Author: Arnab Sen, Chief Strategy Officer, Omega Healthcare
From HealthLeaders Revenue Cycle Technology Week, Nov 13-17, 2023. https://interactive.healthleadersmedia.com/revenue-cycle-tech-week
What are the top two challenges revenue cycle leaders face when trying to implement new
technology and how can they solve them?
One of the biggest challenges RCM leaders face is having sufficient resources available to implement new solutions. This becomes especially difficult when new technologies need to integrate with existing systems, such as EHR, billing, and finance systems. Moreover, ensuring new solutions meet security and compliance requirements is essential. Leaders must stay ahead of evolving policies and regulations in today’s environment of cybersecurity threats data privacy.
The second challenge is managing the technology adoption curve. RCM leaders must be able to justify the investment and prioritize their needs against other initiatives within the organization. Administrative staff and clinicians will need to be introduced to new processes that can impact their daily workflows. While operational efficiencies and cost savings typically come with time, RCM teams must be ready to support change management efforts across multiple stakeholders.
What technology solutions does your company offer to revenue cycle leaders looking to
streamline possesses and efficiency?
Omega Healthcare offers end-to-end RCM solutions, enabled by the Omega Digital Platform (ODP), to drive improved outcomes across the Patient Access, Mid-Revenue Cycle, and Business Office functions. The ODP leverages artificial intelligence (AI), machine learning, natural language processing, and robotic process automation, to automate repetitive tasks, reduce turnaround time, and increase accuracy.
“AI and rules-based algorithms are integrated into workflows to identify eligibility and prior authorization issues, prevent denials, enhance coding accuracy, and prioritize high-risk claims.”
Given ongoing staff shortages and margin pressures, RCM leaders need solutions that can increase administrative efficiencies to improve revenues and accelerate cashflows, while reducing costs. The ODP uses AI and automation to remove manual tasks, thereby improving productivity and allowing staff and providers to focus on higher value activities and direct patient care.
The ODP also features a predictive engine to help prevent issues across the entire revenue cycle—even before they occur. AI and rules-based algorithms are integrated into workflows to identify eligibility and prior authorization issues, prevent denials, enhance coding accuracy, and prioritize high-risk claims.
Finally, the ODP enables clinical workflows that alleviate administrative burdens. Clinical documentation improvement (CDI) capabilities provide real-time feedback and education opportunities, enabling providers to become more efficient and compliant with their documentation, freeing up their time from administrative tasks.
What revenue cycle technology trends do you see emerging over the next few years and why?
Generative AI is garnering a lot of attention in the industry, and it does hold promise to improve process efficiencies, particularly with manual tasks and clinical documentation.
In addition, solutions are emerging that aim to identify and resolve issues in the front end of the revenue cycle, rather than waiting for a retrospective review during downstream processes.
Finally, the industry will continue pushing for increased integration of clinical and financial data and processes. As value-based care and tighter payer-provider relationships continue to evolve, these integrations will become more essential to enhance outcomes.