UBMC faced significant challenges in identifying and addressing issues contributing to revenue loss. Their denials management process overwhelmed their small revenue cycle team, resulting in financial setbacks and the loss of a significant amount of annual revenues.
Angie Draper, UBMC’s Director of Revenue Cycle, had a clear objective: to develop comprehensive visualization tools that would uncover the root causes of denials. REDi Health worked to centralize and analyze vast amounts of data, enhancing UBMC’s denials management process and aligning with their goals.
REDi Health committed to UBMC that they would only use the technologies already available at UBMC, to deliver customized analytic solutions. In this way, we keep the cost of implementation low; an important aspect of the REDi Health business model. “We want to focus on solving healthcare problems that are both meaningful and measurable and do so in a manner that can be absorbed into very busy workflows. Impact and sustainability are key ingredients to client success,” says John Wadsworth, co-founder of REDi Health.
The impact of this project is becoming transformative for UBMC. The improved analytics and reporting enable Angie and her team to drill into denials by department, category, and reason, enabling them to identify training, timely filing, and other factors contributing to denials. With data-driven, root-cause analysis, UBMC can now identify opportunities for improvement related to tasks such as tracking timely filing or obtaining updated insurance cards. And the bonus is, now the improvement can be tracked within the same reporting tools so UBMC leaders can accurately measure what they seek to manage.
With REDi Health, UBMC is pursuing a remarkable turnaround in denials management. Together, teams are working to capture a significant amount of lost revenue due to timely filing, and a lack of easy access to the root cause of denials. Speaking on the denials work with UBMC, Wadsworth commented, “With the right combination of technical expertise, change management, healthcare knowledge and collaboration, we are achieving remarkable outcomes with our invested partners. It’s truly exciting to see healthcare leaders begin to trust their data and then make data-informed decisions to drive change. We are helping UBMC achieve sustained outcomes improvement at a fraction of the cost of larger consulting agencies.”
UBMC’s progress on improving denials management exemplifies how strategic collaboration and innovative solutions can revolutionize revenue management in the healthcare industry. The partnership with REDi Health is helping UBMC overcome their denials management challenges and is establishing a foundation for continuous improvement and sustained success in the years ahead.
REDi Health is empowering our staff to navigate the complexities of denial management. Their effort speaks volumes because we have not had the resources available to showcase our denials in such a seamless manner. They are assisting us in developing tools to identify the root causes of our challenges and explore upstream processes that require improvement. Together, we are establishing a process for sustainable success.
