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Dan Murdoch

August 31, 2023
Revenue Intelligence
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4 Steps To Improving The Claims Adjudication Process with Adonis

4 Steps To Improving The Claims Adjudication Process with Adonis

Claims adjudication is a critical cog in the healthcare machine, determining the fate of healthcare claims. The aim for all providers is to ensure that the process is as seamless, efficient, and effective as possible. Through Adonis, a robust Revenue Cycle Management system, the journey can be streamlined to improve financial outcomes. Here's a look at how:

1. Embrace Automation with Adonis 

Automation's power to revolutionize operations and procedures throughout a claim’s life cycle, is undeniable. Adonis RCM stands out as a pioneer in this arena, providing healthcare providers with state-of-the-art automation tools. These tools serve a dual purpose. 

First, they drastically speed up the claims submission process, ensuring that claims reach their destination in a fraction of the traditional time. Second, they offer unparalleled precision, significantly lowering the chances of errors that lead to claim rejections. The built-in features for real-time error detection pave the way for smoother operations, allowing staff to direct their focus to other critical areas. 

Predictive insights further fine-tune the process, bolstering the chances for claims to pass through successfully on the first try. The result? A diminished reliance on manual checks and a sharp reduction in the vulnerabilities associated with them.

2. Enhance Accuracy with Front-End Edits and Coding Checks

The realm of  medical claims is riddled with intricacies, where even a minor oversight can result in substantial setbacks, including revenue losses, extended delays, and outright denials. Recognizing this, Adonis has seamlessly integrated cutting-edge editing tools that operate in real-time. One of Adonis’ largest hospital system clients has already reaped the dividends of aligning with this innovative platform. By leveraging Adonis's in-depth A/R evaluation capabilities, this customer received an invaluable insight: a staggering surge of $1.7 million in Accounts Receivable. 

This unexpected jump was manifested across 771 claims, with the primary culprit being CO266 denials. Such discerning revelations underscore the transformative potential of Adonis in pinpointing revenue anomalies.

By adopting this forward-thinking approach, providers can stay several steps ahead, curbing the chances of claim rejections right at the onset. This not only ensures a smoother claims journey but also prevents the time-consuming and often challenging process of manual rectifications post-rejection.

3. Facilitate Clear and Secure Patient Communication

In today's healthcare landscape, transparent and robust patient-provider communication is more crucial than ever. Adonis RCM acts as a bridge, strengthening this essential connection. With its integrated patient portal, individuals are empowered to have direct access to their comprehensive health records. This not only grants them the autonomy to review their data but also the ability to promptly identify and rectify potential discrepancies.

The value of this transparent access goes beyond just data accuracy. It instills a sense of ownership and responsibility in patients regarding their health information. By being actively involved, patients are more likely to be proactive about their health, leading to better overall outcomes. Moreover, this level of open communication builds a foundation of trust, ensuring that patients feel valued and understood. As a result, there's a natural and seamless progression in the claims adjudication process, with fewer hiccups and greater satisfaction on both sides.

4. Standardize with Adonis for Uniformity

The realm of claims adjudication is fraught with complexities, especially when dealing with the varying requirements and protocols set by different payers. Providers often find themselves navigating a maze of specifications, leading to inefficiencies and potential errors. Enter Adonis RCM – the game-changer.

By advocating a standardized approach, Adonis RCM reduces the complexities that often plague the adjudication process. Providers no longer need to juggle multiple formats or constantly update their systems to meet the ever-changing demands of different payers. Instead, they can rely on Adonis RCM's unified platform that's designed to be in sync with the latest payer guidelines. This not only ensures that claims are consistently up to par but also expedites the review and approval process. The result? A more streamlined workflow, reduced denials, and enhanced revenue generation for healthcare providers.

To learn more about Adonis can help you as a healthcare provider, use the scheduling link below to set up a quick demo call.

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