Millions Lost From Being Afraid of Change with Kyle Devereaux
June 28, 2024 – accūrō Solutions
By Kyle Devereaux, Edited by Allison Brekosky
We live in a world of technology. Those unwilling to learn and unwilling to change are quickly passed by those always looking to innovate. Have you ever tried to break the trend of not upgrading your cell phone? For a few years, you can get away with patch-updating, but eventually even basic updating becomes impossible. Now imagine being on a cell phone from the ’80s or ‘90s (and yes, they were around back then.) The phone will provide the user basic functionality, but it certainly could not compete with the iPhone 15.
Our industry of Workers’ Compensation Bill Review is no different. So many utilize bill review technology from the ’80s and ’90s, band-aided together to try and compete with newer software platforms. Some of these old platforms were supported at one point by the dreaded green screen, yet people stayed loyal to these platforms because they were afraid of change. I believe, however, the cost of not changing bill review systems/partners substantially outweighs the time commitment and monetary cost of change.
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Medical Spend is the #1 expense of any insurance carrier or payer. Can you imagine saving 5% when your medical spend is $100,000,000? That is $5,000,000! Imagine cutting wages by $5,000,000. You would have to make some serious sacrifices/changes in any organization. Now when it comes to medical spend, a change to your bill review system could save you $5,000,000, if not more. Yet people remain complacent due to the fear of changing bill review platforms/partners: the fear of the cost and time it may take to make that change. When given the opportunity, our team would be happy to show the impact that such a change can make to improving your bottom line.
In an industry where it is imperative to support and update timely fee schedules, which includes UCR and Medicare data, wouldn’t you expect a system that was built with these important factors in mind? And, not only that, but is fully transparent to the client from mailroom to payment? This is why modern technology in our industry is key.
For example, the NPI (National Provider Identifier) is one of the easiest places to find savings. Providers and billing companies are looking for ways to beat the technologies being used to identify payments. Physician assistants and nurse practitioners are certainly reimbursable medical expenses. However, if NPI data is not updated, you are probably paying for an MD while a PA actually handled the service. More and more, providers are moving to billing companies that sell their services to maximize billable hours. The only way to combat this on a regular basis is to have every NPI listed in your database. This has always been a problem for old platforms to handle, however, with new technology available, it is actually very easy and seamlessly achieved.
Imagine being an adjuster and having a new platform that was built with flexibility and tools to help you maximize your claims handling processes. In an industry where keystrokes are monitored and time spent reviewing a bill is at a premium, you need a platform that is efficient and accurate. Our clients rave about this very thing!
Many decision makers will not change due to their fear surrounding file transfers and APIs. Using a software platform, built decades before APIs, would make me nervous, too. Now, imagine a system built for this very thing – software built to go from one network to the next, in turn garnering the greatest savings while having the ability to monitor those feeds and know exactly where the bill is at, at all times. accūrō Solutions’ ARC provides exactly that.
Changing bill review platforms doesn’t need to be scary, and it’s not with accuro’s ARC platform. What is scary is the amount of cost-savings companies are missing out on by not changing! To this point, changing bill review platforms used to take the better part of a year, if not years. With new technology, those changes can be made in just a few short months!
In our March Experience in Action, we highlighted Our Medical Bill Review Check-Up and how it helps the payor identify their current true Net Savings, so they have a real benchmark from which to begin analyzing performance. It is a very simple process to get started. When provided historic specific performance reports, we can determine how much the payor is saving or wasting. Our analysis provides the clarity needed to make an informed decision to make a change.
Take your organization to the next level. Imagine saving your company $5,000,000 and what that would mean. Let us help you reach that potential by reaching out to us today to learn more.
About the Author
Kyle Devereaux currently holds the position of Vice President of Sales. He has over 18 years of experience in the Workers’ Compensation Industry selling bill review, PPO, Managed Care and Pharmacy solutions, holding key roles at Enlyte and Prime Health and United/Optum.
Kyle is a solutions-focused sales executive that puts the client first in understanding their needs and what will drive their success through true partnership. He loves to dive into solving complex challenges and thinking outside the box.