Denials are the biggest reasons for the revenue cycle underperformance. With payers constantly changing their requirements, and in some cases automating denials, providers often feel overwhelmed trying to keep up. Without meaningful denial analytics, providers struggle to find the root causes of preventable denials and are unable to take corrective action. The result is high A/R days, too many write-offs, and sluggish cash flow.
Waukesha-based ProHealth Care does not have any of these problems, thanks in large part to its use of efficiency. Not only is efficient a clearinghouse and a claim scrubber, but its Insights analytics platform also provides a robust denial analytics platform that enables leaders at ProHealth to quickly address the root causes of denials and improve financial performance.
“If you have current data coming through like we get every day through efficiency, we can get on top of things right away,” said Curt Glaunert, vice president of the revenue cycle. “If you have the right data coming through from a good system, you can use that to help correct problems. Not at the end of the month, not at the end of the week, but daily.”