Prevent Revenue Roadblocks: Staying One Step Ahead of Claim Denials

If you can think of your Revenue Cycle as a long drive on a sunny day, claim denials are the metaphorical construction site that blocks off your route and prevents you from efficiently getting where you need to go. Much like sitting in traffic burns expensive gas in the tank and slows down your trip, denials are costing your team money and burning through valuable time.

Because of this, most RCM teams we speak to wish there was not only a way to address denials quickly, but a way to prevent them before they even occur. The problem is, it’s hard to anticipate problems that don’t exist yet, and it’s arguably harder to find extra hours in the day to dig into denials, look for trends, and address any impacted claims.

If you’ll indulge us for a moment, we’re going to double down on this driving metaphor.

When you’re about to embark on a long drive, what’s the first thing you do? If you’re like us, you’ll probably say that you check Google Maps, Apple Maps, or even Waze before starting your car. 

While these different map applications have their own unique features, they each have one thing in common: before you hit the road, the technology will scan your route for accidents, road closures, or construction, and tell you the most efficient way to get where you’re going while avoiding any roadblocks. These tools also adapt on the fly to save you time and money. Accident reported a few miles ahead? Take the next exit to save time and avoid the traffic, and redirect back on the highway when you’re in the clear. Police stationed a few miles down the road? Double check that you’re cruising at the right speed limit to avoid a costly ticket. 

Adonis Intelligence works similarly for RCM. The platform uses predictive analytics to continuously monitor claim submissions and denial patterns to detect trends in your revenue cycle. If a payer changes their rules and begins denying claims with a certain code, the platform will alert you before you submit your next batch of claims, enabling you to address the issue before it results in hundreds of denials. 

Intelligent alerts give you the ability to address denials quickly and in real-time, bubbling up any claims related to problematic denial codes and providing you with context around the denial and recommended next-steps to address the issue at hand. 

While road trips can be impacted by accidents, construction, and weather patterns, your revenue cycle can be affected by payers changing their rules, processes breaking down, or claim errors from manual data entry. Much like sharing the road with other drivers, you can’t always predict when environmental changes will negatively impact your revenue cycle, but you can bring in technology to prevent and mitigate challenges before they develop into something more serious.

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