Strategic data leverage helps healthcare providers navigate rising claim denials and reclaim lost revenue streams
In this episode, Jeff Tanner takes a thoughtful exploration into the intricate landscape of healthcare, focusing on the hurdles healthcare providers often encounter concerning revenue and reimbursements. Drawing from his extensive experience and insights gained through his association with Acclara, Jeff delves into patterns he’s observed across numerous healthcare facilities, addressing the nuanced changes in insurance company strategies that lead to a rise in claim denials.
Jeff also underscores the significance of data in healthcare, pointing out both its immense potential and the challenges it presents. Interpretation and application of this data become crucial, especially when healthcare providers are inundated with vast amounts of it. The episode also touches on the importance of having a broader perspective, enabling providers to proactively address issues and anticipate future challenges.
Jeff’s perspective offers a unique blend of expertise, highlighting intersections between healthcare practices, data management, and consultancy.
Jeff’s perspective offers a unique blend of expertise, highlighting intersections between healthcare practices, data management, and consultancy. This discussion is ideal for healthcare professionals keen on deepening their understanding of their industry’s financial intricacies, data implications, and the evolving landscape they operate within. It’s not just a conversation about problems but also a deep dive into sustainable solutions for the future.
Video TranscriptExpand ↓
There's so many challenges that, you know, there's probably somebody that has endured or solved that challenge before and leveraging that expertise really helps these these providers. Tell us, so we we're gonna talk about denials and and the increase that we've seen in those rates and and the challenges that presents But let's talk about the consulting side of it for for a little bit because I like y'all's approach, at Acclara in terms of flipping this dependency. And, so talk a little bit about, you know, what that consulting engagement looks like when Acclara partners with a provider. Sure. And, you know, to preface that, I would say an important thing for providers to know is how to create a successful consulting engagement before the consultant steps on the floor. That's the most critical part of a consulting engagement. Is knowing what it is you're trying to solve for and having the, you know, the outcomes and the measurements of how you're gonna show success. So I would say be very careful about how you engage before you engage. But the way, I've operated for many years and many of my colleagues. We all of us have pretty much the same list of areas we're gonna go look at. You know, I'll I know this is a problem at the ten other facilities I've been at. It's probably a problem here. Yeah. Let me go look there. And I do tend to find a lot of the same issues that plague most hospitals. They really haven't changed all that much, but we are seeing some new, we'll call them strategies by insurance companies that are increasing denials that have a very difficult path to recovery. You know, I think you, you've touched on something there that I think it's important for the entire provider community. When when partnering with yourself and companies like Acclara, you guys have a unique perspective, almost a a bird's eye view of what's going on across the provider community because you work with so many different providers and you get to see things at a higher level, which gives you ideas on where opportunities might be at a specific provider. The provider alternatively you know, they're they're solely focused on their data, their revenue, their reimbursement, and sometimes they don't get that get that wider picture And, I bet that pays off when you bring that perspective. It does. A lot of times, the providers know they have a problem but they can't put their finger on it. And and a lot of that is because there are difficulties with data. There's, you know, how do you analyze the data? What outcome do you see out of that data can be very different depending on who you ask. And if you're using, for example, an eight thirty five source, the versus your, you know, your system that you're using. You can end up with varying things, and and it's hard to know what the truth is. And so when we come in, a lot of times there aren't specific metrics. It's just please help us. And we try to do that. So we go for the big things first. What's going to potentially bring in revenue as quickly as possible? Because ultimately, that's what we need to do. But then on top of that, we've gotta document everything. We have to train the staff that's there because when we're gone, we don't want that bucket to fill back up. Right. So we leave you with the tools and the knowledge necessary to stay on top of that area. And the things to look for in the future. And that's very important. Any consultant can come in and fix your problem today. But is it gonna be a problem in three months when they're on?