Solving the denials and patient payment responsibility conundrum requires process changes that are challenging
Revenue Risk Recovery is a tech-enabled service for the PwC Model Office on Microsoft’s Cloud for Healthcare, leveraging Microsoft Power Platform (Power Apps, Power Automate, Power BI) and Dynamics 365 to connect distributed patient access and finance teams in a deferral decision process. It provides the ability to receive real time insights into the volume and location of services. These digital automations, coupled with improved connectivity and insights help enable immediate reduction in revenue risk exposure.
Health Provider Challenges : - Solving the denials and patient payment responsibility conundrum requires process changes that are challenging. The clock is ticking against the scheduled service date to receive both the prior authorization and* the patient payment, and intervening with impact requires immediate and efficient action - Most health systems don’t have specific insights into these losses, much less the controls to mitigate the revenue risk - Even if the system has some insight, enterprise collaboration and decision making related to rescheduling patient services has not been easy to manage
Solution : - PwC delivers industry leading revenue cycle programs to craft the controls and digitization for a deferral process - PwC has configured Microsoft’s products to automate the collaboration required to facilitate service deferral decisions - PwC's tech enabled service, alongside Microsoft, provides reporting and real time insights into the volume and location of services that could be deferred and the associated revenue at risk
Price of services varies by scope of work