5 Themes from HIMSS16

March 06, 2016

OS President Lori Zindl and OS Director of Product Strategy & Development Pat Curran attended the annual HIMSS Conference February 29-March 4 in Las Vegas, where they discovered the newest technologies, trends and solutions in health IT. Lori and Pat walked away with these five prevalent themes:

Emphasis on Denial Prevention over Denial Management

We already know the ultimate goal is to eliminate denials completely rather than manage denials that already happened, but the analytics available today show the costs of denials, appeals and rework are huge!  Providers need systems like efficientC that do more than track and trend denials – a system that will eliminate them.

Structure Workflow around Denials More Likely to Pay

Do you know how many appeals are sent out of your office?  More importantly, of those you send, how many are paying?  Providers need data on appeal/rebill success rate in order to make good decisions on where staff should be spending their time.

Tackle Denials Daily

The days of working high to low and old to new are gone and systems that only sort this way are being phased out.  Denial and workflow systems should be based on the premise that your team needs to manage a day’s worth of denials EVERY day.  With the right filtering, sorting and workflow distribution it is possible and prevents untimely follow up resulting in unnecessary write offs. 

Estimate What Patients Owe Prior to Scheduling

Out-of-pocket estimates given to patients prior to scheduling helps them decide if they want to come in for the service. The OS team met with some vendors that have pretty amazing tools for estimation and verification.  Technology has really improved in this area and it’s no longer an option for healthcare providers to not be doing this. 

Collect Up Front

Interesting that the hospitals who talk to patients up front about expenses actually have higher patient satisfaction scores than those who don’t.  So invest in upfront technology and beef up your pre-registration and collection process.