Focusing on esMD for Healthcare Revenue Cycle Optimization
By - With such a high volume of requests for medical documentation each year, handling them efficiently is beneficial for those working toward healthcare revenue cycle optimization in the years to come.
Claim review contractors receive over 1,000,000 annual requests for medical documentation each year — most via paper or fax. A primary disadvantage of managing a high volume of hard copy requests as opposed toelectronic submission of medical documentation (esMD) involves decreased efficiency and ineffective time management. The result is generally a severely reduced revenue cycle time.
Nonetheless, hospitals often face numerous elements of analytical hardship due to a widespread resistance to current technological trends regarding meaningful use payments. Financial departments commonly utilize hardware/software that is a minimum of a decade old.
“Frequently software vendors will have clients request that they omit key data elements from a newly installed database because the file can’t be loaded onto their aging legacy system,” says Jonathan Pearce, CPA, FHFMA.
Many healthcare organizations are willing to explore the many advantages of esMD and their long-term benefits, which include:
72% quicker payment turnarounds: Providers utilizing esMD report turnarounds of only 6 days. Contrastingly, the average paper process takes approximately 21 days to complete.
Savings in labor costs: esMD eliminate the need to physically print and mail paper, send faxes, or burn a disk/CD, resulting in less communication lag time and a more pleasant work environment.
Reduced hard costs: esMD easily reduces expenses involving postage, black and white/color ink cartridges, and shipping and handling costs.
This clean connection between CDI technology and optimization of revenue cycle is also emphasized by interim CEO of Optum360, Ron Jones.
“From identifying inappropriate claims denials, pre-determining payment information, delivering operational transparency and automating revenue cycle functions including clinical documentation improvement (CDI), IT investments can have a great impact on the bottom line,” he explains.
“Healthcare leaders have high expectations for IT-enabled activities to deliver sustainable financial benefits,” continues Jones. “By automating detail-focused processes in the revenue cycle and adopting a real-time CDI program, healthcare organizations will benefit from accelerated administrative workflows and improved accuracy — allowing staff to focus on supporting the patients’ need for transparency and consistency in their care experience.”
It is possible an addition of database training initiatives to foster a stronger skill set or exposure to software courses would be beneficial to hospital staff, according to Pearce:
Hospital finance and decision support teams generally [lack] the capability to work effectively with databases, and even fewer are familiar with advanced data tools like Python, SQL Server, or R. Often there is resistance to the use of new and unfamiliar tools by management, fearing (not unreasonably) that the departure of a key staff member may create a void that cannot be easily filled. Therefore, inadequate skills and inappropriate software may be applied in an attempt to spread the work among multiple staff members, with the result that nothing gets done well.
With such a high volume of 1,000,000 annual reports for medical documentation, clearly getting things done…well is beneficial for all parties when it comes to excelling in healthcare revenue optimization for the future.
