Case Study
Optimizing the Revenue
Cycle for Healthcare
Introduction
Lydonia Technologies transforms the Healthcare claims process
By partnering with a leading GI specialist in healthcare, Lydonia Technologies was able to revamp the client’s charge entry process and optimize claim submission and reimbursement procedures. Through intelligent automation, they achieved operational efficiency, minimized manual work, and enhanced revenue cycle management.
Challenges
The manual claim entry process posed several challenges for the company, including:
- Time and resource-intensive: The process required a dedicated team to manually enter claim information, leading to significant time and effort expenditure.
- Potential for errors: Manual data entry increased the risk of human errors, leading to claim rejections and delayed reimbursements.
- Operational inefficiencies The manual process resulted in a lag in charge entry and increased overtime payroll costs.
Approach
The charge entry process is vital for effective revenue cycle management as it enables the submission of claim data to payers for reimbursement. Previously, the company relied on manual claim entry, taking two to three minutes per claim. With an annual volume of 600,000 claims for GI procedures, this manual process consumed a substantial amount of time, totaling up to 1,800,000 minutes per year
Results
The client’s intelligent automation program is operating across 70% of the total centers serviced by the company and is growing everyday. To handle cases that automation cannot process, targeted exception-handling protocols have been established, with an expected occurrence rate of 2% to 5% of total transactions.
Apart from saving 3,750 full-time equivalent (FTE) days per year in the charge entry process, the company anticipates several additional benefits:
- A reduction in claim denials, thanks to improved accuracy and data quality
- A decrease in the time it takes to enter charges, with the lag reduced from two days to one
- Decrease in overtime payroll expenses
- Expedited claim approval and reimbursement