Healthcare Revenue Cycle Management (RCM) Solutions Powered by the Nividous Platform
Increase appointments, streamline claims management, and achieve faster claims to cash.
Healthcare RCM Automation Success Stories
RCM Automation with The Nividous Platform
The Nividous Platform-enabled Revenue Cycle Management process allows companies to utilize automation in order to have greater control over collection costs, make data-backed organizational decisions, reduce manual admin functions, increase operational efficiency, and produce positive financial performance across business units.
Revenue Cycle Management Process
Revenue Cycle Management initiates when a patient makes an appointment and concludes when a provider receives payment. There are five steps a company must complete once the process begins. These include:
1. Verification Of Eligibility
Providers will check insurance eligibility before seeing a patient to verify the parties responsible for payment. For employees, this process is often tedious and involves access to several insurer portals, increasing the risk of errors and rework. With Nividous Bots, this process is automated and error-free.
2. Medical Coding And Claim Preparation
Providers must assign an accurate code for each service and supply. Providers cannot collect from insurers without providing these codes, so accuracy is paramount. Automating medical coding with a combination of RPA, AI, and Low-Code Process Automation (LPA) — three pillars of the Nividous Intelligent Automation Platform — typically slashes time-to-cash in half.
3. Claim Submission
Providers transmit claims to insurers via online portals. Each insurer operates a separate portal, making coded integrations untenable. Nividous Bots operate through user interfaces, allowing providers to automate claim submissions through a diversity of insurer portals.
4. Dispute Management
Insurers often dispute or reject claims. By automating revenue cycle management with the Nividous platform, companies can implement rules to automatically escalate exceptions to staff, optimizing their talent pools for faster resolution and payment.
5. Claim Reconciliation
Insurers often transfer funds directly to providers’ bank accounts after approving claims. Staff must then reconcile these payments using complex financial systems. Nividous’ AI-powered bots can automate this task, eliminating human error.
What Sets the Nividous RCM Automation Solution Apart?
The Nividous platform combines RPA bots, AI capabilities, and LPA capabilities to deliver comprehensive process automation. The platform empowers users to create workflows and connect various intelligent automation components through plug-and-play tasks for humans and Bots. The platform also offers advanced analytics and dashboarding features for customized insights from relevant business KPIs, allowing administrators to continuously refine revenue cycle management with real-time visibility.
Key indicators important to Revenue Cycle Management include:
Accounts Receivable
Insurer filing limits usually expire 90 days from the date of service. The Nividous platform ensures timely payment within the industry-standard 30-45 days.
Bad Debt
Nividous platform-enabled automation helps you improve the effectiveness of your collection efforts and minimize your bad debt rates.
Discharge Not Final Billed [DNFB]
The cost effects of outstanding DNFB accounts and claim denials are staggering. Minimize claim delays and improve cash flow with the Nividous platform.
Net Collections
Improve the efficiency of your overall revenue cycle management process by 85% using Nividous end-to-end automation.
Clean Claim Ratio
Boost the average daily claims that pass without revision compared to the total number of claims accepted by 30%. It is a key indicator of claims processing effectiveness.
Document Processing
Nividous’ IDP capabilities, natively built within the platform, can save >$15/hour automating data extraction from patients’ insurance IDs, claims documents, etc.
Benefits of The Nividous Healthcare Revenue Cycle Management Automation Solution
- 45% Improved Claim Adjudication
- 60% Greater Efficiency for Patient Scheduling
- 55% Increased Patient Account Settlement
- 80% Improved Auditing and Compliance
- 75% Superior Management of Claims
- Over 90% Data Extraction Accuracy
- Up to 50% Faster to Implement
- Over 85% Reduction in Processing Time
- 6-8 Months to Realize ROI
- Lower Total Cost of Ownership
Revolutionize Your RCM with the Nividous’ Holistic Approach to Intelligent Automation
Hear it From Our Happy Clients
Discover how we’ve helped your peers succeed.
“Nividous platform-enabled process automation has proven to be a game-changer to support our rapid growth. Our highly skilled resources are freed up to focus on more value-added tasks, delivering better customer services. We have seen great success with Nividous platform across different departments. The platform has played an instrumental role in revolutionizing overall revenue management.”
AEG Vision
Chief Information Officer
“Nividous’ AI-powered RPA Bots allowed for frictionless medical data retrieval to complete complex coding that is required to ensure fast, maximum Medicare payment. The automation has also enabled us to file reports directly into our customer’s EMR (Electronic Medical Record) system within 24 hours thus cutting down on their administrative burden. With the success of this automation, we are anticipating a significant increase in revenues and overall cash flow for our business.”
Kane Wound Care
Founder & CEO
“Nividous platform-enabled process automation has proven to be a game-changer to support our rapid growth. Our highly skilled resources are freed up to focus on more value-added tasks, delivering better customer services. We have seen great success with Nividous platform across different departments. The platform has played an instrumental role in revolutionizing overall revenue management.”
AEG Vision
Chief Information Officer
“Nividous’ AI-powered RPA Bots allowed for frictionless medical data retrieval to complete complex coding that is required to ensure fast, maximum Medicare payment. The automation has also enabled us to file reports directly into our customer’s EMR (Electronic Medical Record) system within 24 hours thus cutting down on their administrative burden. With the success of this automation, we are anticipating a significant increase in revenues and overall cash flow for our business.”
Kane Wound Care
Founder & CEO
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FAQs
What is Revenue Cycle Management in healthcare?
Revenue Cycle Management is the process of securing payment for medical services in the US healthcare industry. It is an end-to-end process that includes, patient registration, scheduling, eligibility verification, medical coding, and claim preparation, claim submission, dispute management, and reconciliation.
Why is Revenue Cycle Management important in healthcare?
It helps to ensure consistent cash flow and superior service. Revenue Cycle Management impacts both the healthcare provider’s short-term service capabilities and its long-term operating margins and sustainability.
How can a healthcare organization improve its Revenue Cycle Management?
By automating the process with a leading technology partner, such as the Nividous platform. Once applied, organizations can dramatically improve core processes in order to ensure dependable revenue while demanding fewer staff hours..
What is the most important part of Revenue Cycle Management?
An integrated approach that requires your clinical, financial, and operational data to work together. To run a successful business, it is crucial to automate tedious tasks and free up specialized employees to focus on the patient experience, leading to efficient organizational growth.
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