Please wait, loading...

 

BI Solutions-Pharma Company

Several issues hindered growth and profitability for this organization:

Revenue consistently fell short of expectations across the organization, with no clear insight into root causes or areas of needed improvement.
Information was decentralized and mostly distributed via spreadsheets, resulting in inefficient manual effort, high risk of error, inconsistent action plans by management, and low adoption.
Employees only marginally understood their Revenue Cycle Management Model, causing operational and procedural errors, along with unknown pathways to success.
Poor insight into the impact of rate- and code-changes was making negotiations with payers and forecasting difficult.

 

In response, the following reports were developed in Power BI:

Visual Claims Report

blue-margin-power-bi-private-equity

Key Features

  • Clear indication (via KPI) of greatest variance by RCM step.
  • Heat-mapped flowchart illustrating which steps in the revenue cycle cause the most draw-down.
  • From contracted rates to actual payments, pertinent info is grouped by procedure code, payer, and facility.

Expected vs. Actual Report

blue-margin-power-bi-expected-vs-actual

Key Features

  • Clear indication (via KPI) of greatest variance between Expected vs. Actual revenue by claim step, facility, and payer.
  • List of transactions filtered by variance and sorted by magnitude to produce highest-value lists of revenue opportunities.

Rate Management Report

power-bi-blue-private-equity-management-dashboard

Key Features

  • Dynamic, multi-variable, what-if analysis to forecast the impact of proposed rate changes.

Benefits

With easy ranking of transactions and clear visual indicators of issues impacting revenue, the company was able to focus their attention on the highest-return efforts and reduce the gap between expected vs. actual:

  • Revenue variance and shortfalls improved when leadership and management gained the ability to clearly identify sources of variance at the process step, facility, and payer level.
  • Operating efficiency increased and errors decreased after management and leadership began developing operating guidelines and procedures based on highest-impact variables.
  • Standard Operating Procedure compliance increased through employee use of the heat-mapped, revenue-cycle flowchart because it provided a clear visual depiction of the Revenue Cycle Management Model.
  • Profitability increased through code optimization and payor negotiations, as enabled by the Rate Management report. With the included what-if analysis, management was able to calculate the cost/benefit equation of proposed payer terms.

Leave a Reply

Your email address will not be published. Required fields are marked *

Follow UsConnect with Us
T-1,2,3, Sharda Chamber-1, Central Market, Prashant Vihar, Sector 14, Delhi
PartnersPartner with Us
GET IN TOUCHFermion Social links
Taking seamless key performance indicators offline to maximise the long tail.
Follow UsConnect with Us
Organically grow the holistic world view of disruptive innovation via empowerment.
PartnersPartner with Us
GET IN TOUCHFermion Social links
Taking seamless key performance indicators offline to maximise the long tail.

Copyright by Fermion. All rights reserved.

Copyright by Fermion. All rights reserved.