The Risk-Free Way to Achieve Transparency in Coverage

Big changes are coming in the world of healthcare data. New legislation is going into effect which will require newer, higher levels of transparency from organizations both big and small. By July 1, 2022, health plans have been required to publish in-network providers charges as well as out-of-network “allowed amounts” on a website that’s available to the public. It’s a lot to handle.

But while this legislation can present a challenge to large organizations with entire swaths of data to dig through, it also represents an opportunity

If you’re part of a healthcare organization that’s been caught off guard, you may find yourself flooded with data. Your team may be poring over all sorts of in-network information and out-of-network “allowed amounts” you have to publish. And much of this data can be low-quality, hard to find, or, worst-case scenario, unusable. So how does it represent an opportunity?

Because as an organization, it may be the perfect time to learn how to add transparency in coverage, untangle the knots of your massive amounts of data, and completely upgrade the way you publish information online. Here’s how.

The challenges in achieving transparency in coverage

Let’s start with the basics. As notes: “Beginning July 1, 2022, most group health plans and issuers of group or individual health insurance will begin posting pricing information for covered items and services.”

We recently spoke to someone in the business, and that interview was enlightening. For starters, the description above can make the transparency process sound easy—the simple flick of a switch. But the individual we spoke to, who works for one of the largest healthcare enterprise organizations in the country, found it frustrating to sift through all of that data.

For starters, he said, they have to find the data. And in large organizations, the amount of data can be massive. And even when the files are there, there might be problems with it. So this leader found that they were now in the position of fixing data issues they didn’t know before.

Sound like good news? Maybe not, but it can be—if your organization is ready to respond to a challenge like this. 

And what defines the challenge? In this case, it may come down to a lack of tools to address the agile business needs of large companies. Typically, these tools are either…

  • Time-consuming, especially for large organizations with a lot of data to sort through
  • Complicated, especially when the data you’re trying to make public isn’t high-quality

But discover the right tools, and your business can cut through all of this confusion. 

For example, consider your ReM score, or readiness score. Used effectively, it has the opportunity to transform the way your organization handles readiness—potentially paving the way for dealing with challenges like these for years to come.

ReM score, or a readiness score, is a modern tool that measures your capacity for dealing with sudden changes like these. At M Corp, for example, our 15-minute digital interviews can produce same-day insight reports that help cut right through the confusion and get to the heart of what’s complicating your data challenges.

In particular, the ReM score highlights key business weaknesses—such as lack of alignment between teams, or outdated business rules—so you can address them immediately and take your business to the next level.

The Benefits of M Corp’s RPA-as-a-Service solution

The question, then, is how you move to that next step. Enter RPA-as-a-Service, short for Robotic Process Automation-as-a-service.

M Corp’s RPA-as-a-Service solution makes it easy for hospital senior management and administration to process and manage data quickly. As a result, you can move just as quickly to ensure maximum compliance. Even better, M Corp’s RPA-as-a-Service solution is pay-per-outcome, creating a “pay-as-you-go” situation: we guarantee the execution of data migration so you only pay for the end result.

In the phone call we alluded to above, an executive was dealing with all sorts of headaches as the result of outdated data—and entire swaths of it. RPA-as-a-Service is essentially a way to dig out of this. Leadership can then spend less time worrying about the right RPA vendor—especially when there are hundreds of vendors to choose from—as our RPA-as-a-Service can do that part for you.

But that’s not the only problem it solves. By acquiring RPA-as-a-service, you can work towards greater compliance with the following benefits:

  • No more upfront costs
  • No more tech to purchase or operate
  • No more manual workloads
  • No more human-based error

The overlap: handling more transparency in coverage with less manual work for your team

Our RPA-as-a-Service delivery model features a risk-free approach, which separates it from other options on the market. Executives like the one we recently spoke to are looking for solutions like these not because it reduces a few headaches (though it does do that), but because it represents a way to elevate an organization’s overall capacity to handle change.

In other words, M Corp’s risk-free model takes these colossal, time-consuming data overhauls work much more quickly, much more easily, and doesn’t require taking on the risk of frustrated teams and incomplete processes.
When our automated bots run 24 hours a day, potentially completing hundreds or even thousands of records per day during that time, your organization has less on its plate. That gives you more opportunities to level up your services elsewhere—to become more agile, more efficient, and more capable of handling sudden change. It’s the kind of challenge that, when properly handled, has the potential to uplift your entire business.