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The Top Two Opportunities for Missed Revenue Recovery

UPDATED:
January 25, 2024
Healthcare team reviewing revenue data

Chief Financial Officers (CFOs) and their revenue cycle management teams work to balance everyday tasks while guiding their organization to a future strategic vision and navigating obstacles along the way. 

When facing challenges such as looming recessions and disruptions to government reimbursement, everyday things like revenue recovery become that much harder. To combat these difficulties, the best course of action often lies in making day-to-day tasks easier. Simplifying the revenue stream for work that has already been completed frees up space for tackling the more challenging aspects of the job.

Key opportunities for revenue recovery

Revenue recovery should be efficient, easy and fast. A sizable portion of revenue recovery efforts can be handled with two key technology solutions: insurance discovery and Medicare underpayment recovery. 

  1. Insurance discovery

    Insurance discovery tools conduct an automated, expansive search for any existing insurance coverage a patient may have. Insurance discovery works to find active, billable insurance by cross-referencing an exhaustive list of government and commercial payers with patient account data.

    Of course, this process is entirely automated. In most cases, it requires only providing a data file. For providers still relying on out-of-date vendors, cross-referencing by hand or ignoring this revenue stream altogether, insurance discovery is a simple way to find and recover revenue that would otherwise remain uncollected.

  2. Medicare Underpayment Recovery

    Medicare underpayments occur when a Medicare patient is discharged to a setting subject to the post-acute-care transfer (PACT) policy, but there is no PACT billing. It’s up to the provider to identify and correct the claims subject to underpayments if the patient did not receive the expected post-acute care or the post-acute care provider is unable to submit a claim.

    Unless a specific underpayment audit is conducted for these cases, the revenue loss will persist and continue to increase. Technology solutions can automate this task, finding revenue otherwise impossible to recoup without serious allocation of resources from the hospital.

Embracing technology solutions for success

To better balance all the tasks on a CFO or RCM Director’s plate, revenue recovery efforts can be taken care of with technology solutions. Office Ally’s objective is to identify additional revenue recovery opportunities for your organization. Our industry-leading team offers tools for Insurance Discovery and Medicare Underpayment Recovery.

Our Medicare Underpayment Recovery tool optimizes the identification of Medicare Underpayment loss, finding revenue with a 99.89% success rate over the course of the last 15 years. 

Our Insurance Discovery tool has helped providers recover, on average, 10-30% of accounts. Our team is committed to maintenance, with regular updates to ensure we stay at the forefront of an industry constantly in flux.  

For healthcare finance professionals interested in new technologies to automate pressing tasks and improve revenue recovery, Office Ally offers a free, no-risk Insurance Discovery assessment. This assessment has no upfront cost, and providers only pay if Office Ally’s Insurance Discovery solution helps recover revenue. Implementation is simple, and results in a complete and trusted back-end revenue recovery loop with guaranteed results.