Modernizing Revenue Cycle and Claims Management
Deploying the latest technologies to help Health IT Vendors, Providers, and Health Plans improve RCM and Claims Management.
![Revenue Cycle Management for Healthcare](https://www.3pillarglobal.com/wp-content/uploads/2024/06/RCM-Featured-Image-2.jpg)
Deploying the latest technologies to help Health IT Vendors, Providers, and Health Plans improve RCM and Claims Management.
Submitting and paying claims is the financial underpinning of the U.S. healthcare system and shapes every other aspect of the industry. An efficient billing function protects margins while leveraging claims data and workflows to drive other institutional priorities.
However, RCM and claims workflows are full of manual processes and are reliant on ossified systems that slow innovation. 3Pillar’s team of product managers, designers, and engineers will partner with your team to modernize your systems and accelerate the implementation of your digital health strategy.
Healthcare organizations can leverage AI, robotic process automation, and low-code/no-code tools to address well-known break-points.
Based on our extensive work in RCM and claims management, 3Pillar has identified the following opportunities to leverage modern technology:
1. Recreate the health plan algorithm:
Automate manual processes and leverage AI to better understand claims requirements and medical policies.
2. Provide real-time coding assistance:
Leverage a robotic-process automation-based rules engine to flag expected documentation issues.
3. Engage patients up front:
Build better user experiences with digital check-in, more effective use of eligibility data, and point-of-service payment collections.
4. Create interoperable, efficient work streams across EMRs:
Use modern APIs for timely access to data residing in various systems to standardize data to build or operate efficient solutions.
5. Create open platform RCM architecture:
Elevate the role of RCM by creating open architecture that healthcare organizations can leverage to integrate data and workflows to support other organization goals.
6. Serve as a member financial concierge:
Develop digital, personalized campaigns to engage members and help them proactively understand the costs of care.
7. Reduce provider abrasion:
Ease provider frustration and make your network more appealing with faster process claims and prior auth request processing times and upfront, transparent claim submission guidelines.
Understand the current state of your software, identify risks, and plan needed development + technology strategy to achieve your business goals.
Build, scale, automate, or modernize your digital products. Create high-value digital experiences for customers and efficient, integrated internal workflows for employees.
Ground all applications, workflows, and decision making in a strong data foundation and real-time, high-quality insights.
Leverage AI to digitize data, generate insights, and give coders, clinicians, and patients real-time, contextual decision support.