This is the first in a series of four articles highlighting costly RCM issues and what providers need to address them.
For large healthcare providers looking to recover more revenue with fewer resources, the back end of the revenue cycle is ripe for change. A/R teams are under increasing pressure to recover every payer dollar, and they’re struggling to handle growing account volumes. Meanwhile, high churn on the front line continues to sabotage collection efforts and eat profits.
Underlying all these challenges are two of your A/R team’s biggest productivity drains when calling payers: time spent navigating IVRs, and time spent on payer hold.
To determine how much time collectors lose waiting to connect with insurance reps, we conducted our own analysis of thousands of calls to various payers. Our findings indicate it takes a collector eight minutes, on average, to navigate an IVR and wait on hold for a payer. This means collectors can spend roughly a third of their shift trapped in limbo, simply waiting to follow up on a claim or denial.
Imagine your collectors’ frustration. Think about the revenue you’re leaving on the table. Fortunately, there’s an easy way to eliminate all that wasted time.
What If You Take the Wait Out of the Equation?
By simply enhancing their EHR host architecture, providers can do a lot to boost their collectors’ productivity and results. Insurance Hold Manager (IHM), a key feature of Artiva Magnify™, is an easy fix designed to address the long IVR navigation and hold times that plague so many A/R operations.
The Artiva Magnify solution determines which payer to call next and uses IHM to automatically navigate payer IVRs and consume the time collectors historically spend waiting on hold. With IHM, the collector completes follow up on claims with the current payer and is then connected to the next payer call that is already in progress with IHM, thereby dramatically reducing time spent navigating IVRs and listening to hold music. All day long, collectors move seamlessly from one call to the next without having to navigate payer IVRs or endure painfully long and unproductive hold times.
This simple EHR complement translates into a significant increase in productivity and can have a dramatic impact on A/R operations.
The Other Side of the Coin: What’s Happening During Payer Calls?
IHM is one of many EHR enhancements that can supercharge your collectors’ productivity. But the health and success of your A/R operation also depend on how well your collectors—including the growing number who work from home—perform in their roles.
Without a steady flow of specific, timely performance data, there’s no way to know:
- How many claims collectors are working on each payer call
- How much time collectors are spending away from their desks
- Which accounts they’re working on each call
- Whether they’re asking the right questions
- How well collectors are performing relative to each other
If you’re operating with these blind spots, you can’t identify knowledge or productivity gaps across the team. And you can’t help collectors improve their individual performance.
We can show you how to manage on-site and work-at-home collectors, recover revenues more easily, and combat attrition, all in one easy step. Subscribe to the OS blog and catch the next post in our RCM Reality Check series. In it, we’ll reveal the three keys to building an accountable A/R team—one whose value is primed for growth.
Disclaimer: Ontario Systems is a technology company and provides this blog article 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.
© 2019 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.
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