This is an important analysis - Benefits Verification, Prior Auth, and payment transfers are a burden on a lot of practices, and often when we flip it to payors - they see upcoding/billing issues, and offering services without prior auth as some of the thorny points that extend the life of an episode/transaction. A lot of private practices also run on low to no profit margins - ACH transaction fees matter to them and add to that the problem of accounts receivables sitting at 60-90 days which means they often need to borrow money to cover monthly operational costs (a lot more prevalent in rural settings), this can make tech adoption a luxury for them. Would love to hear your perspectives on what policy changes/incentives can drive such an adoption.
Thanks Sameer. I agree. There is a lot to be done to streamline rev cycle operations. Innovation in claims adjudication and regulations/policy requirements from No Surprises Act, Good Faith Estimates, Advanced Explanation of Benefits will help improve pre-service and pre-revenue cycle activities. A lot of new fintech products (like Buy Now Pay Later models) are targeting out of pocket costs which might also address accounts receivable and revenue unpredictability for providers.
This is an important analysis - Benefits Verification, Prior Auth, and payment transfers are a burden on a lot of practices, and often when we flip it to payors - they see upcoding/billing issues, and offering services without prior auth as some of the thorny points that extend the life of an episode/transaction. A lot of private practices also run on low to no profit margins - ACH transaction fees matter to them and add to that the problem of accounts receivables sitting at 60-90 days which means they often need to borrow money to cover monthly operational costs (a lot more prevalent in rural settings), this can make tech adoption a luxury for them. Would love to hear your perspectives on what policy changes/incentives can drive such an adoption.
Thanks Sameer. I agree. There is a lot to be done to streamline rev cycle operations. Innovation in claims adjudication and regulations/policy requirements from No Surprises Act, Good Faith Estimates, Advanced Explanation of Benefits will help improve pre-service and pre-revenue cycle activities. A lot of new fintech products (like Buy Now Pay Later models) are targeting out of pocket costs which might also address accounts receivable and revenue unpredictability for providers.