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Big Data, Big Deal or Big Dread? And How Does It Impact Medical Billing?

What is Big Data, and how does it impact Medical Billing?

Big Data is on a lot of people’s minds lately, including those of medical billing administrators. Social media news feeds are filled with stories that promise everything from a cure to cancer, to the downfall of personal privacy as we know it. So what is Big Data, and how does it have any application to the world of medical billing? This is a question that many practice administrators are looking to answer. This post will explore the impact of Big Data reporting, and offer a few considerations to keep in mind while selecting a reporting solution to purchase.

Wikipedia has a well-written article on what Big Data is, and defines it as, “an all-encompassing term for any collection of data sets so large or complex that it becomes difficult to process using traditional data processing applications.”

Questions to Consider:
• Have you ever wanted to see what the true impact of CMS (Centers for Medicare and Medicaid Services) combining services has on your business?
• Have you ever tried to setup reports that show a comparison of insurance adjustments to uncover factors that are involved in the changes you see happening in your payer mix?
• Are you interested in showing the Relative Value Unit for how much work your doctors have performed, relative to the reimbursement amount they are receiving for their services?

If you have ever wanted to know the answer to these questions, or similar questions, then Big Data collection and analysis applies to your medical billing practice. With most billing systems a user can only use a small amount of the data to establish trends for these kinds of questions. Depending on the daily volume of posted charges, sometimes you can access as little as 5 months worth of transactional data before reaching the limit for the amount of data that can be shown in a report. This limitation is not always the fault of the software, and typically resides with the computer hardware not being able to process the required amount of information. Trying to establish trends while working around these limitations can become nearly impossible for some practice managers, due to the sheer volume of data they have to organize. Big Data is not a theoretical concept that may one day start to impact the medical billing office, it is an everyday reality for any practice manager who posts more than half a million procedures a year. This massive amount of data illustrates what the IT industry is referring to as Big Data.

The good news is that while the amount of data being pulled to do business analysis has changed, the concepts of what needs to be analyzed is still the same. The need to report on trends for metrics and key performance indicators has not changed. What has changed is the increase of complicated business research required to help managers and administrators set benchmarks and forecast trends. It now includes a more sophisticated method for processing data. Big Data has created a need to not just store massive amounts of information; it has also forced software developers to come up with innovative ways to make that information accessible for analysis. So what kinds of reporting tools do you need to accomplish this? You will need advanced tools that offer everything from early warning alerts and user productivity dashboards, to secure web accessible items that allow any member of your organization to remotely monitor your business. Most advanced reporting tools fall in to the Business Intelligence software category, due to their capability of monitoring live data trends without the user being required to open the application.

Before you look into a new reporting tool, here are a few things you may want to keep in mind:

Separate what you Need from what you Want:
It would be nice for every team member to access all of the metrics for their responsible areas from their smart phone, any time they are away from the office, but do you need this ability? Most reporting tools charge a per user access license fee, and most price their licensees based on the kinds of features and access each user will have when working with the product. Make sure that you are planning ahead for future licensing needs as well as purchasing features that are relevant to your business model and that your team prioritizes needs over wants before negotiating a contract.

Nothing powerful comes for free:
Time to talk about system performance cost. If your system has a massive amount of data to process before it can be extracted for a reporting tool to access, then a server somewhere on your network is going to need to dedicate resources to make that happen. Virtual servers usually are very bad at this kind of processing but cost less money to get off the ground. If you do not have the ability to create a new server, what will the performance impact be on the existing server(s) that will host the reporting processes? Make sure your IT team is part of the discussion with your vendor to ensure that running a report will not bring your billing system to a halt while the report is running.

The more powerful the product the higher the learning curve
One of the biggest obstacles that Practice Administrators will be facing as they look into obtaining a reporting tool will be determining who on their team needs to be trained to use it. Some organizations have a heavy enough volume of analysis needs that they have a full time employee who does nothing but run advanced reports. Others do not have this resource available. It is important to realistically evaluate whether or not your team members tasked with running advanced reports have more than a passing knowledge of Excel. At the same time, your reporting product needs to be intuitive enough that these individuals can learn it without earning a business degree in the process. Make sure that you collect plenty of user experience feedback on potential reporting solutions to see how long it took users to get up and running.

The most meaningful data comes from focused analysis
Any reporting tool you use to help dig through your data is going to provide you with a number of ways to categorize and sort that data into meaningful categories and relationships. The only way to maintain your sanity in this kind of situation is to stay focused. Before purchasing a tool, have a set of specific reporting needs that you want to accomplish with it. Keep the list small, no more than five, ensuring your most important reporting needs are being directly addressed. Many Billing Software Vendors have advanced reporting tools that have a number of prefabricated reports that may or may not meet your needs. Ask them to demonstrate how to meet your list of needs in their tool to make sure that you are getting what you need, not just what you are being offered.

Keeping these items in mind while approaching a new reporting tool will help set expectations when evaluating products, and guide you towards a tool that will provide you with meaningful data. By considering these factors, you will be able to reach your operational goals as opposed to choosing a tool that is so complex your team does not embrace it.

Will Big Data mean anything for the day-to-day life of front line workers? Yes, but in indirect ways. The real impact will be felt by managers and team leaders who oversee daily operations, who now have real data on how their team is contributing to meeting organizational goals. Advanced reporting tools will not just monitor employee progress, but will also identify breakdowns in processes and highlight areas where the team needs more resources, in order to meet their goals. These tools will also give new insight into shifts in revenue and services your doctors are preforming. If your organization has a clear direction and focus on where it wants to go, business intelligence reporting tools like our company’s ImagineIntelligence module, will not only validate the reality of those goals, but will help you stay on target to accomplish them. That only becomes possible if you have the ability to leverage your Big Data in a meaningful way. Big Data ultimately means more information to base decisions on. Make sure that you are taking full advantage of your data today.

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