During recent years, outsourcing by health system administrators has evolved as a practical strategy to enhance profitability and enrich financial performance margins. Offshore sourcing engagements also play a critical role in easing the strain these same executives face due to the shortage of skilled workers here in the U.S.
Everyone acknowledges that the US healthcare system has many inefficiencies that drive costs up and impede the delivery of care. The current prior authorization (PA) process is a perfect example of this as it is fraught with issues that create higher costs, frustration for care providers, and more importantly can lead to adverse outcomes when patients are not treated timely and judiciously.
The objective of this paper is to spotlight four developments that impact the face of revenue cycle management as we know it and, by extension, construct a different future for the back-office processes in healthcare.
The Problem: A leading orthopedic specialty group in the Southeast came to Vee Healthtek with a major scheduling problem: its front office team could not keep up with calls from patients looking for appointments.
The Problem: One of the world’s leading cancer hospitals was struggling to keep up with its overwhelming volume of prior authorization requests. Although it had hired a vendor to help with reviewing and submitting the influx of requests, the problem persisted.
Physicians today cite the administrative burden added to the work of patient care as the main reason for burnout. Chief among those administrative burdens was documenting in the electronic health record (EHR).
The Problem: A leading health system in the Northeast came to Vee Healthtek with a problem: its quality of patient care was decreasing due to low provider engagement during pre-visit reviews. Conditions were overlooked and important contraindications were missed, exposing the health system to the risk of making serious but preventable errors during patient care.
The Problem: Vee Healthtek was approached by a large hospital in the Northeast that was experiencing significant gaps in clinical documentation, which resulted in the under-capture of HCC conditions.
The Problem: A large, multi-specialty medical group and health system on the West Coast was on the brink of a financial crisis due to its poorly managed accounts receivable process.
