Today’s healthcare institutions are having a hard time maintaining positive operating expenses while leaving room to fund new patient services. If this issue is not quickly addressed, this can lead to a large number of denials from insurance companies, mismanagement of financial resources, and failure to improve patient experience.

This is where Hospital Utilization Management comes in. With this practice, you can safeguard your assets in your revenue cycle management process and provide the best healthcare delivery & experience to your patients.

Don’t know if you need to integrate Hospital Utilization Management?

Read on to know if you do.

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The Main Problem: Late Incoming Data, Late Decision-Making

The healthcare industry relies on data as much as any other industry, and more so as professionals need to consistently update important financial information to make right decisions when it comes to allocating budgets for operations and patient care.

Unfortunately, many healthcare workers still rely on month-old data, given that they might have to wait around 30 days to see how much they’ve spent and where the majority of their budgets are going to. Thus, it becomes more difficult to understand such budgets in a timely way and make the right decisions moving forward.

The Solution: Hospital Utilization Management

According to the Healthcare Financial Management Association (HFMA), Healthcare Utilization Management is the “integration of utilization review, risk management, and quality assurance into management in order to ensure the judicious use of the facility’s resources and high-quality care.”

Through Healthcare Utilization Management and a complete review of their Revenue Cycle Management (RCM), financial leaders in the healthcare institutions can integrate data from various sources, such Electronic Health Records (EHR) and other accounting management software, so that they can track and predict financial and operational performance and accurately inform their decisions, not only in the finance department but also in patient care.

Read More: 5 Ways Big Data is Impacting Healthcare

Great Results Await

Once you have an effective Healthcare Utilization Management in place, you can expect better quality in financial management and, in turn, patient care. But that’s just the surface of the outcome. On a much deeper level, you can anticipate the following, among others:

• Financial transparency for faster decisions to improve budget planning
• More productive staff while enhancing patient care
• More accurate monthly financial statements

How Outsourcing Can Help

In many cases,  Healthcare Utilization Management may be improved by partnering with a trusted outsourcing company. They can provide not only accurate documentation to avoid denials, but also work on reinforcing strategies that can optimize important financial activities to improve your company’s bottom line.

A business solutions partner can also help you alleviate costs on manpower and technological infrastructure. A good partner will understand that healthcare institutions should not over- or under-staff, so when you trust your backend tasks to a partner, you can start with a small, dedicated team of HU specialists, and scale as you need them. All specialists should work with updated and reliable tools that are in compliance with HIPAA and GDPR, for global data privacy best practice.

Infinit-O is the trusted customer-centric and sustainable leader in Business Process Optimization to Small and Medium businesses in the Financial Services, Healthcare and Technology sectors by delivering continuous improvement through technology, data and people.

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