HCL Technologies
Provider Revenue Cycle Management
Provider Revenue Cycle Management
Client Information
A large U.S. healthcare service provider group providing multi-specialty care and diagnostics and genomic test services across several states in the U.S.
Business Challenges
- Rising incidents of patient self-pay and bad debts
- Reimbursement cuts across the board from Government and commercial payers
- Transition from ICD 9 to ICD 10
- Increasing focus on payment integrity by payers, to reduce medical payouts
- Expansion of utilization management and reviews
HCL Solution
This solution applies autonomic science and predictive analytics to maximize revenue cycle outcomes by using new generation technologies. It provides:
- Process industrialization across payers and specialties
- HCL Toscana EDEN – plug and play point solution for RCM acceleration
- Adaptive rules engine
- Real time predictive analytics
- Intelligent denial analytics
Value Delivered
- Upfront performance guarantee for revenue cycle outcomes
- 23% increase in cash flow
- 18% reduction in DSO
- 6% increase in collection ratio
- 30% reduction in administrative costs beyond traditional ‘Lift & Shift’ BPO
- 20% increase in patient satisfaction
- 32% reduction in rework for rejects, denials and appeals