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How Revenue Cycle Management Software Makes Providers More Profitable

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Xand Griffin
June 22, 2022

For healthcare providers, communicating the cost of care to patients can be challenging. So many factors impact healthcare expenses, making it difficult to provide accurate estimates.

Patients often leave frustrated and dissatisfied due to the lack of transparency in the estimation process. Thankfully, Rivet has an easy-to-use solution through its powerful revenue cycle management software. 

Read on to learn more about our partner Rivet and how they improve profitability for healthcare providers.

Ted Ferrin is the co-founder and CEO of Rivet, which is a transparent pricing tool for healthcare providers. 

Improving the Patient Experience

Rivet is unique because it allows the provider to send this information directly to the patients via cell phone or email. Then, they get various payment options that allow for a more flexible transaction process.

“In 30 seconds, when someone asks: 'What is this going to cost me?’ Rivet will run their benefits, reference payer contracts, and it’s going to pre-adjudicate the claim once you key in the codes you’re going to bill. It’ll spit out, with a high degree of accuracy, what the out-of-pocket patient liability will be.” -Ted Ferrin, Co-founder and CEO of Rivet

When patients receive this information through Rivet, they gain more confidence in their provider and continue coming back.

Rivet Offers a Solution for Payer and Claims Management

Most providers are not sure what their payers are supposed to be paying them. To solve this problem, Rivet offers a product called Underpayments. This product ensures that payers are holding up their side of the contract. 

Using the same software as the transparent pricing tool, Rivet audits what the insurance company paid the provider to confirm that they are paying according to the contract. When there is a pattern of inaccurate payments, Rivet will catch it for you.

Since Rivet pulls all of the claims data for the provider, they only need to use the supplied analytics tools to determine which payers are worth continuing a contract with and which are not. Providers can then negotiate future contracts and use that data to back up the terms.

Through financial and patient data, Rivet directly impacts provider revenue efficiency. Providers have more information on what to expect from payers based on their contracts.

Managing Denials and Appeals with Rivet

Denial rates, particularly in specialty medicine, can account for up to 10% of claims. That has a massive impact on the profitability and revenue stream of a provider.

However, determining which denials are from contractual requirements and which ones are from errors or other issues is time-consuming. Many providers have to create complex spreadsheets and allocate tasks to staff members.

Rivet can route every detected denied claim to the assigned person and explain to them, step-by-step, what the process is. This technology assists in training new employees who have never dealt with denied claims before.

In addition to guiding staff through denials, Rivet also makes it easy to fill out appeals. With the data collected through Healthjump, Rivet automatically populates appeal forms so that employees won't have to spend precious time filling out the same boxes on repeat.

By using Rivet, providers can worry less about providing patient cost estimates and tracking payers and instead focus on delivering high-quality care to their patients.

Using an EHR Data Collection Partner

Collecting data from many EHRs can be time-consuming, so Rivet partners with Healthjump to solve this problem.

Ted discusses why partnering with Healthjump is beneficial to a company like Rivet.

“Healthjump, to me, is a way to save a lot of engineering money on manually building integrations.”

Since Rivet's partnering with Healthjump, they don't have to hire engineers to exclusively work on data integration. They are able to focus on their core product and make it the best they can for their customers.

In fact, Rivet just raised $20.5 million in Series B funding as they look to increase their presence in the outpatient segment and expand into larger facilities, hospitals and health systems.

Healthjump is a data platform for healthcare technology companies looking to simplify the data collection process. Our team is always excited to work with innovative healthcare companies like Rivet.

Contact us to learn more about our products and see what Healthjump can do for you. 

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