In order to streamline revenue operations, providers must optimize the claims process, manage denials, develop payment plans, and report on KPIs that impact the business of healthcare.
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Optimizing revenue in a healthcare setting no longer depends on rigid, managed point solutions. Salesforce's flexibility, thanks to a declarative workflow engine, allow providers to leverage its security, performance, and rich ecosystem.
High operational costs, claim denials, delayed payments, and manual processes
Salesforce Health Cloud, Mulesoft, and Sift Healthcare
Decreased operational costs, continuous data-driven improvement, faster payments, and fewer denied claims
To start, we recommend three products.
Configuring Health Cloud for revenue cycle management starts with creating personas, permissions, and roles for the key stakeholders. These include:
Health Cloud's case object allows us to group every patient interaction into a unified data point. This means that we configure queues for pre-registration collections, denied claims, and patient collection workload tracking. Additionally, we build workflow queues for collection and claims overturns.
We configure roles that route each case to a team member based on skill, capacity, and prioritization. This means that specific tasks are routed to the best team member to handle it. Furthermore, omni-channel supervisor helps management gain real-time insights into the team's workload, and collaborate in order to remove roadblocks are re-distribute tasks.
Thanks to Mulesoft, we're able to configure Health Cloud to display clinical information about patients, meaning that case workers have full context and 360-degree views for each task. It eliminates the need to navigate between multiple systems on the journey to improving the revenue cycle, case by case.
Penrod enables success for the future by configuring Salesforce knowledge to document the process for working with specific payers. We set these up to load automatically based on the case type, meaning that staff is enabled with the right information, at the right time, to create the best possible outcomes.
In order to enable leadership with the right data to drive better decisions, we configure a standard dashboard that contains:
This dashboards helps access the health of the revenue cycle management process, and helps leaders eliminate roadblocks to maximizing revenue.
Holistically, this system enables Health Cloud to act as a revenue cycle management platform to accelerate revenue, make processes more efficient, and ensure KPIs are being met.
Uncover the missing info, duplicate claims, and coverage details that cause denials before they happen
Prioritize denials based on their likelihood of overturn
Give leadership the data they need to drive continuous improvement