Author image - Revenue Cycle Management with Adonis

Dan Murdoch

May 30, 2023
  -   
5
  min
Revenue Intelligence
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Spring 23' Release: Revenue Intelligence Platform Innovation Forges On

Spring 23' Release: Revenue Intelligence Platform Innovation Forges On

Healthcare providers are often challenged with managing their billing processes efficiently. Being unable to readily identify collection rates or specific issues in their billing process can be a significant hindrance. Even the most sophisticated billing teams often lack the necessary insight to identify and rectify these problems.

Identifying the Problem

In today's complex healthcare landscape, providers often grapple with several challenges related to their billing processes. These issues can compromise their ability to effectively manage and optimize revenue cycles.

Primarily, these challenges stem from three fundamental areas:

  1. Outdated Billing Platforms: Many healthcare providers still rely on antiquated billing platforms. These systems are not only often inefficient, but also lack comprehensive reporting functionality. This deficiency hampers providers' ability to accurately track and analyze their billing processes, leading to potential revenue loss and inefficiencies.
  2. Lack of Actionable Intelligence: Even when reporting capabilities exist within a platform, the reports generated often lack actionable intelligence. This means that while they might present data, they don't offer the insights needed to identify issues and rectify them. As a result, significant time and effort are required to analyze these reports and extract meaningful information, slowing down the problem-solving process.
  3. Sophisticated Denials from Payers: Finally, the billing process is further complicated by the increasing sophistication and automation of denials from payers. This complexity often results in providers struggling to navigate the intricacies of these denials, leading to delays and potential revenue leakage.

Adonis Intelligence: Addressing the Challenges Head-On

Adonis Intelligence presents an innovative solution designed to effectively address these challenges. By integrating advanced features into a user-friendly platform, Adonis Intelligence empowers healthcare providers to take control of their revenue cycle management.

  1. Modern Billing Platform: Adonis Intelligence provides a modern, robust billing platform, overcoming the limitations of antiquated systems. This platform offers comprehensive reporting functionality, giving providers the tools they need to monitor and manage their billing processes effectively.
  2. Actionable Insights: Adonis Intelligence goes beyond raw data, providing actionable insights that can drive decision-making. These insights help identify root cause issues, allowing providers to rectify them promptly, reducing the time and effort required for analysis.
  3. Navigating Payer Denials: Adonis Intelligence also offers a solution to the challenge of payer denials. By providing real-time insights and alerts on denials, the system enables providers to react swiftly and effectively, preventing potential revenue leakage.

By addressing these critical pain points, Adonis Intelligence is setting the stage for more efficient, effective revenue cycle management in the healthcare sector. By offering real-time, actionable insights and executive-level KPIs, Adonis Intelligence provides providers with the tools they need to collect their hard-earned revenue effectively.

Adonis Intelligence's Solution: Executive-Level KPIs

In the realm of healthcare revenue management, one of the most significant challenges is the tracking of key performance indicators (KPIs). These indicators, spanning segments like Payment, Accounts Receivable, Denial, and Payer Performance, are critical for executives to gauge the financial health of their organizations. Unfortunately, the information is often scattered or not readily available, making it difficult to identify and address areas for improvement.

Adonis Intelligence addresses this challenge head-on by providing executive-level KPIs across the four primary segments. This comprehensive overview allows executives to gain a clear picture of their organization's financial health. By making these KPIs readily available and easy to interpret, executives can quickly identify and address areas that require attention, leading to more effective revenue cycle management.

Real-Time Billing Insights

Another common issue faced by healthcare providers is the lack of real-time insights into denials, account receivables, and claims. This lack of timely information can lead to delays in addressing potential issues, resulting in inefficiencies and possible revenue loss. Furthermore, when systems do provide alerts, they can often result in information overload, with trivial issues burying critical ones.

Adonis Intelligence counteracts this issue by providing real-time, actionable insights on denials, account receivables, and claims. These insights act as an early warning system for potential issues, enabling billing teams to act proactively. To ensure only critical issues are brought to the billing teams' attention, the system applies thresholds to the alerts. This approach helps avoid information overload and ensures teams can focus on the most impactful issues.

Underpayments

Underpayments by insurers pose a significant problem in the healthcare industry. Providers often find themselves receiving less than the contracted amount for a service, leading to revenue loss. Tracking these underpayments and correcting them can be a complex and time-consuming process, impacting the overall financial health of the organization.

Addressing this issue head-on, Adonis Intelligence offers an underpayments detection feature. The system systematically compares the contracted rate for a service against the actual amount paid, flagging any discrepancies. This proactive approach ensures providers are appropriately paid for their services, safeguarding their revenue and improving their bottom line.

Billing Process Customization

Customizing the billing process to ensure accuracy and efficiency is another challenging aspect for healthcare providers. Standard systems often lack the capability for creating custom scrubber edits, which can lead to inefficiencies and inaccuracies in the billing process.

Adonis Intelligence, in collaboration with ApolloMD, introduces the feature of scrubbing edits in Athena, a healthcare service system. This capability allows for custom scrubber edits to be created, improving the accuracy and streamlining the billing process. The scrubbing edits feature is a proactive approach that enhances overall efficiency in the billing process.

Reporting and Data Analysis

Accurate reporting and data analysis are critical for assessing an organization's financial health. However, standard reporting tools may not always cater to the unique needs of each organization. Furthermore, exporting data for additional analysis or integration with other tools can often be a cumbersome process.

Recognizing these challenges, Adonis Intelligence offers a comprehensive reporting solution. This includes standard claim and financial reports that provide immediate insights into key metrics. However, understanding the unique needs of each organization, Adonis also allows users to create custom reports. This flexibility enables a more detailed, organization-specific analysis.

Functioning similarly to Excel, the system allows users to easily sort and filter data. In addition, Adonis facilitates data portability by allowing users to export reports into .csv or .xlsx files. This feature simplifies data integration with other software or tools, enhancing the overall utility of the reporting feature.

Revolutionizing Revenue Management with Adonis Intelligence

Adonis Intelligence represents a significant advancement in revenue cycle management for healthcare providers. By providing real-time, actionable insights across critical aspects of the billing process, it allows organizations to proactively manage their revenue cycle.

The platform's features, including Executive-Level KPIs, Actionable Biller Intelligence, Underpayments Detection, Denial and A/R Alerts, and extensive Reports functionality, all contribute towards optimizing the billing process and improving the financial health of healthcare providers.

In a sector where efficient financial and operational performance can often be challenging, Adonis Intelligence offers a comprehensive, user-friendly solution. By harnessing the power of this platform, healthcare providers can enhance their billing efficiency, ensure fair reimbursement, and ultimately, focus on providing better care to their patients.

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