Improving Financial Performance & Reducing Burnout for Healthcare Providers | Omniscient Platforms
Improving Financial Performance & Reducing Burnout for Healthcare Providers | Omniscient Platforms
In today’s healthcare landscape, taking the right steps to maximize revenue and collections per patient visit has become critical for providers facing mounting financial pressures.
Reimbursement rate increases have consistently lagged behind inflationary cost increases, squeezing margins and making it harder for providers to cover rising operational expenses. Simultaneously, the growing complexity of payer requirements has contributed to an increase in claim denial rates, further eroding revenue potential. These challenges combine to suppress earnings and reduce overall profitability for healthcare organizations.
Collections Calculator: Proprietary solution developed by Omniscient Health with methodology using the proper contractual amount to calculate what is owed for each patient compared to actual collections and quantified and organized into reasons for shortfalls.
Price Transparency: We have collected approximately 150 trillion records of Transparency in Coverage data from major payers and compare negotiated reimbursement rates across US healthcare providers. This helps with better rate negotiations, ensures collections align with contractual rates, and integrates into tools like the Collections Calculator to maximize collections.
15% increase in the collection rate within six months
A healthcare provider, implemented a “Collection Calculator” to improve collections. The project involved extracting and organizing data on patient transactions, payer contractual rates, and payment denial history into a comprehensive data lake. Key metrics included expected versus collected amounts, reasons for payment shortfalls, and classifications for underpayments.
Analysis revealed that the provider was only collecting 80% of contractual amounts due to issues like credentialing, eligibility, and documentation errors. Targeted fixes led to a 15% increase in the collection rate within six months, significantly boosting profitability.