Technologists love creating new terms; new ones are invented every day. Most technical terms have broad definitions and tend to mean different things to different stakeholders. A common explanation of Digital Transformation revolves around social, mobile, analytics and cloud (SMAC). When RCM practitioners hear this common interpretation, we try and relate these terms to RCM processes. However, many of these technologies have limited impact on the RCM cycle and, at this time, certainly not a transforming impact.

Given ApexonHealth lives and breathes RCM every single day of the year, we wanted to implement digital technologies that have a transformative impact on our ability to deliver daily production workloads. Each organization needs to set their own goals; at Apexonhealth we set our selves the following goals to justify the investments required for Digital Transformation of our production RCM processes.

Design Goals for RCM Automation team @ ApexonHealth.

  • End customer revenue increases by at least 2%
  • Cost of operation reduces by at least 30%
  • Turnaround time improves by at least 40%
  • Quality levels increase by at least 5%

The above is to be achieved without compromising compliance, security and privacy requirements. As we all know RCM business processes have their unique challenges in terms of volume of data, privacy, coding ambiguities, lifetime of a claim etc. It is therefore important to remember that we are seeking transformation of business outcomes and not using technologies for the intellectual satisfaction of the automation teams. Given that digital technologies are rapidly evolving, at ApexonHealth we focused our efforts on the leading edge and not the bleeding edge. Some examples of use cases we still believe are at the bleeding edge are facial recognition for insurance eligibility, block chain for reimbursement etc. Though the aforementioned, use cases will significantly enhance the efficiency of reimbursement. We believe the required eco-structure and industry infrastructure is yet to be established.

Keep up with our blog to learn more about our innovative solution that solves all these concerns while preventing new ones.

What goals do your company strive to achieve? What would your ideal solution for those goals look like? We’d love to hear your thoughts.