All the Things You Need to Know about Business Intelligence in Healthcare

The trademark of a Business Intelligence system is that it makes critical information accessible in real time thus allowing early identification of potential problems and early intervention. It allows them to make better decisions using more accurate, up to date information.

Maximizing Revenues: Revenue cycle management is critical for all provider organizations. A Business Intelligence system can use analytics to look at payment patterns. This allows physicians to negotiate better contracts with payers and create payment terms with patients.

For example, a clinic sends one thousand claims and the insurer pays seven-hundred. SO there is a thirty percent denial rate. It is up to the provider to figure out why the other three-hundred weren't paid. Using Business Intelligence, the accountants can track the CPT codes, ICD-9 edits and all the carrier required elements and figure out the reasons. The providers at greatest risk of revenue loss due to uninsured patients and reimbursement cuts are primary-care physicians. If physicians are only filling up their appointment books and charging for cancelling appointments, they are going in a bad direction. They need to use Business Intelligence to get to a more comfortable reimbursement position. They can do this by presenting data to payers to prove the quality of patient care.

Health Care Providers: For a while now health care providers have been receiving Business Intelligence from corporate technologies. Business Intelligence gives health care providers the much needed information to help them manage operations more efficiently. They can now gain control over cost inflation, simplify complex patient record-tracking, automate billing and claims processing and also manage human resource allocation. Business Intelligence solutions help make better, more informed decisions in key business areas such as the following:

Financial Intelligence: Health organizations can gain greater visibility in to their financial operations. They can learn and do things like getting a detailed analysis of their costs and revenues. They can view data underlying cash flow statements and they can compare and margin planned income versus actual income. BI makes it possible to analyze and pattern their current care practices, identify underutilized services and then create reports to use for mandated reporting.

Patient Care Intelligence: Business Intelligence solutions include analyzing patient data for clinical patterns and treatment protocols. They can then share this information with patients and connect them across hospitals, physician offices, physical therapy offices and nursing homes. Business Intelligence allows better monitoring. They can forecast patient diagnoses to improve patient care, administer better treatment and reduce wait time.

Billing and Claims Intelligence: Business Intelligence improves billing and claims. Health care providers can use it to generate clinical and service-line reports. These reports are used for a myriad of things such as analyzing and monitoring claims to determine risks, create effective rate structures, prevent fraudulent claims from processing, improve claim response times, identify potential losses and analyze risk across the entire network.

Marketing Intelligence: Health care providers can now review and analyze the success of their marketing efforts. Using Business Intelligence to measure the impact of marketing and communication efforts on brand perception and performance will improve clinical effectiveness of their products and services plus allow them to track campaign costs and compare them against their budget. Monitoring products and services that are profitable in specific patient segments gives them the ability to calculate the ROI on their campaigns and then match it with their performance goals. Business intelligence creates more solutions than problems. BI can help a company become more efficient and find ways to cut costs while also identifying new business opportunities.

Author Bio:- Sumit Kumar is a business strategy consultant and involved in designing breakthrough BI Consulting and Business Intelligence Services derived from a blend of powerful fusion of knowledge and imagination. He occasionally writes articles in niche marketing segments and consumer insights.

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