Read this article about Cognizant Technology Solutions, one of our finalists, in the category Best Achievement in Operational Excellence to deliver an outstanding Business Expansion and Revenue Growth, selected by the independent judging panel, for the 2019 Business Transformation & Operational Excellence Industry Awards program. Click here to read articles on other finalists.

Revenue Cycle Management Reimagined

Healthcare providers must think about revenue cycle management in a whole new way, which Cognizant calls RCM 3.0 -  It envisages ownership of improved performance across all aspects of process and organization, keeps the patient experience at the center of all collections and leverages analytics and technology predictively. 

30% of Cognizant’s Digital Operations’ revenue comes from Healthcare services today, and the offerings are spread across payer and provider health services. Revenue Cycle Management is one of the key service line offerings by Cognizant for physicians, hospitals, channel partners and medical equipment manufacturers. Cognizant offers a range of product, platform and service solutions to help our end customers recover their cost of medical services and products faster and with lesser cost.

 Major shift in industry trends and How has Cognizant responded to changing trends in RCM

• Moving towards Business Process as a Service model(BPaaS)-Acquisition of companies like Trizetto & Bolder to enhance our platform & product based offerings and shift from standalone services to affordable platform and solutions; Adding new capabilities like provider credentialing support and multiple specialties
  
• Readiness to adapt to ever changing payer needs and behavior–Offering data science driven analytics solutions for denial management, underpayments, patient lifestyle behavior leading to medical incidents; sentiment analysis for better patient servicing; Leveraging credentialing data to understand payer contracting issues and integrate insights with the business processes
  
• Transition from traditional RCM to value based reimbursement model -Leveraging analytics to guide the contract and service rates based on patient lifestyle and payer behavior; Integrated delivery business model with products and IT for better outcomes; shared service model for cost optimization
  
  
• Bringing on disruptive changes in the commoditized market of RCM through digital intervention –Leveraging our IT arm to drive enhancement to client platform, implementation of robotics automation services to develop 100+ automation solutions, process reimagine to reduce voice based activities by using more websites, physician portals etc

PROCESS IMPROVEMENTS IMPLEMENTED IN RCM SERVICE LINE WITH PROVEN RESULTS

The RCM 3.0 framework gives us a robust foundation for business scalability and growth for Cognizant and create significant value for our clients by realizing faster cash along with cost optimization. 

Below is the summary of our value levers implemented and benefits delivered for our clients.

• Focus on metrics that matter
• Robotics Process Automation
• Predictive and Descriptive Analytics / AI
• Advance Reimbursement Manager Solution Tools
• Continuous Process Improvements
• Value Stream Mapping, Lean Six Sigma
• Redundancy in Process & Data
• Agile Operating Model
• Collaborative and Flexible engagement models
• Flexible Pricing Models
• Business Impact Monetization
• Gateway EDI for claims management

BENEFITS

• Accelerated collections for clients up to $150+Million
• Bad Debt reduction up to 3%
• Collections% improvements in the range of 5% to 9%
• Total cost of operations reduced by 40% to 50%
• RCM service line has grown by 67% in last 2 years