In the last post (Read it Here) I discussed the importance of being able to see your entire hospital as one whole entity. As discussed, a typical traditional 3 years back cost recovery firm will find savings missed inside and outside of your system. Recovery by itself is not enough, nor is it good enough for the changing healthcare environment. Only an in-depth continuous audit with deep dynamic analytics will reveal every issue or confirm your processes work.
Deep analytics give rise to the following types questions:
1. Why did we have $2M in duplicates caught last month?
2. What is the full value of our unprocessed returns?
3. How are many duplicates payments made?
4. Where does our return process break down?
The force multiplier is root cause analysis and mending. The ability to ask why is this happening? Where does our system come unstitched? How do we mend this?
Recently, a hospital was able to recover a $1,000,000 duplicate payment that had evaded their internal controls. In fact, during the process, it was revealed that the internal system had gaps in their measures. The deep analytics and horizontal view across their enterprise discovered the issues and pointed the internal team toward the corrective measures. This is where recovery and visibility meet to deliver recovery and resolute savings.