Overview
Hospitals frequently lose revenue not because claims are denied, but because payments arrive short, delayed, or incomplete — often hidden within payer adjustments or slow follow-up processes. Traditional RCM systems lack the intelligence to surface these gaps proactively.
Generate’s Revenue Erosion Tracker for Healthcare continuously analyzes claim aging, reimbursements, and payment variances to highlight where money is slipping through the cracks. This gives revenue cycle teams the insights they need to take action early and recover dollars that would otherwise go unnoticed.
Problem
Healthcare revenue erosion happens quietly but consistently. Common causes include:
- Underpayments hidden in payer adjustments
- Claims aging beyond timely follow-up windows
- Payments posted below contracted rates
- Delayed reimbursements that stall cash flow
- Overwhelmed teams unable to monitor thousands of accounts
- EMRs that don’t reconcile expected vs. received payment variance
Over time, these small discrepancies add up to millions in preventable losses.
Solution
The Revenue Erosion Tracker for Healthcare automatically compares expected vs. actual payments, monitors aging accounts, and identifies patterns of erosion across payers, service lines, and claim types.
The solution enables:
- Early detection of underpayments and delayed reimbursements
- Prioritized lists of accounts with the highest revenue at risk
- Visibility into payer-specific erosion patterns and trends
- Better forecasting and cash flow management
- Stronger adherence to payer contracts and negotiated rates
This turns reactive revenue cycle management into a proactive, data-driven process.
Key Benefits
- Recover Revenue Hidden in Aging Claims: Identify underpayments and delays before they become write-offs.
- Strengthen Payer Accountability: See exactly where payers are short-paying or missing contractual obligations.
- Improve Cash Flow Predictability: Uncover delays early and empower teams to follow up before revenue slips away.
- Boost Productivity with Clear Priorities: Teams know exactly which accounts need follow-up today to protect revenue.
- Reduce Financial Leakage: Prevent repetitive patterns of underpayment with actionable analytics.
Who It’s For
- RCM Directors & Managers
- Revenue Integrity Teams
- Hospital CFOs
- Analysts monitoring cash flow or payer behavior
Example Outcome
Hospitals using the Revenue Erosion Tracker typically see:
- 3–5% increase in collections
- Faster identification of underpayments
- Higher payer compliance with contracted rates
- Reduced revenue left in aging accounts
How It Works Inside Generate
The Revenue Erosion Tracker operates as a secure, local agentic workflow inside Generate:
- Runs entirely within your hospital environment (on-prem or private cloud)
- No PHI ever leaves your network
- Ingests EMR exports, EDI files, and contract data
- Provides clear, actionable variance insights daily
It’s a powerful tool for protecting hospital margins in an increasingly complex payer landscape.
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