The RCxRules Blog

How HNI Healthcare Reduced Denials and Achieved a 40% Automation Rate

HNI Healthcare is a healthcare technology and physician practice management company focused on improving clinical, operational, and financial outcomes for healthcare facilities and patients.

The Challenge

HNI wanted to control more of the data they were passing along to their billing company but struggled with a limited ability to create automated front-end rules to reduce the number of manual processes in place.

They wanted to be able to provide more accurate information by handling billing and coding corrections on the front end and avoiding issues on the back end. In short—they wanted to get paid correctly the first time without unnecessary back and forth.

The Solution

The RCxRules Revenue Cycle Engine enabled HNI to streamline the front end of their process through automation. The team at HNI set an initial goal of automating 25% of their corrections and ended up achieving an automation rate of over 40%.

“We’re continually reviewing our back-end denials to see what rules we can create on the front end. We regularly find solutions to issues we can automate and fix on the front end to avoid denials,” explains Twyla Fuertes, VP of Revenue Cycle and Managed Care at HNI.

“We really enjoy working with the RCxRules team to figure out what’s possible and find new ways to automate tasks. The Support Team is very responsive and knowledgeable. If we have an issue, I have confidence it will get resolved in a timely manner,” says Twyla.

The Results

By automating so many previously manual tasks, HNI was able to redefine job duties for their front-end staff as well as their revenue cycle team. Rather than having to juggle disparate systems and multiple reports, many tasks are streamlined within RCxRules, which simplifies day-to-day operations.

The automation of the Revenue Cycle Engine has contributed to increased efficiency through the billing process. HNI was able to reallocate responsibilities for several full-time positions, and team morale has improved overall, as Twyla explains: “Our team is very happy working in RCxRules. There’s a satisfaction to be found in fixing a rule—our team is able to directly appreciate the impact they’re having and feel like they’ve contributed to success by working exceptions.”

Their team has reduced their monthly backlog to a 2% average and improved their processing speed to an average turnaround of one day. “Since we’ve implemented RCxRules we have improved our backend denials—and we continue to see a decrease as time goes on,” Twyla explains.

“The design of the Revenue Cycle Engine gives the end user a unique ability to create rules that are specific to their specialty. RCxRules isn’t afraid to think outside of the box to automate tasks that could reduce denials. When you have a high-volume business, automation is the best option to reduce manual errors—and this particular type of transparent automation that gives the user clear oversight and full control is a game changer. Being able to choose the rules to enable or not enable, and having full confidence that everything will work the way it’s designed allows us to adapt as the industry changes and work to stay one step ahead,” says Twyla.

Find out how other large medical groups use RCxRules software to boost efficiency by exploring these success stories.

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