Current Situation
Providers cannot afford to miss any opportunities to optimize revenue and acquire new, or retain existing, patients via better payment processes, revenue cycle interactions, and financial experiences. Payers are streamlining the payment process, adopting value-based initiatives, and melding with provider RCM to enable one bill and other consumer-friendly paradigms.
Goals and Objectives
Increase the likelihood of revenue assurance and integrity to be achieved upfront. Facilitate the ability for patients to uphold their financial obligations throughout the journey and benefit from better experiences. Drive better organizational performance and financial health. Enable member loyalty to insurance companies.
Technology Deployed
Digital, voice, and printed messaging and outreach tools
Web-based cost estimators and online bill payment tools
Predictive analytics and modeling algorithms
EHR and RCM integrations, payer rules engines, claims processing, and clearinghouse interfaces
Bundled payment processors
Adjudication engines
Preauthorization engines
Member responsibility calculators
Use Case Summary
Patient financial management includes multiple technologies and capabilities that ensure providers and payers to shape an end-to-end dialog with the patient that clarifies financial obligations, increases the propensity to pay, and decreases the likelihood for amounts to be owed or transferred to collections.