Insights from Advent

How Technology Impacts Bundled Payments

Posted by Advent Health Partners on Mar 28, 2018 9:00:00 AM

The bundled payment model has taken hold for payers, and it doesn’t look like that momentum is about to slow down. According to a recent study, bundled payments are likely to grow by more than 5% between now and the next several years, making them the single quickest-growing payment model in healthcare.

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The State of Value-Based Payments: Payers' Perspectives

Posted by Advent Health Partners on Mar 20, 2018 10:00:00 AM

Most of us think of the implications of value-based care in terms of how they affect providers. But they impact payers, too. With value-based care's emphasis on improving the quality and efficiency of care delivery, payers are increasingly recognizing the need to adjust their policies and practices according to this approach.

Since 2015, the percentage of insurers that have sought to align with this model has doubled. Here are some of the key considerations that payers are thinking about -- and acting on -- in striving toward a value-based payment model.

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What Improvements from Data Analytics in Healthcare Can Payers Expect?

Posted by Advent Health Partners on Feb 28, 2018 8:30:00 AM

As computing technology expands to mine the world's digital records for valuable, actionable information, “big data” is the buzzword infiltrating the business world. In healthcare, it can be defined as "electronic health data sets so large and complex that they are difficult (or impossible) to manage with traditional software and/or hardware; nor can they be easily managed with traditional or common data management tools and methods."

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How Claim Review Technology Helps Government Payers Be More Productive

Posted by Advent Health Partners on Feb 13, 2018 8:30:00 AM

Settling provider claims fairly and efficiently is paramount not only for commercial health insurance organizations but for government payers, as well. Considerable resources pour into that effort even when all goes well, but when questionable claims arrive, productivity can take a dive -- and inappropriate payments can be costly.

When -- and why -- do payers waste time and money on review?

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Resolving the Document Intake and File Management Nightmare for Coders and Clinicians

Posted by Advent Health Partners on Jan 31, 2018 10:00:00 AM

Documentation in healthcare is a large issue that technology can address far more seamlessly than prior manual methods allowed. When you consider the amount of information that's collected for a single patient, the data can be immense. Multiply that by every patient who enters a facility and then further magnify that by the amount of documentation needed to run the administrative and financial aspects of an organization.

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Technology Can Easily 3x Claim Review and Intake Processes: Here's How

Posted by Advent Health Partners on Jan 16, 2018 10:32:09 AM

In an era of constant change in healthcare paradigms and regulations, claims-management can be cumbersome for payers. Consider how automation can help you triple the effectiveness of your document intake and claim review processes.

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The Impact of Medical Image Scanning on Machine Learning

Posted by Advent Health Partners on Dec 20, 2017 10:00:00 AM

As any reviewer who has to deal with medical claims knows, it is an extremely time consuming process to sort out legitimate claims to approve from ones that need to be denied. An employee handling any given claim will need to look through a large pile of submissions across formats, manually log the information into the chosen system and then begin to access the merits of the claim. When the claim is finished, it will be time to start on another one and on it goes. Thankfully, there is technology in place that can enable machine learning in order to not only dramatically shorten this process, but also make it far more accurate and efficient than it has ever been before.

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4 Strategies to Improve Healthcare Claim Review Efficiency by 100% +

Posted by Advent Health Partners on Dec 12, 2017 8:30:00 AM

Medical facilities are busy places with people coming and going at all hours of the day. When all is said and done, each facility could have hundreds— if not thousands— of insurance claims occur each week.

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3 Ways Payers Can Review Insurance Claims More Efficiently

Posted by Advent Health Partners on Nov 29, 2017 9:30:00 AM

There are two different methods hospitals use to deliver insurance claims to payers: on paper and electronically.

Most healthcare providers have adopted payers’ prefered method of an electronic claim system. An electronic claim system that is integrated into an EHR allows for a faster, more accurate, and cheaper way to process claims.

But because paper claims have not yet been completely removed from the insurance claims process, payers face a challenge - how can they aggregate all of their data all in one place?

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How Technology Can Solve Payment Integrity Challenges

Posted by Advent Health Partners on Aug 29, 2017 1:30:00 PM

Payment integrity has become an essential part of the process for healthcare organizations, but it's traditionally been given a lower priority in resources. As Healthcare Tech Outlook noted, organizations often devote their IT and analytics resources to specific concrete areas, such as billing or claims. If your organization focuses more on payment integrity as an umbrella to ensure that the overall revenue cycle management of your organization runs smoothly, technology and analytics can significantly improve your projected data and bottom line.

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