The Next Era of Healthcare Revenue Cycle Management: Why Experience and Expertise Matter More Than Ever

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October 30, 2023

In an industry characterized by tightening margins, workforce reduction, and the omnipresent rise in medical claim denials, hospitals and health systems find themselves grappling with an age-old question: How do you do more with less? The answer may be simpler than one might think—partner with experts.

The healthcare revenue cycle management (RCM) domain, a crucial component for any healthcare establishment, has seen seismic shifts since the pandemic. As eligibility denials soar and automation becomes the holy grail, there’s a palpable need for solutions that offer tangible results with a tried-and-true approach. A solution that’s been proven time and time again—relying on experience, longevity, and a hands-on approach.

Evolving Needs in the Healthcare Revenue Cycle Management Landscape

The ongoing global pandemic has added complexity to an already intricate RCM landscape. With health systems confronting workforce shortages, the challenges of managing an efficient revenue cycle have multiplied. Automation and AI tools, although promising, aren’t the complete answer.

Eligibility denials, particularly, have been a sore point for many. SSI claims and clearinghouse data trends reveal that hospitals could benefit substantially by:

  1. Incorporating pre-billing eligibility edits, ensuring last-minute eligibility checks before billing.
  2. Accelerating payment times through the adoption of electronic attachments.
  3. Employing claims analytics and reporting tools to gain insight into payers that are taking the most time to pay, aiding in improving speed to payment.

The SSI Advantage

But where does one turn to ensure these strategies are efficiently executed? Enter The SSI Group, LLC (SSI), a beacon in the RCM industry for 35 years and counting.

What sets SSI apart isn’t just its storied legacy or its robust suite of solutions, but its commitment to personal touch—a rarity in today’s automated world. When you reach out to SSI, you’re not just met with a bot or a vague, scripted response. You converse with real, seasoned professionals who are based entirely in the US. This high-touch, tenure-rich approach is underscored by testimonials from partners who’ve seen firsthand the difference SSI brings:

Jennifer Ruda, from Augusta Medical, highlights the ease of the system and the standout customer service, recalling personalized interactions that made her feel valued.

“I very much like the feel of the system, the functionality of the system, and the ease of using the system for me, even when I was just doing billing, but also as a manager and as a leader. Also, the customer service is great…I can remember for years always being able to pick up the phone and always getting Horacio…he knew me.”

Elayne Perry from Regional One emphasizes the functionality and cost-saving potential SSI offers.

“We switched to SSI because we needed a better product that would do reconciliation for us and capture our 277 rejections. With our previous vendor, the 277 rejections would be lost with no way to identify them and see if we worked them…they all jumbled together. Additionally, our 835 remittance advice were not delivered timely. The SSI functionality is really the primary reason we switched as well as the ease of the system. We’re also saving money compared to what we are paying because with SSI the fees are all inclusive.”

It’s not just about the systems or tools, but the people behind them—professionals with an average tenure that’s unheard of in the industry.

18 years average tenure for edits team blue box graphic
15 years average tenure for implementation team blue box graphic
12 years average tenure for customer support blue box graphic
13 years average tenure for account management blue box graphic
This longevity translates to unmatched expertise, ensuring that hospitals and health systems can navigate the intricacies of the revenue cycle alongside seasoned experts with ease.

Being a privately held entity, SSI has never been swayed by external acquisitions or competing interests. This steadfastness ensures that the company’s sole focus remains on delivering unparalleled service to its clients – another rarity in the RCM marketplace.

Switching to Excellence: Overcoming the Fears of Transition

A common trepidation among healthcare institutions is the perceived hassle of switching vendors. This reluctance often stems from concerns about data loss, downtime, and the burden of retraining staff. But in the dynamic realm of B2B software technology, these fears are more myth than reality.

Across industries, numerous enterprises have made successful transitions to new platforms and reaped benefits that far outweigh the challenges. Take the banking sector, for instance. Many banks have transitioned to modern core systems, enabling them to offer enhanced digital services and improved customer experiences. Similarly, retail businesses have transitioned from traditional point-of-sale systems to integrated e-commerce platforms, leading to heightened sales and expanded customer bases.

In the healthcare domain, such transitions are not only possible but can be transformative. Hospitals and health systems, when transitioning to a new RCM vendor, often unveil operational efficiencies they were previously unaware of. These can range from better integrations with existing health IT infrastructures, improved workflows, to even the discovery of previously unclaimed revenues. Clients of SSI frequently highlight their exposure to a multitude of edits they hadn’t encountered with previous solutions, guaranteeing cleaner claims right from the outset.

Jason Nesbit of Monument Health cites their move to SSI as a testament to this transformative potential. Frustrated with their previous vendor’s limited offerings and unresponsiveness, Monument Health sought a change. With SSI, they not only gained access to advanced features without exorbitant costs but also harnessed the power of SSI’s enrollment portal to manage tasks autonomously, leading to significant cost savings.

“Our previous vendor was nonresponsive and we were not happy with some of the services we were getting with them as there were a lot of features in Epic that weren’t available to us without a major upgrade and increase in pricing. SSI has a reputation with its clients for being good at handling enrollment and making sure that we’re as electronic as possible. And now with SSI we have an enrollment portal that allows us to manage the work ourselves, which in the long run saves us money.”

Kim Beecher from Hughston Memorial Hospital recalls the profound impact of switching—shifting from offshore-based support to SSI’s US-centric team. The result? More comprehensible, actionable support, leading to rapid issue resolutions and a marked reduction in operational hiccups.

“The SSI support being US-based versus our previous vendor’s being offshore is a big improvement. We can understand each other…whereas with our previous vendor the support people did not understand so therefore we wouldn’t get the correct answers we needed…which led to a lot of frustration. Also, the SSI system can pull so much more that we need, like partial denials.”

For those dissatisfied with their current claims and clearinghouse vendor and considering a switch, it’s crucial to understand that it isn’t just a technical change but a strategic one. When healthcare institutions align with a partner that mirrors their commitment to excellence, the results are palpable—improved financial outcomes, streamlined operations, and most importantly, a renewed focus on patient care.

A Call to Action

As hospital margins remain thin and administrative challenges grow, the choice of an RCM partner becomes paramount. It’s not just about selecting a vendor; it’s about choosing the best partner for the journey—a partner like SSI Group, LLC.

If your organization seeks to enhance its RCM operations to best navigate the challenges of today’s healthcare financial landscape, the choice is clear. Reach out to a team that understands the heartbeat of healthcare, a team with the most experience in the industry that’s been proven over and over again – every transaction, every time.

Considering a transformative leap in your RCM strategy? Contact teamssi@ssigroup.com and discover the difference.

Engage, evolve, and excel with SSI.

#ExperienceMatters

 

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