The five interrelated business functions Contract management, Claims denial management, Coding & compliance, Credentialing, and Cash from patient payment obligations are managed independently in practices or are outsourced completely. There is no easy way to manage the data that is collectively generated by these functions, as result this contributes to revenue leakage experienced by medical groups.
Outsourcing any of these five interrelated business functions without integrating the data generated from the processes and workflows into your in-house business functions disrupts the information necessary to manage revenue integrity. It’s impossible to manage the sheer volume of data produced by these functions daily without the aid of business intelligence tools. It’s not surprising the revenue integrity is an elusive goal for medical groups.