December 10, 2014 | By Rey Villar
In any payment recovery program, multiple areas of technology need to talk to each other in an orchestrated fashion. Some plans still rely on multiple antiquated platforms or manual processes to manage their data, which is costly and prone to errors. The best systems will account for the automation and integration required to optimize your payment integrity program.
Data mining and analytics are critical in measuring and managing payment integrity performance. Your data should be standardized and shared across multiple areas of the business. For example, data should look at eligibility across the entire business. State-of-the art technology allows you to capture quality data and distribute it out to the people, processes, and systems that need it. To maximize your technology, you should focus on these specific areas:
- Case management tools that allow access to all case data and workflow prioritization
- Consolidated database with all of your recovery information
- Data mining capabilities that analyze which high-recovery cases are available to be worked
- Analytics that show how your recovery program is performing and which areas need improvement
- Automated and integrated systems that work together across your entire business
Improvements with the right technology
With the right technology in place, you should start to see improvements in three key areas of your recovery program: workflow, case management, and dashboard and reporting.
An automated workflow system achieves maximum efficiency by allowing you to automatically import critical data, identify opportunities to recover, and prioritize cases with the highest recovery potential. The automated flow of information to, from, and within the organization is crucial to the program’s success.
Technological improvements result in better overall case management of your payment integrity program. With automated technology, each case is assigned a unique ID, giving internal resources and external vendors the ability to see the status of their cases at any point in time, see who is working on it, and identify the next steps. Additionally, it allows you to capture all the data to support each case and fulfill compliance requests.
Dashboard and reporting
An integrated system with dashboard and reporting capabilities will provide the insight into how recoveries are doing by internal department as well as by each vendor by recovery area. It helps you improve financial forecasting, alerts you to potential problems, and indicates where performance is strong. With ongoing feedback through dashboard and reports, you can continue to strengthen your payment integrity program and improve your contribution to the bottom line.