Solution for Healthcare Denial Management

Improve your organization's financial performance

Healthcare organizations invest heavily in choosing the right billing and AR systems, yet most solutions fail to capture or contain the content needed to effectively manage your business. OnBase Revenue Cycle solutions can help.

The fact is, much of today’s business content is still communicated in an unstructured format, such as phone, fax, email, or through other paper-intensive work processes. As a result, today’s HIS solutions are often ill-equipped to help manage the information needed for healthcare workers to make timely and efficient decisions on behalf of the organization.

Benefits of denial management in healthcare

OnBase RCM’s receivables management helps today’s healthcare facilities capture, store, process, integrate and manage exception-based accounts, along with all of the unstructured content that encompasses them. The result is single, system-wide workflow solution that enables healthcare organizations to:

  • Improve their days receivable outstanding (DRO), receiving more cash, faster
  • Reduce their cost to collect 
  • Increase account collections and decrease denial/defects
  • Unify disparate data into a single platform with one-click access 

OnBase RCM combines the best of OnBase’s Enterprise Content Management (ECM) repository with a client-definable RCM user interface, along with simultaneous access to your line-of-business billing and AR system for seamless integration and ease of use – a key step for efficient workflow. Moreover, the Denial Management solution identifies the reason and source of each denied claim, allowing your staff to isolate and prevent future reoccurrence of the denial while improving training of those involved in the process. As a result, cash flow is improved, denials are reduced and staff is freed to resolve even more accounts. Oversight and management of the solution is provided through client-definable work queues, tracking performance at the facility, department, or user levels with dynamic drill-down reporting and charting tools for real-time status, data analysis and trending, and productivity.

The application tracks the complete cycle of open receivables, including both open AR and denied accounts, and it generates reports to identify the efforts that resulted in payment. Additionally, lag times between follow up and resolution are documented, providing valuable information when it comes time for contract renegotiations.

Proven RCM solutions for patient financial services

Because OnBase RCM provides the tools to capture denials, analyze trends and identify key issues that result in defects and denials, management can make informed, knowledgeable changes within those deficit areas. The account analysis application provides the tools needed to help:

  • Identify the root cause of your most costly denials
  • Detect denial patterns and trends, as well as process breakdowns
  • Assess the financial impact of denied claims, delayed payments and partial payments
  • Analyze the effectiveness of follow-up resolution procedures
  • Uncover areas for improvement in your overall business process

The healthcare revenue cycle consists of a complex set of data-intensive work processes, inherently presenting opportunity for heightening efficiencies. Hyland Software’s RCM solution enables hospitals and healthcare organizations to manage many significant aspects of the revenue cycle – at both a document and data level. This includes capturing data/documentation from the initial patient touchpoint in patient access through the final collection process, which helps ensure recovery of appropriate reimbursement for services rendered. As a result, critical information becomes immediately accessible to those people who need it, when they need it and within the applications they use most. Organizations can automate the handling of data and information from practically any source and seamlessly integrate with any application, thereby reducing manual work effort and the potential for error. In addition, once data is captured and resides within the system, data analytics and report mining become a natural byproduct of the solution’s workflow, thereby providing improved business intelligence for more informed business decisions.

The connected healthcare enterprise with OnBase by Hyland