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Behavior and Mental Health EHR and RCM Utilization Review

Written by Kirk Monroe | Aug 2, 2022 10:53:23 AM

 

By saving money, treatment centers can dedicate their time and resources to improving patient care. Lightning Step’s All-In-One System puts everything your staff and patients need all into one place. 

For treatment facilities to grow, they need to be able to maintain low management costs. Lightning Step provides a simple solution for successful treatment facilities to operate with fully integrated CRM (Customer Relations Management), EMR (Electronic Medical Records), and RCM (Revenue Cycle Management). 

What Is Utilization Review?

Utilization review is a process essential to treatment facilities to ensure that patients are provided appropriate care and that insurance companies are covering all necessary costs. It refers to the process that insurance companies use to approve or decline services. This process helps to determine the necessity for procedures and treatment and may recommend alternative forms of care if one doesn’t seem the most suitable or cost-effective. 

The utilization review process is an important factor in improving care services, determining appropriate care, and managing care costs. When Utilization Review is poorly managed, it can affect businesses by limiting their profits and also impact patients’ length and access to treatment. 

How Does Utilization Review Help Companies Save Money?

Lightning Step’s All-In-One software helps companies save money with no hidden fees and has everything you need all under one price without having to pay for separate systems. Having a seamlessly integrated system allows for maximum accuracy, data integrity, and efficiency. 

One specific benefit of utilization review is that it helps to identify unnecessary costs and provides alternate solutions. This prevents fraud, abuse, and a waste of funds. Utilization review also serves as an integral part of avoiding claim denials. At Lightning Step, we set ourselves apart from other companies by going after payment on denials and requests until our clients receive what they need. 

Lightning Step makes it effortless to perform business audits. A fully integrated EMR and RCM prevent overlooked billing opportunities by ensuring that all billable items are accounted for and are billed properly. 

Our software saves you the time and cross-communication required from working with separate systems. With Lightning Step, authorizations that do not match admission records are automatically red-flagged when claims are submitted, without having to spend endless hours filing through stacks of paper. 

Oftentimes, businesses may need to assign a staff member to make sure billing is being handled properly. Lightning Step automates the work, and by saving time, businesses are able to save money and be more involved in patient care. 

What Are Some of Lightning Step’s RCM Software Features?

When you choose to use Lightning Step to help your business grow, everything you need from before the patient is admitted to after discharge is all in one place. 

Our EMR automatically threads authorization numbers from utilization review to the RCM. With an RCM that is fully integrated with EMR, any information collected during the patient intake to perform a verification of benefits will be lightning threaded between the EMR and RCM. Without our fully integrated system, that same information would typically have to be manually re-entered into separate systems, lacking efficiency and allowing more room for error. 

One feature of our RCM is that claims are auto-generated in batches and sent to insurance companies. Auto-set and follow-up alerts are then sent to the billing team member to follow up, making it easier to manage time and information. 

Our system also can detect payer reimbursement errors. It contains patient ledgers and can research all claims and payments under one specific patient. This makes it much more simple to track patient history without having to go back and forth.

Lightning Step’s software can also provide reports on AR aging and can run historical data that does not change and see summaries and claim-by-claim data. You will be able to see the percentage of claims that are denied and view it by reason, the average attempts at claims being filed before payment, and the total claims billed by the month. 

Another notable feature of our software is the patient portal. Patients are able to access information like payment statements or other things they may need access to without waiting on the phone. With Lightning Step, important information is available to them at any time.  

Having your workflow automated through Lightning Step’s All-In-One system eliminates time-sensitive issues that can be associated with having to keep up with the many tasks you once had to do manually. Our fully integrated CRM, EMR, and RCM ensure that treatment facilities provide the best care possible to their patients and save money. 

Lightning Step Technologies’ fully integrated CRM, EMR, and RCM have all the tools behavioral treatment facilities need to operate and grow. Utilization review is a process done to make sure patients are receiving proper care and to make sure that insurance companies are covering the necessary costs. Utilization review is essential for any behavioral health care facility and can help manage costs. Utilization Review helps businesses save money by identifying any unnecessary costs and providing more suitable solutions. It also works to prevent fraud, abuse, and a waste of funds. With Lightning Step, you will see that we are the best at utilization review because of our efficiency, our focus on client satisfaction, and our relentlessness. Lightning Step’s All-In-One system gives treatment centers the tools to allow them to focus on providing the highest quality care to their patients. To learn more about our All-In-One system, schedule a demo today.