Q&A: The Transformative Impact of a Technology-Forward Revenue Cycle

The world we live in today is driven by technology. The emergence of technology has brought new consumer expectations around price transparency, ease of use and the idea of choosing how they want to spend their money. These expectations have been integrated into all aspects for consumers including, healthcare. With this pressure for health systems to become technology savvy very quickly, some are questioning if it’s possible to meet the consumer’s expectations.

The reality is that the tech-enabled, highly-automated revenue cycle of the future is here now. Technology tools have made managing the entire revenue cycle more strategic and transparent which allows health systems to meet consumer’s expectations around hot topics such as price transparency, ease of booking appointments, ease of paying their portion of care with flexible options and the idea of choosing which doctor they want to see. Artificial intelligence and business intelligence have a transformative role in the revenue cycle and it is time for health systems to reevaluate their organization’s tech strategy.

“The revenue cycle of the future should be more transparent for consumers and providers alike. When a patient goes to an appointment, they should know how much insurance is covering and how much they will owe, and what payment options are available for them. When providers submit a claim, they should know what they’re getting paid for and why. Technology can deliver both of these, today.” Says Conifer’s Chief Information Officer, Scott Rowe.

In the following Q&A with Becker’s, Scott elaborates on what a technology-forward approach to the revenue cycle looks like and how it can positive impact health systems financials and patient satisfaction.

Q for question
What does healthcare need more of? Less of?
A for answer

Rowe: The revenue cycle of the future must be defined by price transparency and self-service. There are steps, processes, and loops we’ve fallen into as an industry around how payers, providers and third-parties interact. We need more collaborative venues where teams get together to eliminate waste and friction. To achieve this goal, payer and provider interactions need to become more digitized. Currently, there is still a large volume of interactions that require a high degree of manual intervention. When more payer and provider interactions are digitized, this will lead to the real-time adjudication of claims and more certainty by providers that they will be paid for the care they’ve delivered. Ultimately, more digital data exchanges between providers and payers can help reduce friction between the two parties and elicit greater transparency around reimbursement. This transparency will be passed on to patients in the form of a more streamlined, straightforward billing process and ultimately leads to more cost-effective healthcare.

Q for question
What is one topic or issue in which you’ve been investing time lately to better understand it?
A for answer

Rowe: One topic that has been on my mind lately, is the vast potential that automation and AI bring to the revenue cycle. I truly feel that we are only beginning to scratch the surface of what is possible. As a technology-forward company, we are always investigating new technology trends and seeing what they can bring to our clients. Historically, healthcare as an industry has always been one step, or many steps, behind leading technology companies (think Apple, Google, Amazon, etc.). I truly believe that healthcare should be on the cutting edge of these emerging technologies. I can’t think of a better industry to bring automation and advanced technology to. The possibilities are endless – from system operations to patient satisfaction, to clinical outcomes and of course overall revenue cycle. I am excited about the future and the strides the industry has been making as of late.

Q for question
What contributes to better conversations between a health system’s financial and clinical leaders when it comes to the patient’s experience?
A for answer

Rowe: Financial and clinical leaders need to work together and understand that the patient experience is not limited to clinical care — it encompasses the full spectrum of a patient’s interaction with a hospital or health system that often begins before the patient steps foot in a care facility and extends beyond discharge. With price transparency being at the forefront of patient’s minds, having the ability to predict whether patients will be able to pay or if they would benefit from a payment plan before they step foot into your facility could be a game-changer for your revenue cycle and for the patient’s overall experience. On top of that, having the ability to utilize emerging technologies to predict, whether a payer will dispute, deny or pay a claim and in what timeframe can bring a tremendous benefit to the financial and clinical leaders relationship so they can forecast with more accuracy and deploy resources more effectively, because you have a good idea of what is going to happen.

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