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Recently, I shared six healthcare industry predictions for 2020. These trends are motivating providers to take a fresh look at their revenue cycle performance in the hope of finding ways to cut costs and boost revenue.

If you’re aiming for similar results this year, your accounts receivable (A/R) team may hold the key.

In truth, most healthcare agents aren’t equipped to maximize their time. As a result, they lose opportunities to recover revenue, and accounts languish in A/R. As providers expand their workforce without addressing common productivity drains, these lost opportunities multiply.

Meanwhile, ineffective agents lose heart and head for the door in large numbers. Providers scramble to backfill positions while scaling their A/R operations. Hiring and onboarding costs continue to rise.

Many healthcare leaders struggle with how to tackle these problems effectively. There are only so many hours in a workday (with a significant portion of an agent’s shift spent navigating IVRs or on hold with payers). Managers can provide only so much guidance and support to on-site agents, and remote agents are practically on their own. “Peak performance” must be defined within these limits.

If this is your thought process, it’s time to start questioning what’s really possible in 2020.

Here are four essentials you need to boost agent productivity, optimize your A/R operation, and transform your revenue cycle.


1. Workflows That Prioritize High-Value Tasks

Your investment in people should deliver the highest possible return for your organization. Are your agents dedicating most of their time to performing high-value tasks? An automated A/R environment can help them do that in two important ways.

  • Automation of workflows – Rather than being inundated with tasks that don’t require human intervention, agents are presented only with exceptions to automated tasks (e.g., insurance denials). Codified business rules can ensure high-value accounts are routed to agents in order of importance.
  • Agent schedules – This guides agents through a predetermined order of what work queues should be worked first. It schedules them to move between work queues (based on time of day and/or duration) so they can work accounts more evenly.


2. Shorter Payer Hold Times

Time spent on hold is one of the steepest barriers to A/R optimization, and many providers are resigned to it. What can be done to overcome IVR navigation and wait times? Agents have to make their way through the IVR, however painful and wasteful it may be, to connect with live insurance reps.

Here again, with automation and artificial intelligence, providers have a real shot at overcoming this seemingly insurmountable problem and reducing insurance hold times significantly—by up to 80%. If your system automatically navigates payer IVRs and tees up new payer calls while agents are working claims, agents can glide seamlessly from one payer call to the next. As the system performs, it analyzes call data and adjusts the neural network for the expected hold time to route new payer calls more precisely.


3. Agent Guidance to Promote Uniformity

All agents have procedures they must follow when working accounts. If a denial is identified, an agent needs to perform certain steps when talking to the payer. Uniformity on the front line improves performance, as agents follow established procedures that work. As performance improves across the board, so does productivity. Having a playbook that’s visible to agents while they work accounts will help them move through the follow-up process more efficiently.


4. Real-Time Views of Priority Accounts

The last piece of the productivity puzzle is helping agents make the most out of every payer call. As each payer call is connected, agents should be able to see on their screen exactly which high-priority claims need to be discussed on the call. The system should have a summary of those top 25 key accounts in a gadget that can be used to open the account in a separate tab. This allows an easy transition on the call and helps the agent work many more accounts for each interaction.


All of This Is Possible with Your Existing EHR

These transformative changes are achievable without disrupting your EHR workflows or your operation. In fact, you can fill the “EHR gap”—and get the agent productivity tools you’re missing—with a simple complement that’s designed to work seamlessly with your current setup.

You can learn all about it in our free eBook “The Accountable Collector: Transforming Healthcare A/R with One Simple Fix.” Download your copy today, and discover the easy way to supercharge your agents’ performance and results.


GetixHealth Increases Claim Follow-up Efficiency by 60%

Learn how this leading RCM provider transformed its collection team's performance with the addition of a simple EHR complement.

Disclaimer: Ontario Systems is a technology company and provides this infographic solely for general informational and marketing purposes. You should not rely on the content of this material for any other purpose or as specific guidance for your company. Ontario Systems’ advice, services, tools and products described herein do not guarantee compliance with any law or industry standard. You are ultimately responsible for your own company’s actions and compliance efforts. Because everyone’s situation is different, you must consult your own attorneys, accountants, and/or other advisors to obtain specific advice on your company’s compliance, legal, tax, regulatory and/or other business needs. Despite Ontario Systems’ efforts to provide current and up-to-date information, you need to recognize that the information contained herein may become outdated quickly and may contain errors and/or other inaccuracies.

© 2021 Ontario Systems, LLC. All rights reserved. Information contained in this document is subject to change. Reproduction of this publication is not permitted without the express permission of Ontario Systems, LLC.

How to Build a Faster, More Powerful Accounts Receivable Process (and Watch Revenues Soar)

How to Build a Faster, More Powerful Accounts Receivable Process (and Watch Revenues Soar)

Healthcare providers are struggling to contend with COVID-related financial challenges and a growing work-from-home trend that’s complicating workforce management. To successfully adapt to these realities and improve their financial health, providers must identify and address revenue leaks, lost opportunities, and missing capabilities on the back end of their revenue cycle.

Posted by Shawn Yates

Shawn Yates serves as Director of Product Management for Ontario Systems, defining the company’s strategy for product and service offerings in the healthcare market. With over 20 years of experience managing self-pay receivables and collection operations for a top 20 healthcare system, Shawn’s background also includes working for a national outsourcing company helping clients manage their insurance and self-pay receivables, and Experian Health, the largest data and analytics company in the country.
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