Revenue Cycle Services: Put your data to work for you and your clients

It’s no surprise that more ambulatory practices are outsourcing their billing and collection processes due to complex regulations and changing payment models that make it more difficult than ever to get paid. In fact, 90% of solo physician practices plan to outsource billing and collections within the next 24 months, and small physician practices (1 to 5 practitioners)with employed billing staff plan to outsource within the same timeframe.


Revenue Cycle Services

To meet market demands, revenue cycle service companies are increasing staff, while traditional electronic health record (EHR) and practice management companies are adding billing and collection services to their offerings. Due to increased demands and a growing market the competition is fierce.

To thrive in this market, Revenue Cycle Service (RCS) companies need solutions that set themselves apart from the competition by providing additional value to their current clients and prospective clients. As such, many are turning to comparative analytics solutions to better understand their data, establish benchmarks, compare performance against peers and develop actionable insights.

Comparative analytics solutions increase transparency into the revenue cycle process, enabling outsourced billing and collection companies to:

  • Earn new business and efficiently manage it once they get the contract by leveraging data about physician practice revenue cycles
  • Identify and proactively address issues before they impact cash flow − for themselves and their clients
  • Benchmark key metrics and compare the performance of themselves and their clients against peers
  • Access data in a timely manner so they can work denied claims, resubmit them and get paid before they impact cash flow
These solutions allow RCS companies to differentiate themselves from competitors by giving them insights into revenue cycle processes that others can’t deliver. Most importantly, comparative analytics solutions allow RCS companies to optimize business performance through increased productivity, more efficient denial management, and improved collections – for themselves and their clients.
Let’s examine how RCS companies are using comparative analytics solutions to gain a competitive advantage.

How Do Comparative Analytics Solutions Work?

Not all analytics solutions are created equal. Many people do not realize the differences between business
intelligence (BI) solutions and comparative analytics solutions.
BI solutions use technology that enables an organization to collect, maintain and organize specific knowledge,
such as key performance indicators. Traditional BI solutions primarily focus on an organization’s internal data,
and generally do not allow the comparison of data against peers.
Comparative analytics solutions leverage the concepts of business intelligence with the vital addition of
contextually comparing the data against peers and other benchmarks. Comparative analytics solutions include
the use of real-time data to benchmark against peer indicators, such as claim denial rates, denial reasons,
deviations in coding and claim types, staff productivity, payer performance compliance, utilization, and more.
More timely data allows for more accurate comparisons that reflect what is happening now so that it can be
corrected or modified immediately, before the financial impact is realized.

Staff Claim Processing Time (Days)

[caption id="attachment_3175" align="aligncenter" width="1062"]Revenue Cycle Services - Graph #1 Revenue Cycle Services – Graph #1[/caption]

Top 5 Clients by Denial Rate (%) with Comparisons

[caption id="attachment_3176" align="aligncenter" width="1075"]Revenue Cycle Services - Graph #2 Revenue Cycle Services – Graph #2[/caption]

Three Ways to Put Comparative Analytics Solutions to Work

1. Client Acquisition – Comparative analytics solutions enable RCS companies to thoroughly analyze

the actual revenue cycle data of prospective clients. With better insight into prospective client data, RCS companies can identify areas needing performance improvements and deliver that information in proposals to earn new business. Additionally, comparative analytics solutions allow RCS companies to benchmark client performance and compare to peer organizations, such as:
  • How fast they are getting paid
  • How their code utilization differs

2. Client Retention – Using comparative analytics solutions provides opportunities for RCS companies to deliver services that were previously unavailable. Analyzing a client’s actual revenue cycle data with comparative analytics solutions creates transparency to identify issues that impact business performance. It also allows comparisons against peers with real-time data access, instead of historical data from published reports that is often outdated. For example, RCS companies using comparative analytics solutions can provide their clients with peer comparisons that evaluate:

  • Utilization of codes and modifiers
  • Denial rates
  • Payment velocity (payer payment turnaround time)
  • Staff productivity and efficiency
  • Compliance and audit risks
3. Improve the Performance of Your RCS Business – The same analytics used to improve the performance

of clients can be leveraged to focus on the metrics affecting the performance of RCS companies. With comparative analytics solutions, RCS companies can focus on ways to accelerate reimbursement to improve cash flow – not only helping to improve the bottom line, but also benefitting clients.

Put Your Data to Work for You and Your Clients

Comparative analytics solutions allow organizations to gain insights from data that previously were not possible
or were too time-consuming to compile manually. With more ambulatory practices looking to outsource their
billing and collections – and with more services vendors entering the marketplace – RCS companies need to
focus on initiatives that will differentiate themselves from competitors.
The RCS companies that leverage comparative analytics solutions will gain a competitive advantage by improving
the proposals that they present to prospects, while also expanding upon the insights and services that they
offer their existing client base.

Read the complete white paper.