The pandemic has laid bare and, in many cases, worsened challenges in the area of revenue cycle management (RCM). Building on McKnight’s recent, high-level roundtable discussion involving pivotal healthcare leaders, a complementary podcast explored the situation that home care and long-term care firms are currently facing.

Participants included:

Missy Miller, VP, Commercialization, Waystar

Cody Chambers, Regional Director, Waystar

Tim Dawson, Account Executive, Waystar

Moderator: Diane Eastabrook, writer, McKnight’s 

Since the onset of COVID-19, health care employment has dropped by 524,000 people. In September alone, 17,500 jobs have been vacant and the demands on our healthcare teams are only increasing. This has resulted in, as Eastabrook mentioned on the opening of the podcast, a major challenge for healthcare, particularly in business operations and administration including billing and revenue cycle management.

“As the staffing shortages affect the revenue cycle landscape, we have to get smarter about the way we work with fewer resources,” said Miller. “The reality is that we can’t hire our way out of this situation, we have to innovate and lean on technology, making sure we are utilizing the best solutions to solve these intrusive problems and help providers get paid quickly and accurately.”

As Chambers noted, one of the biggest challenges in staffing is a lack of expertise which is especially true in long-term, post-acute, home health, and hospice care settings. “The type of expertise that is needed can’t be obtained in a classroom setting, it can only be learned through experience and quality training. When there is turnover, a large burden is placed on the organization to train new staff and even more so when there are old, antiquated systems and processes. When organizations choose to incorporate new, automated technology that’s intuitive and easy to use, the result is twofold: They can quickly onboard new staff and automate manual complex processes,” said Chambers.

To Dawson, embracing intelligent technology not only has the potential to streamline and ease the process of training staff, but it also has the ability to increase visibility into the overall financial health of an organization. “Another challenge with outdated systems is the lack of transparency,” he noted. “Bringing multiple data sources onto one single platform allows you to not only see and understand the financials for the entire organization, but identify and quickly address problematic areas.”

Staff workloads & the right information

The process of leveraging automation, as Miller sees it, can be viewed in two different categories—reducing the number of human touches that are required and when required, empowering team members with actionable insights. 

“Providers still use error-prone manual processes today,” she explained. “Waystar can apply intelligent automation to remove those manual tasks so that the team can focus on complex initiatives that require intervention to yield better outcomes.”

Miller points to RPA (robotic processing automation) by way of example.  “RPA enables provider billing staff to automate time-consuming processes, such as retrieving eligibility information from payers.  Moreover, by adding in expertise around how best to retrieve that information the provider can gain more accurate, useful information much faster than if they were to have to call each payer on the phone or manually go to their website.  Getting this information right not only reduces denials by confirming eligibility but can even help identify insurance coverage that patients didn’t even know they had – which means the patient benefits and the provider gets paid.”

“This same technology and automation is how we can empower teams to work by exception so they can focus on what needs their attention most. I like to think of it as enabling teams to do more with less especially if organizations are facing labor shortages,” said Miller.

Everyone agreed that automating and streamlining workflow processes increases productivity by cutting work time that would normally be 30 minutes or more down to seconds, giving staff the opportunity to complete higher value tasks, or as Missy put it, work by exception—only touching claims that need intervention. 

Managing new technology

Everyone on the panel agreed that intelligent automation saves providers time and money, and it’s important for the entire organization to understand the overall benefits that technology will bring. 

Chambers said, “During our roundtable discussion, it was clear that helping our clients explain to their staff why they’re making these changes is imperative. Staff want to know ‘how will my day-to-day change?’ and how is this going to streamline cash flow for our organization so we can focus on patient care?”

It is important for teams to understand that adopting intelligent automation will automate repetitive, redundant tasks, allowing them to focus on more complex projects and high priority initiatives.  As Miller explained, “For example, by using predictive analytics to analyze payer patterns, Waystar can time remits, identify when a claim needs intervention, how likely it is to be paid or even if it’s likely to be denied – and appealed successfully. Intelligent automation is taking all of these different technologies and predicting patterns to enable the staff to work smarter and be more informed as they go through their day-to-day initiatives.”

“We want to give our clients the tools to be proactive instead of reactive,” said Dawson.  “That’s really what we’re here for, to be a true partner for transformation.”