In healthcare, many people use the terms “electronic medical records” and “electronic health records” simultaneously. However, an EMR refers to a digital version of paper charts in a clinician’s office and contains the medical and treatment history of the patients in one practice, while an EHR focuses on the total health of a patient. It goes beyond standard clinical data collected in the provider’s office and is inclusive of a broader view of a patient’s care.
Another such instance? Integration and interface often get used concomitantly because both processes allow for data to get passed from one place to another. And they’re both employed in revenue cycle management (RCM) software.
Selecting RCM Software
Healthcare providers striving for a strong revenue cycle must employ best practice procedures and processes from the front end all the way to the back office. Utilizing RCM software to achieve this enables them to standardize payment processing, reconciliation, and denials management functions, while improving revenue capture by identifying bottlenecks, minimizing audit risk by increasing audit controls, and offering comprehensive reporting capabilities.
When RCM software is poorly designed or fails to meet the needs of a healthcare organization, inefficiencies occur. The result is more billing errors, lost revenue, and unnecessary administrative time and expenses. This, in turn, often leads to costly reimbursement delays, poor cash flow and overall weak financial performance.
How, then, can you decide what type of RCM software fits your organization’s needs and objectives? What is the best way to differentiate between interface, integration, and fully embedded technology, and learn which option will most positively affect your bottom line? That’s what we’re here to help you find out.
Figuring Out Interfaces
It might be helpful to think of a software interface as a bridge that enables multiple systems and applications to share data. Interfaces are either unidirectional or bidirectional and use established touchpoints to exchange information, even though the data might emanate from sources that don’t use the same programming language.
The benefit of an interface is that it increases functionality without the need for a pause or delay in current operations. It also eliminates the cost of replacing one or more legacy systems.
However, not only do interfaces not allow you to sync data between your systems in real-time, doing so is expensive and may not factor into a healthcare organization’s long-term information requirements.
Because interfaced systems don’t share the same database and are maintained separately, they require more administration for developers and users. In addition, interfaces can be delicate and easily disrupted, meaning data interchange failure is high.
Next, let’s take a look at understanding exactly what integration entails. Most importantly, it enables data to automatically, securely and dynamically flow from one source to another by connecting disparate systems. It combines data, reporting, workflows and functionality into a single system — all without intervention from the user.
With integration, multiple systems and sources seamlessly interact and operate as one. They share the same database, meaning no synchronization process is necessary.
The ability to sync data between revenue cycle systems is one of the biggest benefits of an integrated system. By integrating systems, you can eliminate electronic data file extractions, markedly reducing the chance of data loss and time required for staff members to confirm all data has been transmitted correctly.
Integration also provides numerous advantages to healthcare organizations by:
- Offering detailed real-time reporting
- Enabling more advanced automation
- Helping to bill more quickly and accurately
- Improving customer experience through transparency
- Easily keeping patient records up to date
- Reducing errors by eliminating manual tasks
- Saving staff members time, which enables them to focus on more strategic initiatives
- Increasing reliability and security
- Providing faster time-to-market
- Allowing for better data-based decisions
- Improving data analysis capabilities
- Enabling easier expansion to multiple locations
- Procuring more widespread access to and use of data
- Providing easier scalability for organizational growth
A lack of integration results in users having to operate in informational silos and overlapping databases, causing inefficiencies and data quality issues. Operational and financial performance is hindered, and it is harder to procure a real-time view of your organization’s overall performance.
Depending on various compatibility levels between the systems being integrated, up-front costs can be expensive at the start, although the streamlined workflows that produce greater efficiency typically result in increased revenue.
Embedded systems take a total approach to holistic technology, consisting usually of hardware, software, and firmware. They are designed to be programmable and customizable, functioning as a core piece of an overarching workflow.
Many times, embedded systems are used in real-time operating environments. Other benefits of embedded systems? Because they’re designed natively to complement a series of specific tasks as a single solution, they are fast and reliable.
Embedded systems require all points along the technology spectrum to be integrated and coordinated, from hardware to software. Due to that complexity, the development of these systems can take more time to create and must be developed to ensure there aren’t any issues with the complicated processes they connect.
Why One Embedded RCM Platform Is Your Best Choice
If you’re looking for a long-term solution to best boost your bottom line, prioritizing a billing platform that natively integrates all processes of the revenue cycle into a single embedded system is your best choice.
Embedded RCM technology enables healthcare organizations to pull accurate patient and appointment data to ensure accuracy when verifying insurance eligibility and submitting claims and clearly visualize claim status, denials and rejections. It offers total transparency into your billing process and improves payer-provider communication by automating claim editing and submission, payment posting and patient billing.
Use of a fully embedded platform allows you to streamline communication through a single vendor for numerous stages of the revenue cycle, like clearinghouse services, a patient payment system, advanced reporting, and more. That’s an effective way to reclaim lost revenue.
A single RCM platform can now provide a comprehensive, integrated solution tailored to meet an organization’s unique needs while also offering core benefits (i.e., simplifying tech stacks and providing full transparency across an entire enterprise). Therefore, you’re able to reduce cost and complexity associated with deploying multiple standalone solutions and benefit from more reliable data architecture that integrates correctly and seamlessly across functions. Plus, by simplifying tech stacks into a single-source billing and RCM management system, you can ensure your revenue management is easier to maintain — and avoid costly interfaces to create fragmented solutions with clunky upkeep.
Learn more about ImagineSoftware’s seamless, single billing platform, ImagineOne™.