Summary
In this episode of the RCM Experts Podcast, host Carrie Bauman, VP of Marketing at WhiteSpace Health, speaks with Amar Rao, a seasoned revenue cycle leader with over two decades of hands-on experience. Amar shares his journey through the back end of the revenue cycle, from AR associate to guiding enterprise clients through complex RCM analytics implementations.
With a background in AI, ML, and Six Sigma, Amar discusses how a data-driven culture powered by actionable KPIs and standardized methodologies like DMAIC is essential to navigating today’s complex healthcare landscape. He emphasizes the value of identifying root causes, leveraging data for process improvement, and reducing costly denials through continuous learning and performance tracking.
Key Takeaways
- Amar highlights the importance of real-time analytics to keep up with payer and coding changes.
- The Define, Measure, Analyze, Improve, Control framework helps uncover root causes and drive improvements.
- Most denials result from errors tied to the provider, payer, or patient and require targeted fixes.
- Achieving a 98% clean claim rate signals strong revenue cycle performance.
- Credentialing, coding, and patient information must be kept current to prevent delays.
- Automation reveals insights, but execution relies on skilled human judgment.