Revenue Cycle Management with Prominence Advisors02/21/2023
Becker’s Healthcare predicts an increase in bad debt expense for hospitals across the country in 2023 as Medicaid enrollment is expected to fall in April. Accessing your revenue cycle ahead of these changes could minimize the impact to your bottom line. Prominence can set your organization up for success in 2023.
Prominence’s revenue cycle management tools and applications have generated more than $720 Million in ROI, saving our customers 12,000 hours annually. Contact our team to learn how we can help you move mountains and improve your bottom line.
Prominence’s RCM Accelerators consolidate data from all of your revenue systems into a governed, self-service analytics solution that provides insights to executives and analysts. Leadership and analysts alike can view high-level performance trends and drill down into specific metrics and analyze performance in a matter of seconds. In less than ten days, our team can implement these tools within your existing AR and CRM tools, increasing visibility and accuracy across your whole organization.
The Prominence RCM Scorecard has cleared at over $87 Million in revenue bottlenecks, delivered more than 145 metrics, and is in production use at numerous health systems across the US. By providing a one-stop shop for all things revenue cycle, your staff can rapidly detect outliers, spot trends early and take action to remediate issues before they become problems.
The RCM scorecard combines data from all of your mission-critical systems, including but not limited to EHR, AR, GL, ERP, HR and other financial systems. This provides a comprehensive and consolidated view across hospital & professional revenue in one RCM application. The result? Your leadership, managers and analysts are aligned on actions that will improve your bottom line.
Our team partnered with a hospital group with more than a thousand providers to create an automated RCM Application, bringing visibility to issues in billing, automating their reports, and standardizing their metrics. Historically, this organization was manually creating an Excel-based dashboard, aggregated from multiple sources, each month. This made drill-down analysis impossible without re-running and compiling reports. Additionally, they could not view data across locations to compare performance. Their application sponsor understood the importance of a high-functioning revenue cycle to their organizations ability to survive and prosper and enlisted Prominence’s help.
The Prominence team was tasked with bringing this Excel-based dashboard into Tableau and eliminating the manual reporting efforts needed on a monthly basis. There was a focus on using Tableau filters to enable the team to drill down, making data easily understood and more actionable. Instead of jumping between Excel documents, this team could view their metrics in one place and also view by Service Date and Post Date.
This Tableau dashboard focused on professional revenue cycle metrics and included four types of dashboards. The overview dashboards highlighted key metrics and included detailed tooltips, allowing key decision makers to easily learn more information. Their monitoring dashboards provided a high-level view of KPIs on focus areas like AR, Charges, Payments, etc. The Prominence team also created focus dashboards to visualize a single group or focus of metrics and detail dashboards for more detailed tables and transaction-level information.
Prominence’s work was able to bring light to shortfalls that existed in this organization’s previous RCM. Two people at this organization identified and resolved issues in their billing based on data in Tableau. After implementing our solution, there was an almost immediate 5% reduction in AR and a 12% reduction in AR aging greater than 90 days. This organization was more quickly able to resolve their AR by better analyzing their operations with this new application. Not only could this organization reduce their Accounts Receivable more quickly, but this application enabled them to increase their Gross Revenue by more than $2 Million.
Prominence has also assisted a Midwestern Magnet hospital with a Revenue Realization Application. This organization intended to help shift their financial services team away from using static tabular reporting and toward a more robust visual analytics platform so they can monitor trends in key financial metrics, identify concerning variances, and drill into variances to identify which providers, locations, and departments are not capturing revenue. Prominence partnered with this organization to complete the Tableau UI for their whiteboard and data model.
This Tableau UI aimed to provide an efficient alternative to their previous tabular-style of reporting and provide high-level trending and drill-down capabilities into key metrics like charge volumes, payment amounts, collection rate, open balance percentage, and estimated payment amount per charge. They also wanted to pull hospital and professional billing metrics into one application, keeping these dashboards separate but allowing financial executives to analyze and make decisions based on these metrics. The Revenue Realization Application was created to also provide insight into the payor mix over time.
Leveraging SQL views created by this organization’s BI developer team, Prominence created the Revenue Realization Tableau Application. In this application, SQL views are summarized instead of remaining at a HAR or Account level and tie all transaction information back to the charge. This gives a more complete picture of the life cycle of a charge, and whether payment against that charge was realized. This hospital organization can also report payments according to the service date of the charge rather than reporting to the posting date of the payment. Prominence created overview and payor mix analysis dashboards for both HB and PB data. Our team also built year-over-year comparison for all financial metrics to provide actionable insights into every KPI.
The result? This organization now has consistent, automated reporting across applications that enables their team to make data-driven decisions. This initiative allows for standardized reports of revenue realization for PB and HB across both applications. Instead of manually running reports each month, Prominence was able to create an application that refreshes monthly, giving actionable data to decision-makers in seconds. These decision-makers now have the tools to understand their KPIs and the merit they provide, complete with year-over-year variance to show any drastic changes compared to the previous year.
Organizations without effective Revenue Cycle Management applications can struggle with revenue bottlenecks that create delays in their billing cycle. Prominence’s team of revenue cycle experts collaborated with a large academic physician group to bring light to these missed opportunities. We aggregated the key performance indicators that billing office leadership needed to properly manage their physician billing office and organized them to allow users to drill down from a high-level to detailed transactions, alerting them when bottlenecks increase over defined thresholds.
The application Prominence created monitors revenue through its various stages in the billing process, from initial posting, coding review, billing, and collections. The application was designed to allow the user to identify trends within their revenue capture and collections at the physician, department, bill area, financial class, payor, and provider level, and identify bottlenecks where revenue was being held in a coding review work queue.
By allowing users to drill into bottlenecks within their revenue capture process, they were able to identify over $2 million being held in a work queue for a single physician and bill area. By allocating staff to work with this physician to improve their charge capture process, they were able to fix the issue causing held revenue and reduce the lag time to submit claims for that physician. This lead to a faster billing cycle and increased collections for the organization.
Sophisticated analytic tools and significant expertise in Epic applications and revenue cycle management processes allow Prominence Advisors to generate results faster and with fewer resources than their competitors. Using our advanced analytics, we can uncover problem areas in your AR, as well as your RCM system, more quickly than traditional methods. Our expert revenue cycle team can fix the root cause of AR build up and revenue loss through pairing operational changes with system configurations. Our team has the ability to not only recommend system changes to optimize your revenue cycle workflows, but also implement those changes without burdening your own IT team.
Interested in reducing revenue bottlenecks and improving your bottom line? Contact our team today to learn more about how Prominence can create a consolidated view across your enterprise and give you the full picture of revenue at your organization.
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