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By
October 05, 2020

Lean Business Transformation - SPEAKER SPOTLIGHT : Lean Business Transformation

Courtesy of Cognizant's Anantha Pudukkottai, below is a transcript of his speaking session on 'Lean Business Transformation' to Build a Thriving Enterprise that took place at Business Transformation & Operational Excellence Summit & Industry Awards.

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Session Information:

Lean Business Transformation

As part of RCM 3.0, we will discuss major shifts taking place in the Revenue Cycle space in Healthcare, the impact of those changes in RCM for providers/health systems. We will review capabilities and value propositions to the industry through reimagined RCM 3.0. We will discuss  value levers in RCM 3.0 and committed proven results.

Takeaways:

  • Levers that can be used to maximize collections
  • “Shift Left” strategy to accelerate cash
  • Initiatives to optimize costs

Session Transcript:

Just to give you a little background has over 20 years of experience in the BPO industry with a proven track record and managing profitable business across multiple verticals as strong experience with multiple facets in health care.

Which is very invaluable the payer that provider the PPM's intermediacy and all the medical device manufacturers and distributors and he leads the digital operations business unit for provider health systems unit cognizant he holds an executive certification International Management and the garbin School of Management Thunderbird University Arizona and a master's in the computer applications and a Bachelor of Science in mathematics.

So who can have a presentation and plenty of time for the awards session thank you very much and you know and we still keep up the same stock mentality trying to go proactive to our clans to resolve their eats me you know briefly again you know we are too prone 18,000 employees across hundred plus delivery centers around the globe.

We also have a video for 16 from is not an opportunistic there we have made investments intentional investments to grow the business for jockey and with our gantley and you know we have we are currently present across all phases of that video that we actually working on the rear side premium site provider side laboratories.

You know medical technical organizations working with pharmaceutical organizations and governmental affairs so we work across all areas in health care why is that important it actually gives us no perspective from every other area extra annex for example when we actually work with insurance and claim and then you get a month later saying well you know you still have to pay X dollars now you know maybe the reason was either okay I got rejected by their right we would obey the June's company they were actually able to tell all the you know errors that are being done but actually being submitted from waterside.

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You order the promoter site you see all the you know grateful things that you have to do to make sure that the table comes in on the right from first time so we kind of you know have the best of both worlds we have over 15,000 people whose life actually they're full of chemicals associated working you know business processes standpoint on the paid insurance side from whatever side just as an example right so which means these people really share the best practices with each other issues.

Now so that you really have to be do things faster just a small example you know three engines so we use that to the best of our friends just some context then you know we currently actually serve one 1/2 of every patients our member the US population 150 personal populations actually self bipartisan either by us touching them from a service standpoint or you know giving present in our software applications.

Right you know the health care space we actually serve positions and or to our services and I can go on now we go through each language work there but essentially we are present in almost all areas giving us the advantage now you know little farther into in our healthcare specifically into the revenue cycle space management space this is one of the services that we offer to our product lines.

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Which is which were ADT to you know the healthcare providers health systems medical device manufacturers distributors this is really a simple process of definition services it's a simple process but at the optimal cost which means utilizing the right processes and giving the cost of those collections that they absolutely those right that's really the you know pure definition for Mycoskie we all know we've at least enough for those of us that are working that industry we know that's easier said than now and you know it's never easy process to actually ensure that you're just because there are leakages illnesses and there are no manual processes that actually hinder us from correctly at maximum power o allow us that makes us actually spend much more than what we should really be spending.

Now what do we do at cognizant again just in 30 seconds we have experience in doing this reminisce active management service for our providers health systems in our physicians and medical device manufacturers over 20 20 years we actually have over 150 clients for whom we actually provide a service we 3ns probably.

I stated earlier is being so 60,000 physicians we have 5000 people actually we provide a flexible grid on the mini model to the skin in the game which means money sisters if you don't so we have to know now one of the services that we provide again I'm not going to go through every meter that's given on the slide for you as being material but this was process services standpoint we do soup to nuts now in terms of study with credentialing of a provider to the point of actually having a contact center for our patients to collect the dollars from the patient's insurance companies manage denials and so on we actually you know bowler Clearing House has invested intentionally to grow organically in organically for five years back.

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we actually repressor and the try setup actually has wonderful products and services that they were providing to the healthcare industry and a to tricycles acquisition we really have you know in expertise both the services area and the product side one of the key you know benefits conti provider you know market health care market is that we currently own a clearinghouse we are one of the largest claiming house providers in US airspace and so we don't provide enough again internet radio services as well we do analytics enough from a revenue cycle management standpoint we'll provide intelligent dashpots.

We actually do predictive and descriptive analytics we'll talk about that in a moment as we move forward and then we also do what we call is the contract management analytics so for a very simple business example of submitting a claim many of the physicians and health systems and systems today don't have to bed without the manpower humanly to pick up all those transactions and they will be able to check whether they take if a paper hits you know it's due for the particular claim they say thank you very much they toss the case but we have been able to develop you know technology by which you know from a back-end perspective anything comes through we are able to value it and check we have value it and check whether we got paid appropriately for that particular case and we are actually.

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So we know I seem analytics across all of these we also do consulting to identify gaps and gaps could really result in want solutions or so actually in the was happening which we have seen with our systems groups organizations where there is increasingly population the aging population that there's an expectation that we're going to have much higher in our healthcare claims that again unless you are really ready for it you're essentially adding.

One manual infant a human effort putting more people into the task which obviously is not the right solution the last but not the least is we are seeing the market actually moving into looking at Point solutions from an automation standpoint analytic standpoint we're also looking at how can we ensure that our collection from our perspective is maximized and this done quick as possible time so these are in a few prints that we've seen the top portion of the slightly talks and all the four but essentially you know if you look at it and we did when solar was actually done with the CEOs of hospitals they basically said that the single biggest reason that they really.

You know see as a challenge in the industry is the regulatory in phenomena the changing last state whereas that are changing that's obviously a bigger concern Massimo's perspective to make sure that they're in the cash we are also seeing an uptick where the CEOs CEO most of the operations also she kept saying well I read not just because that's the second topic but more importantly I don't really have the solutions that are we needed to perform the support revenue sector function so you seen nebulizer in the market taking just one step further when we talk about challenges.

I have put support enough challenges in our case twice or thrice now ours being seen from a collection perspective whatever it is he has a challenge so if you look at you know suboptimal collections you know because of the and you know what if you look at the underpayment management just as an example when a dream was actually submitted and you see what really happens is again what I call is a ostium 1.0 was again put more people let those people figure out.

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where is the reason for denying and then just having looking I them so you know more people further and then figure out this other cop yeah steps to the whole process and the solution plan is really from a technology perspective we have developed you know predictive models we have credit of analytics models well before even actually claims some integer based on the past data what actually comes up with sample of things that would get the right.

If another pair of eyes don't look at those games so we make sure that we pull out every single day before it came actually gets some you know the payers list of games actually is being quality or deterred by you know one more pair of eyes that you know ensure those you know errors that we believe would be there in those games are before they are submitted so that eliminates you know are denied and obviously accelerates the cash another one most important that are clearly see as a challenge today is recognized in defender.

There are other points that you see there are three district point solutions but recognizing trends across the whole operations right they have seen is coming under pain you know I'm actually seeing a low first pass claim now I'm seeing more image so there are things that could be happening but if in a holistic way now we are not looking at the trends that are happening in the operations that we use in the whole game so we you know have our in-house proprietary tools.

So if you if I didn't define the processes that we can become each of them individual you know intellectual property and through those you know along with you know the government's approach predictable reliable and repeatable you know operating and we have been able to bring outcomes of you see another side which is really reducing the total cost of ownership for our trans by 40 percent now obviously each so how do we look at the asking industry awesome 1.0 is a scenario where we actually had solution was only putting in 14 oh hey you know too many people for a problem try to resolve the problem doesn't get us out.

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So I seen 2.0 was putting in people but also identifying small buckets of areas that you could really automate bringing some tools that you can you know as a point solution but asking 3.0 is basically a reimagined version from a value stream you know point of view from cognizant where we think we look at this in a completely different lens right we actually look at the every single step of and so and so and so obviously so Deepa so you know the functions at a broad level in terms of from the time comes and for let's say a medical device or the chart entry system and a patient actual business to the point of actually posting the cash what are the typical interventions.

That can be plotted right what are the analytics predictive and descriptive really green so you mainly see that we launched a six point step that we have called out the site where at each step we are really able to perform either you know a process transformative activity which is simple again predictor reliable and repeatable in operating model availability equipment in terms of managing their forecast looking at thewhat is the trend of you know the volume based on seasonality and stuff like that and defying you know correction propensity well ahead of even a claims being submitted and the third step you see is a small part.

This was basically a very interesting you know evolution that cognizant has seen and information Carson has named you know this value chain his feature of really allowing you know that said well the auditor to go to cup of soccer games and perform quality are already on them we actually have a tool that goes back in our historically within the last one week I think the place where have we seen more errors and actually.

It does become focused audits from those particular area and this is being done systematically instead of you know human beings actually going and picking up some engines so we implemented on our process and you know looking at predictive and a retrospective denial management last but not least we have you implement sentiment analytics Park accent this is a pretty interesting concept you know down into the last 12 to 18 months and for our clients.

So we are not contact cetera but we are actually speaking with a pair insurance person all the patients depending upon of the golf course you know based on the you know the tone of the call based on certain catch places if the call is actually going in a very conducive call you know this will call actually a little confrontational and you know heat it out and that actually is not enough real time basis when our auditors and team leaders are able to jump into the right of it.

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When processes are taking the course we're able to identify it is called the 1x that you probably need to jump in and then the quality of our air quality because people to jump into the car and you know address the you know situation instead of just having for more conversations and conflicts and then our contact with our patients and providers so know this is what we call is the sentiment and anything's spelling shows so these are all the stuff that we've been able to do.

I can maximize you know the collections and other sector space for our clients this is a case study in the middle you know the last minute to arrival date which is you know just as an example with DME medical device and so there was a which is we determine that the subscribe would actually be then intelligent - poor but because of the leaders at running operation to the French site and not have issues be managed this line needed a predictive analytics one two things were getting tonight and to that model we were able to determine.

Who are the you know key numbers that will cross in the errors and why which means we were able to take some feedback back to them and say hey if it's you know Susan that sitting and doing this the error will go back and keep that required training they were passing you know problems in that collection plate then we were able to automate you know many of the processes as well and go to the awards everybody's waiting for but please feel free to come speak one-on-one and look forward to seeing you at the awards session.

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About the Author

more (14)-1Anantha Pudukkottai,
Market Leader - Provider and Health Systems Digital Operations,
Cognizant.

Ananth has over 20 years of experience in the BPO industry, with proven track record in managing profitable business across multiple verticals. With strong experience across multiple facets in Healthcare (Payer, Provider, PBMs, Intermediaries and Medical Device manufacturers / distributors), Ananth leads Digital Operations business for Provider Health Systems unit at Cognizant.

Proven experience in managing multi-geography, multi service line portfolio with strong customer relationship management, enabling process transformation in large scale engagements through process improvements, global skill-matching, technology point solutions and automation resulting in strong value. 

Ananth holds an Executive Certification in International Management from the Garvin School of Management - Thunderbird University, AZ, Master in Computer Applications and BS in Mathematics.

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