A reporting tool for RCM functions Introducing RCM SnapShot™
Revenue cycle management (RCM) is a complex process, and one with which healthcare systems often struggle. On a given day, a hospital may deal with dozens of diverse claim types, hundreds of unique insurance plans, and thousands of complicated billing scenarios. The difficulty of aggregating many disparate data sources can compound these issues and make it nearly impossible to provide timely insights about the revenue cycle process. Such confusion often results in payments that are delayed, lower than expected, or outright denied. Without the appropriate tools, a mismanaged revenue cycle can dramatically impair a hospital’s bottom line.
VortexT’s RCM SnapShot™ offers the solution to these all-too-common problems by providing a reporting tool for the key functions in RCM. These key functions include payment balances, accounts receivable, and denial management. Through a unique blend of configurable definitions and statistically-based rules, RCM departments can quickly and easily monitor vital metrics and investigate potential sources of lost revenue.
Features of RCM SnapShot™
- Utilize robust filtering capabilities to drill down into the account-level details. Filter by: facility, payer, bill type, financial class, service line, financial responsibility, date ranges, and more.
- Compare payer-to-payer performance and identify statistically valid outliers to assist with payer contract negotiations and root cause analysis.
- Define and analyze denials and underpayments at the procedure level (rather than simply the account level) and assign appeal priorities based on claim adjustment reason codes, payer, and patient type.
- Categorize denial reasons and automatically detect shifts in payer patterns (e.g., changes in clinical vs. clerical denials).
View data in easy-to-interpret graphs and tables. All data is exportable as CSVand Excel formats.
- Combine data sources—claims and remits, charges and payments, ADT and payer information—into one reporting tool.
- Provide an overview of the entire revenue cycle process through dozens of key metrics in these main areas: operations, billing, denials, and accounts receivable.
- Track RCM metrics over time to easily and routinely identify trends and outliers.