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Why Accurate Provider Information is Critical to Cost Control and Revenue Cycle Improvements

By Blake Marable | January 30, 2017

Our last blog post reviewed the operational impact of the trend toward clinically integrated networks and how they place greater demands on managing provider information. Here we review the financial implications of this challenge including opportunities for cost control and the benefits of direct revenue-cycle improvements.

Cost control opportunities are often seen as “soft” financial benefits because they are realized secondary to other operational or customer satisfaction improvements. However, revenue cycle-improvements can be tangible: they can result in better cash flow and reduce outstanding accounts receivable.

When accurate provider information is centrally managed and automatically shared across IT systems and departments, staff has to spend far less of its time finding and correcting inaccurate information on individual providers in their local system. Such automation amplifies the amount of time saved and could reduce the need for more staff and lower personnel costs.

Do you have long care-to-claims submission process due to poor quality referring provider information?

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Eliminating inconsistencies in entered provider information across IT systems – due to human error --may further reduce these costs when departments rely on the information others manually entered. These improvements are extremely valuable to marketing and provider outreach efforts that rely on accurate provider information to maximize the effectiveness of individual initiatives. Redundant efforts caused by inaccurate provider information not only wastes staff time but it also risks alienating potential providers.

If erroneous provider information is manually entered into admissions, registration and ancillary systems at the beginning of a patient encounter, or critical information is omitted, or inaccurate data is pulled from the EHR, the billing cycle slows. Ignoring the effect of inaccurate provider billing addresses, insurance affiliations and provider identifiers will have the same effect as the wrong billing or diagnosis code. Inaccurate provider information also means delayed payments and an increase in the number of invoices that must be resubmitted. When this effect is amplified by the cost of capital, it becomes easy to see how solutions that improve revenue cycle, such as the Phynd solution, can easily pay for themselves in a very short time.

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