Streamline Revenue Cycle Management With ECM

Some hospitals lose 5% or more of their annual revenue simply as a result of inadequate revenue cycle management. For a 300-bed hospital, this could mean losses of more than $8 million a year. These losses are a direct result of the numerous inefficiencies inherent in manual revenue cycle management processes. For example, most claims aren't paid unless all information and details are complete on a form and all relevant documentation is submitted with the claim. Furthermore, different insurers will have varied claim submission requirements that need to be tracked and accounted for. In a system where physical documents are routed back and forth between departments and personnel, keeping track of all this information can be a challenge. Documents are often lost, misplaced, or submitted incomplete as a result of human error and the paper-shuffling process. As a result, claims are unnecessarily delayed or denied, negatively affecting a hospital's cash flow. Now, you may think getting a handle on your revenue cycle processes will require a cutting-edge (and costly) technology deployment — or an act of God. However, a key component to accelerating your cash flow can be found by harnessing relatively mature ECM (enterprise content management) and BPM (business process management) technologies.

The Revenue Cycle Advantages Of ECM & BPM
Basic document imaging and ECM software packages provide hospital accounts payable and accounts receivable personnel with instant desktop access to patient information, including admission documents, insurance forms, patient record information, billing data, and more. This software stores this information — whether it's a scanned document image, electronic document, online form, or e-mail — in a single repository where it is thoroughly indexed and immediately available to hospital staff via basic search functionality on any PC. An ECM system can prevent documents from being lost, duplicated, or inaccessible, eliminating the human error that often coincides with the act of routing paper.

BPM software can help take your revenue cycle efficiency a step further. This software can actually ensure the data stored in your ECM system is leveraged appropriately according to your unique business processes. Rules-based BPM software engines ensure forms are automatically routed to the correct personnel at different steps in the revenue cycle. The software can also be programmed to automatically send e-mail alerts to users when a specific action needs to be taken regarding a document or group of documents. For example, if a signature is required on a form prior to submitting a claim and an employee attempts to send the form without it, the software can notify the employee that the form is incomplete and specify the information needed. Furthermore, if an employee is slow to take action on a specific claim, the BPM software can be programmed to issue automatic e-mail reminders at designated time intervals to alert the employee of their responsibility. Better yet, all of this workflow information is documented by the BPM system, providing you with a complete audit trail of your revenue cycle. This feature allows you to identify where roadblocks exist in your current processes and proactively enforce change. All of these BPM features will help you ensure claims deadlines are met by ensuring your claims documentation is always moving, accurate, and complete.