How to Improve Claims Management in the Healthcare Revenue Cycle

Healthcare reimbursement models are changing at record rates.

To keep pace and prepare for future evolutions, healthcare providers must reduce inefficiencies in revenue cycle management.

Claims management is one of the most time consuming tasks in the business office.

Mired by manual, labor-intensive processes, claims management creates many opportunities for error, putting timely payment at risk.

Sound familiar?

It doesn’t have to.

Continue reading to learn how claims management technology can automate processes, produce error-free submissions, expedite claims, and aid in denial management. 

What is Claims Management Technology?

Claims management is the function by which providers get paid for the service they provide. Enacting this process, however, requires ongoing efforts to create, track, and appeal claims for reimbursement.

To streamline this complicated system, many providers opt to adopt claims management technology. These solutions facilitate the information essential for evaluating claims with a centralized record system, resulting in:

• Improved operational efficiency
• Reduced claims management costs
• Automated insurance workflows through digital claims

Familiar Challenges

As the senior care industry continues to evolve at a record pace, organizations need deep insights and practical solutions to help them navigate rapidly changing environments and tackle nuanced challenges facing today’s healthcare ecosystem.

Common claims submission challenges include:

• Claims submission is highly manual and labor intensive, consuming multiple staff resources, allowing for errors
• Producing clean claims for initial submission is difficult to achieve due to complexity
• Pursuing claims payment from payers is hampered by lack of claim status information
• Secondary claims creation is impeded by lack of remittance data, resulting in a time‐consuming, error‐prone manual process

Streamline your Revenue Cycle with Ease

Implementing the necessary tools to streamline manual activities and increase efficiency throughout a facility is the first step toward improving your healthcare revenue cycle.

With PointClickCare’s Marketplace, users gain access to over 220 integrated solution partners in the Marketplace, including claims management solutions that support:

• EHR interoperability
• All-payer eligibility and clearinghouse
• Automated e-file for secondary billing
• EzDDE editing interface for medicare
• Customizable, alert-based denial workflows
• Automated, full-service payer enrolment