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Health Systems + Hospitals, Physician + Specialty Practices

10 signs you could be getting more from your EMR, HIS or PM investment 

10 signs you could be getting more from your EMR, HIS or PM investment 

Are you maximizing your electronic health record (EHR), hospital information system (HIS) or practice management (PM) system investment?  

Your healthcare organization depends on accurate and timely data to keep your patients healthy. If you are having difficulty getting the right, actionable revenue cycle data to drive workflows in your electronic medical record (EMR), hospital information system (HIS) or practice management (PM) system, you may need to rethink your approach. 

Remember, your EMR, HIS or PM systems should be making your job easier, not harder. Watch for these signs that you have an opportunity to take better advantage of your investment. 


#1 Your EHR isn’t seen as a source of truth 

Your staff members frequently visit payer portals for eligibility, claim status and authorization information. 

During the patient verification process, visiting websites and making calls to payers shouldn’t be the norm. When strong electronic data interchange (EDI) connections do not exist, it puts more pressure on your staff members and slows down your whole workflow. 

You need a vendor that can handle extensive payer communications across EDI and RPA channels to keep your business running smoothly. Other features like eligibility alerts can also be integrated into many systems to help correct potential denial and billing issues earlier in the process, making the right information available at just the right time. 


#2 EHR + PM systems have trouble communicating 

Your team jumps back and forth between systems to update claims, leading to double work and less productivity. 

Does your current vendor optimize the workflow between your electronic health record and practice management (PM) systems? If your technologies aren’t integrated, you could be duplicating work that’s already been done. 

To maximize the efficiency of your team, find the right partner who can create a seamless stream of communication between both systems. 


#3 Limited visibility into cash slowdowns 

You have difficulty pinpointing where bottlenecks for revenue are happening, and no clear solution on how to get collections moving. 

Does your current EHR, HIS and PM workflows allow you to leverage rich, actionable revenue cycle data and other value-added solutions? You should be able to slice and dice the data to find trends and areas to employ new strategies for growth.  

Your health practice needs more visibility behind the scenes of your revenue cycle. That’s why our platform pinpoints potential areas of improvement by identifying where aging, rejections and denials are higher. 

If you often find missed charges, we can help you achieve a high revenue integrity status using artificial intelligence (AI) to capture revenue that your EHR alone will never be able to match.  


#4 Manual checks for payer requirements 

Relying on time-consuming manual searches for payer requirements can set you back. 

As a best practice, you should always leverage a dependable electronic source to make determinations about payer requirements as it has the most accurate, up-to-date information. Relying purely on staff experience or EHR functionality can leave large knowledge gaps. 

Your organization can’t count on vendors with outdated technology either. These inferior platforms often have difficulty building and maintaining large, specialized rule sets.  

Waystar maintains and curates 1.4 million authorization rules for more than 360 payers. This provides greater access and insights into authorization requirements, which change frequently and require heavy staff intervention. 

Instead of making day-to-day tasks harder for your team members, depend on Waystar’s smart Denial + Appeal Management technology to simplify the process. With paperless appeals and pre-populated forms based on payer requirements, it’s easy to know exactly where all the information needs to be delivered. 


#5 Denials are through the roof 

A high denial rate is an indicator that you could be missing key pieces of information in your workflow. 

No two denials are the same, and your team needs the tools to be able to submit appeals as quickly and efficiently as possible.  

Our technology catches errors before they go out, helping to prevent denials with missing authorization information. We use purpose-built automation to proactively screen, identify and prioritize denials that can be overturned based on the predicted cash value. 

Waystar also utilizes claim scrubber functionality which integrates with many third-party systems to provides edits in a single platform, so everything your team needs is in one place.

#6 Drowning in paper claims, EOBs and attachments 

Dealing with a high volume of paper claims, EOBs and other physical files can cause a slowdown to your productivity. 

Always look for ways to expand electronic transactions and push the boundaries of your EMR system. Every piece of paper you can eliminate is a step towards maximizing efficiency.  

With Waystar, you only need to connect with one vendor to help without relying on a complex ecosystem of payer connections and EDI limitations. Our platform ensures you are enrolled for electronic remittances for all payers where connections exist.  

We have extensive workers’ compensation and third-party liability (TPL) connections for attachments, and we’re continually rolling out more connections to commercial and government payers to make your job easier.  


#7 Low patient engagement rates with paper statements 

Outdated patient engagement or follow-up processes that heavily or solely rely on paper communications could be holding you back. 

To provide a superior patient experience and maximize collections, it’s important to meet your patients’ ever-growing needs and preferences for communication. You should be able to seamlessly shift between paper, text and email contact to optimize your reach and overall financial performance of your EHR. 

Offer an intuitive online portal option for patients so they can stay connected to their health. Be sure to meet patients where they are financially and provide flexible payment plans so they can cover their share of the cost. 

In addition, our technology helps ensure you are not erroneously charging patients who may have coverage. Our advanced Coverage Detection solution helps surface hidden or missing coverage, which can help cover the partial or full cost of services.  


#8 Inaccurate or limited cost estimation capabilities 

Incorrect cost estimates are breeding a pattern of distrust for both staff members and patients alike. 

If your team is manually creating estimates at the time of service or the estimated amount is often inaccurate, low confidence in estimates lead to lower collections.  

Waystar’s comprehensive, integrated platform utilizes the latest RPA technology and a vast number of EDI connections, offering enriched data and three times more information to produce estimates with industry-leading accuracy. 


#9 Manual cash posting processes 

Heavy manual processes around cash posting, cash reconciliation and other billing related tasks decrease efficiency.  

If you find your staff members repeating the same scenarios over and over, there is most likely an automated solution to make your workflow easier.  

Whether it’s creating appeals packages by hand, reconciling remits, closing denials that are uncollectable or editing claims manually to pass edits, there are many everyday responsibilities that can be automated. By moving away from manual tasks, your staff members can focus on high-impact work.  


#10 No strategy for patient prioritization 

You are prioritizing accounts based purely on age and account balance. 

Work smarter, not harder when it comes to patient collections.  

Waystar’s Claim Monitoring solution predicts when to solicit a payer response and automatically checks claim status. That allows you to refocus your energy and reallocate staff time to more pressing tasks. In addition, we help drive follow-up with remits, reducing untimely checks. 

Using powerful predictive analytics, Waystar’s Propensity to Pay solution helps you identify patients based on the expected cash value and communication preferences. That can help your team increase output and focus on cash that is easier to collect. 

We also make it easier to identify true self-pay patients, so you’re not wasting valuable time by contacting those who already have coverage. With our Coverage Detection technology, your team can automatically check for additional coverage before any patient billing has occurred.  


Get way more from your EHR 

It’s time to take full advantage of your EHR, HIS or PM investment.  

To boost your efficiency and maximize your revenue potential, you need the right partner to bridge the gap between all your systems. 

To put these strategies into action + get the most from your EMR investment, contact our experts to get started today 

Find this post helpful? Learn how to outsmart the moving denials target 

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