In the competitive world of healthcare, where a whopping 90% of revenue is generated from insurance companies, capturing every dollar is crucial. Yet, the industry grapples with revenue leakage due to ineffective tracking of claims paid and denied, a situation further complicated by paper checks and documents. The result? An escalating toll on an already overwhelmed accounting staff.

However, emerging technologies offer a solution to this multi-million-dollar conundrum. Automating Revenue Cycle Management and introducing AI workers provide a better way forward. With these tools, organizations can automate claim auditing and account reconciliation processes, improving accuracy and reducing revenue leakage.

Revenue Reporting and Reconciliation is one such suite of automation products already proving invaluable to healthcare organizations nationwide. With this in mind, let's dive into three ways Surveil is helping organizations save millions. 

The Case For Streamlining the Healthcare Reconciliation Process

Hospital finance departments are constantly struggling, often stressed by the pressures of patient payment collection and accurate financial recording. The nerve-wracking task of payment reconciliation—linking a patient's payment status with the respective bank deposit—has become a choke point in an otherwise smooth process.

Most healthcare organizations are still burdened by manual reconciliation, a practice that is not just time-consuming and error-prone but also redundant in this age of digital solutions. Closing monthly accounts becomes a significant hurdle, as revenue cycle managers are swamped with queries about payments made throughout the previous month. This is further complicated by multiple payment systems, bank accounts, and payment card providers, all closing at different times.

But there's a clear path forward—automation. An effective automated reconciliation service empowers revenue cycle managers to pinpoint the funding status of any patient payment, identify the costs included in a specific bank deposit, and recognize any canceled payments or ACH returns such as insufficient funds, invalid accounts, or chargebacks. Automation is not just a convenience—it's a necessity for modern healthcare finance.

How Revenue Reporting and Reconciliation Is Saving Millions in Revenue Leakage

Claims Auditing

Revenue Reporting and Reconciliation automation significantly enhances the efficiency of both external and internal claims audits. It swiftly tackles common claim denials and delivers crucial insights into aging claims. Revenue Reporting and Reconciliation uncovers significant patterns in claims denials across payors and locations by intelligently cross-referencing diverse data sources—from payor portals and clearinghouse data to internal systems and emails.

Consider this scenario: Revenue Reporting and Reconciliation detects a pattern of denials related to incomplete documentation from a specific payor. It immediately alerts the staff, enabling them to call to resolve the issue promptly. As denial reasons are tracked and standardized across various payor platforms, this real-time response addresses the immediate problem but also aids in preventing future occurrences. Ultimately, Surveil supports transparent, concise performance reporting, making claim management smoother and more effective.

Account Reconciliation

Revenue Reporting and Reconciliation automates regularly reconciling accounts across multiple banks and compares them against the debits and credits posted to the Electronic Health Record (EHR). This automation eliminates the need for time-consuming manual reconciliation and allows for comprehensive account reconciliation daily. Identifying problem areas sooner enables faster course correction, freeing up the team's time for analysis and next steps rather than manual reconciliation tasks.

Consider this scenario: Revenue Reporting and Reconciliation identifies an irregularity in the EHR transactions compared to the bank records. This immediate detection enables a swift correction course, averting potential long-term complications. 

Revenue Reporting

Revenue Reporting and Reconciliation automates Revenue Cycle Management (RCM) reporting, providing valuable insights into performance. It helps identify bottlenecks and opportunities for improvement in the revenue cycle, offering actionable intelligence that can help organizations improve their financial situation and focus on strategic goals. Revenue Reporting and Reconciliation automation can highlight training opportunities and effectively communicate these insights to leadership for prompt action, leading to enhanced revenue performance.

Final Thoughts

By harnessing powerful automation capabilities across claims auditing, account reconciliation, and revenue reporting, healthcare organizations can achieve a monumental shift in financial management. The benefits are undeniable, with an 80% reduction in time spent on reconciliation and audit reports and a 100% increase in the feedback loop for identifying patterns in denial reasons. This isn't about short-term financial tweaks; it's about fundamentally reshaping the financial management landscape in healthcare.