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Top Requests for 2015 – Naughty or Nice List? Checking IT Twice

If you were texting Santa with your health system’s wish list, what would it contain? With so much accomplished in 2014, it’s a fair bet your place on The Nice List was earned. Contemporary healthcare finance leaders and their teams are expected to do much more for their organizations than in years past. Operational concerns are an abiding factor in all finance strategy, informing all aspects of healthcare management. No one wants their name on The Naughty List made by external auditors. December 18, 2014 AHA RACTrac results for Q3 2014 show record numbers of audit requests and denials, and that these numbers continue to rise. Naughty 2014 events, like choosing whether to continue to appeal or to take CMS’ settlement offer this past October, have taken lots of focus-time from key people on your team. To stay safely in The Nice List zone, hospitals and health systems are highly focused on
  • Process improvement

  • Systems integration
  • Data management

  • Collaboration and communication
To get to actionable information, and validate its accuracy by “checking it twice” requires software to pull key performance indicators from today’s “big data,” which only gets bigger in 2015 (think ICD-10). Check this list twice to see if your health system is being naughty or nice on the following fronts.
  • Competitive pricing
  • Preventing denials

  • Managing audits

  • Compliant charging

  • Successful appeals

  • Utilization review

Whispers from the North Pole say some leaders, who are solidly on The Nice List, are asking for software to help their health systems’ team successfully meet ongoing challenges in these areas.

Not that I’m hinting or anything… Well, yes I am hinting. Your staff wants to help improve financial performance. Trying to manually stay ahead of payors’ ongoing changes to charge rules and regulations is a strain and a drain. If Santa brought new software subscriptions and services that made their jobs more efficient, automatically, well you’d definitely make The Nice List in 2015.

Tell us, what’s on your health system’s holiday wish list?  What about your focal points for 2015?