By Jeffrey DiLiddo
Welcome to our first post! I guess a good place to start is to answer the questions; Why did we do it? Why did we start RevenueHealth?
RevenueHealth Systems was started by medical billers. Nearly every member of our team has decades of experience in the medical billing and revenue cycle management field, either directly working for practices (ranging from small physician offices to large community health centers and teaching physician hospital systems) or working for outsourced medical billing companies.
We were frustrated (alongside our clients and industry peers), with the challenge of getting easy to use data that helped us understand how well we were performing at our jobs in the billing department.
We were frustrated with so many practice management systems that (out of the box) simply deliver electronic piles of paper for our billers, without providing us with easily accessible data that we could use to tell how well our team was performing. Most of the time billers expend their effort just resolving denied claims and when we asked them for honest, data-driven perspective on the work we were giving them, they were typically unable to tell us the primary sources of the denials and how successful they had been in resolving them.
Inevitably we had to rely on important billing performance metrics such as “Days in A/R” or “A/R over 90 days”, but it was extremely time consuming compiling the data necessary to know if our denial management processes were a source or a solution to those A/R issues. Equally as time consuming was the process of gathering data for our practice-clients to tell them where they could improve their processes and possibly prevent denials to begin with.
We looked everywhere for the best automation solutions. Most of the practice management systems offered a wide breadth of reports, and most even offered some dashboard tools, but rarely were they able to get us farther than “Top 10 Denials by Adjustment Code”. We even invested in other software vendors, but there was always something that the software couldn’t or wouldn’t do.
Wait… top 10 denials? How about we start with the top denial? Can the dashboard tell me why we’re getting that one denial reason and does it tell me if that denial reason eventually gets paid or are we just writing it all off?
Almost as bad, was the complete lack of real customization in every system we tried. We wanted custom denial code and procedure code mappings, and most of all we wanted a rules engine that was dedicated to us, that we could use to determine claim dispositions and route just the “actionable” claims to our team.
So we built our own and deployed it to our billing clients, churning through millions of claims.
While outsourcing is the right solution for many, it’s not the right solution for everyone and that’s how RevenueHealth came to life. We’ve set out to build the best possible software solutions, enabling our users to achieve the best possible revenue cycle performance, and we’re making it available to everyone.
We’re extremely passionate about our solutions, and hope we get the opportunity to show them to you!