How Data Analytics for Revenue Cycle Management Can Transform Your Organization

A healthy revenue cycle is the foundation for a strong healthcare organization. But optimizing revenue cycle management can be difficult, or impossible, without the right insights - when organizations don't have transparency in their revenue cycles, it's hard to know where to make the most impactful improvements or have accurate revenue projections.

Utilizing data analytics for revenue cycle management could be the key. When organizations embed data analytics in revenue cycle management, they can provide valuable insights to accelerate cashflow, improve efficiency, and make-data driven decisions to set and reach organizational goals.

Leverage data analytics for cleaner claims and a higher first-pass yield

Most healthcare organizations know that increasing their clean claims rate - the percentage of claims that can be submitted without additional manual editing - can keep the revenue cycle flowing smoothly and reduce the amount of time staff need to process claims.

While a healthy clean claims rate is valuable for strong revenue cycle management, perhaps an even more impactful KPI is first-pass yield. First-pass yield measures the number of claims that are approved the first time they are submitted. Improving first-pass yield results in faster payments and cost- and time-savings.

Data analytics for revenue cycle management can provide visibility into the revenue cycle to identify current clean claims rates and first-pass yield, set performance benchmarks, and monitor claims and denials.

For a reported 67% of healthcare organizations, front-end issues are the top contributor to denials.¹ Taking into account that, on average, 15% of all claims to private payers are denied on first submission - and it costs healthcare providers an average of $44 to reverse denials² - better visibility into the front-end processes that contribute to denials is crucial to improving revenue cycle health. RCM data analytics do exactly that, empowering billing teams with the real-time insights they need to identify process improvements to drive better results.

Enhance predictability in your revenue cycle

Perhaps the most valuable benefit of data analytics in revenue cycle management is visibility. Real-time RCM insights can help RCM leaders monitor key data points throughout the revenue cycle. Not only does this data visibility help drive improvements that impact key performance indicators in the revenue cycle, it also can introduce better predictability in revenue performance by enabling organizations to more accurately forecast revenue timelines.

In fact, with award-winning RCM data analytics, providers report up to a 40% reduction in denials and an average of a 5-day reduction in Gross Days Revenue Outstanding (GDRO). Additionally, RCM leaders can forecast revenue more accurately and monitor the revenue to identify leaks or potential problems before they have a negative impact on the organization.

Improve RCM health with data analytics

Data analytics for revenue cycle equips providers with the information they need to create and maintain a healthy revenue cycle. Discover how RCM Intelligence can deliver the data insights your organization needs.

1. Inovalon internal reporting, survey of 400 healthcare professionals, April 2024
2. Trend Alert: Private Payers Retain Profits by Refusing or Delaying Legitimate Medical Claims," Premier, March 21, 2024, https://premierinc.com/newsroom/blog/trend-alert-private-payers-retain-profits-by-refusing-or-delaying-legitimate-medical-claims
3. Inovalon Internal Reporting, Average of customer results, accessed August 2022

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