Understanding the Claims Lifecycle: A Step-by-Step Guide
Grasping the details of the claims lifecycle in healthcare is crucial for getting timely reimbursements and maintaining financial well-being. As...
In today’s complex healthcare landscape, accurate reimbursement is crucial for maintaining financial health and operational efficiency. Revenue cycle management teams face the challenge of ensuring payment accuracy from multiple payers, each with its own intricate rules. FinThrive’s innovative, intelligence-driven platform addresses these challenges head-on, helping organizations strengthen contract negotiations, eliminate labor-intensive processes and optimize workflows.
This blog will explore a real-world case of an organization that successfully leveraged FinThrive Contract Manager to streamline contract management processes. By using this advanced solution, the health network was able to improve payment accuracy, reduce administrative burden and free up staff for more strategic work. See how our technology is transforming healthcare revenue management—one organization at a time.
The Challenge: Addressing Revenue Leakage and Rising Costs
A health network in the Midwest, consisting of eight hospitals and over 120 outpatient facilities, was grappling with significant financial and operational challenges. This network was experiencing increasing financial strain due to outdated, inefficient contract management processes. Issues included growing underpaid claims, limited insights into government payer reimbursement rates, rising bad debt and soaring collection costs—all of which hindered its financial stability. To secure its revenue and optimize cash collections, the health network needed a transformation.
The Solution: Transforming Revenue with Automated Contract Management
Seeking a comprehensive solution, the health network turned to FinThrive. Our contract management solution was built to address the exact challenges the network faced. This technology automates the contract lifecycle, calculates net accounts receivable at claim submission and flags accounts with potential underpayments for proactive follow-up. Moreover, it generates timely reports to monitor payer performance, quickly identifying variances that require attention. FinThrive’s contract management technology even provides precise, patient-friendly cost estimates at various points of service, ensuring a seamless experience for both the provider and patient.
RELATED: Unveiling the Future of Contract Negotiations in Healthcare
Realizing the FinThrive Value
The decision to partner with FinThrive proved to be transformative. Serving more than 3,250 healthcare providers across North America, including 37 of the top 40 largest hospitals and health systems, FinThrive brought its expertise and innovative solutions to address the network’s specific needs. The health network saw remarkable results:
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$40 million in underpayments identified within seven years, with over 95% successfully recovered;
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An increase of $6.1 million in upfront cash collections;
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Collection of up to 50% of payments at the point of service.
The Vice President of Revenue Management and Patient Accounts highlighted FinThrive’s impact: “We’re fortunate to have a revenue management partner so we can focus on our patients and our community. We’ve been able to improve standardization, optimize revenue cycle performance and enhance high-level effectiveness in payer contract modeling and management.”
Through FinThrive, the health network achieved the streamlined, sustainable revenue cycle transformation it sought—enabling it to continue providing top-tier care while improving financial performance and operational efficiency.
Automating Healthcare Contract Management
FinThrive Contract Manager simplifies complex payer relationships by automatically calculating reimbursements, forecasting revenue and reducing contract loading time. With this automation, staff are freed from labor-intensive tasks, enabling them to focus on strategic, higher-value work.
Contract Manager not only optimizes workflows but also ensures accuracy across intricate payer contracts, including government, commercial and patient sources. By centralizing and automating these processes, FinThrive’s solution helps healthcare providers improve financial performance, reduce errors and maximize revenue potential—allowing for a more profitable, streamlined operation.
RELATED: Intelligence-Driven Contract Negotiation Solutions | FinThrive
To learn more about our various solutions across the revenue cycle continuum, explore our case studies in the resource center.
