Modernizing revenue cycle and claims management
Deploying the latest technologies to help health IT vendors, providers, and health plans improve RCM and claims management.
Submitting and paying claims is the financial underpinning of the U.S. healthcare system and shapes every other aspect of the industry. An efficient billing function protects margins while leveraging claims data and workflows to drive other institutional priorities.
However, RCM and claims workflows are full of manual processes and are reliant on ossified systems that slow innovation. 3Pillar’s team of product managers, designers, and engineers will partner with your team to modernize your systems and accelerate the implementation of your digital health strategy.
7 opportunities to streamline the payment ecosystem
Healthcare organizations can leverage AI, robotic process automation, and low-code/no-code tools to address well-known break-points. Based on our extensive work in RCM and claims management, 3Pillar has identified the following opportunities to leverage modern technology:
Provider opportunities
1. Recreate the health plan algorithm
Automate manual processes and leverage AI to better understand claims requirements and medical policies.
2. Provide real-time coding assistance
Leverage a robotic-process automation-based rules engine to flag expected documentation issues.
3. Engage patients up front
Build better user experiences with digital check-in, more effective use of eligibility data, and point-of-service payment collections.
Health IT vendor opportunities
4. Create interoperable, efficient work streams across EMRs
Use modern APIs for timely access to data residing in various systems to standardize data to build or operate efficient solutions.
5. Create open platform RCM architecture
Elevate the role of RCM by creating open architecture that healthcare organizations can leverage to integrate data and workflows to support other organization goals.
Health plan opportunities
6. Serve as a member financial concierge
Develop digital, personalized campaigns to engage members and help them proactively understand the costs of care.
7. Reduce provider abrasion
Ease provider frustration and make your network more appealing with faster process claims and prior auth request processing times and upfront, transparent claim submission guidelines.
The Revenue Cycle Playbook
7 Opportunities to Modernize the Healthcare Payment Ecosystem
Download now
Who we help
Providers
- Integrate RCM into customer and clinical workflows
- Provide real-time coding assistance
- Automate review of claims to reduce denials
- Streamline RCM vendor integrations
Health IT vendors
- Recreate health plan denial logic
- Integrate your solution across multiple EMRs
- Automate manual internal processes
- Build new product functionality
Health plans
- Modernize claims management systems
- Provide real-time prior-authorization support
- Ensure payment integrity
- Improve member and employer experience
Top Healthcare Third-Party Adminstrator
“We got better results than we expected. Not only did 3Pillar reduce our claims processing time, they increased our auto-adjudication rate to 97%!”
COO
Leading provider of home health benefits management services
Top Healthcare Third-Party Adminstrator
“We got better results than we expected. Not only did 3Pillar reduce our claims processing time, they increased our auto-adjudication rate to 97%!”
COO
Leading provider of home health benefits management services
How we help
Understand the current state of your software, identify risks, and plan needed development + technology strategy to achieve your business goals.
Build, scale, automate, or modernize your digital products. Create high-value digital experiences for customers and efficient, integrated internal workflows for employees.
Ground all applications, workflows, and decision making in a strong data foundation and real-time, high-quality insights.
Leverage AI to digitize data, generate insights, and give coders, clinicians, and patients real-time, contextual decision support.
Evolve. Enhance. Elevate.
Deliver innovation and services faster and more efficiently to enhance patient value and improve outcomes. Reach out today to get started.
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