How to Track and Improve Billing Patterns with Predictive Analytics and Insights

Predictive analytics can do a lot for your facility. With a deeper, more accurate view into your billing patterns, you can see trends in billing mistakes, claims denials and other patterns that may cause delays and other problems in your revenue cycle.

Traditional analytics applications give you a look back at things like your billing, care required, care provided and reimbursements. While these insights are no doubt useful, they inevitably come with a delay. With analytics, you can leverage the power of machine learning and big data to identify trends and unintended billing patterns before claims are even submitted.

So, how can you implement analytics to track and improve your billing cycle?

Predictive analytics and insights in the shift to value-based care

In the transition to alternative payment models (APMs) and other value-based care reimbursement models, you will no longer simply bill patients and residents based on the services you provide. Rather, your reimbursements will depend on several factors, including the quality of care you provide, patient experience and patient outcomes.

This shift in billing and reimbursement models comes with new billing patterns and the opportunity for more mistakes. However, by recognizing and analyzing past billing mistakes, you can adjust accordingly to submit more clean claims the first time around. Using the latest technology to triple-check universal billing (UB) and other claims, you can create better continuity between the care you provide and the reimbursements you receive. And, by automating manual processes — such as the time-consuming UB-04 check — you can save time and labor for your billing staff, as well.

Better insights: Minimizing audit risks and increasing revenue

Monitoring and analyzing your billing cycle will make it easier to spot examples of when the underlying MDS does not support your billing, or vice versa. Getting this feedback and insight early and having the opportunity to correct it prior to submission can help your facility avoid an audit.

At the same time, you may find treatment listed in the MDS that was missed on a claim. The opportunity to make these corrections early will result in more accurate claims that represent higher reimbursements for your facility. And accurate, clean claims also tend to get paid faster.

Using analytics to track your billing trends is exceptionally valuable, especially when it turns up new opportunities for increased reimbursement. With a tool like ABILITY UBWATCH®, you can coordinate financial UB records, potentially increase reimbursements, accelerate A/R and guide your facility toward continuous improvements in billing and patient outcomes.

Better billing practices and increased cash flow are within reach. Check out our application landing page for tips that can transform your revenue cycle management.

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