with robust reporting capabilities, it can be overwhelming to sift through and determine the best method for what your organizational leaders need. Data analytics teams can help make sense of this plethora of information to fuel data-driven decision-making, but retaining a team these specialists in-house can come at a premium – an extra expense that many providers cannot afford to maintain in the current economic landscape of healthcare.
Let’s explore a few of the ways that remittance advice data and effective reporting can make a marked difference in cutting down on administrative burdens in healthcare.
Trend Analysis
Pulling categorized reports based on denials, error codes, and missing information can help providers identify trends and address them quickly. For example, pulling a comprehensive denials report can help identify specific services or charges that are routinely underpaid or unpaid by particular payers (for more on effective denial management, check out “Proactive Denial Management for Proven Performance”). With this data in hand, this can help facilitate productive conversations with your payer representatives and address issues collaboratively.
Another example would be analyzing remittance dates and payment amounts rendered to monitor revenue cycle key performance indicators (KPIs) such as days in accounts receivable. If you notice an increase in accounts receivable claims which are 60-90 days old, this is an indication of billing problems as it is taking longer for cash to be posted. This is where powerful reporting can help identify less obvious causes, such as payer-specific or productivity problems.
Quality Improvement
Once key trends are identified, they can be a useful tool for quality improvement initiatives. Creating positive operational change involves digging into the root causes of trends and addressing them using powerful data. For example, your organization can pull patient demographic and cost data to generate reports on which populations cost the most for their care. With this information, your team can dive deeper into the root causes and develop population-specific interventions to help lower costs. Additionally, one of the greatest advantages of reporting in the digital age is its dynamic flexibility. Once your organization uses a report to address one problem, the data filters and comparison metrics can be adjusted to monitor results of any interventions, or to tackle the next problem.
Another impactful quality improvement initiative that can be enhanced by reporting data is your organization's continuing education programs for staff. For example, if certain diagnosis-related groups are showing lower rates of reimbursement or being frequently denied for improper documentation, it is crucial for organizations to examine these cases, identify any documentation errors, and educate their staff on steps they can take to prevent the issue. Utilizing real organizational trends as case study examples can help paint a clearer picture on how small practice changes can impact the organization’s performance and maximize financial recovery.
How Signature Can Help
Signature Performance has consistently been a leading force in reducing the administrative burdens of healthcare. Our company is equipped to help our clients address the knowledge and bandwidth challenge when it comes to effective reporting. The Consulting and Advisory team delivers accurate, on-demand reporting services to help your administrators make the important decisions that increase cash flow, maximize reimbursement, improve patient outcomes, and reduce overhead costs.
To find out more about how Signature Performance can help optimize your reporting and financial performance, please visit Our Capabilities page today.