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The Intersection of Human
Capital and Technology

The Value Delivered by Sona ProMISe

Introduction


Traditionally, Accounts Receivables (A/R) work was a manual process leveraging callers attempting to track down owed monies. But our clients want to receive cash faster, reduce losses, identify and correct issues that delay payments, and move to a more prescriptive denials management process. Through Sona ProMISe, a web-based A/R and denials workflow tool, Vee Healthtek is delivering on that vision today. The solution is evolving from being descriptive to predictive, and then to an ultimately prescriptive solution.

Problem Statement


Accounts receivable work requires skilled and knowledgeable resources to successfully process work that can be tedious and complex, while requiring an analytical approach. Finding and retaining this type of individual can be challenging. Not having properly trained and experienced staff can mean delays in receiving payments or uncollected money. The inability to identify and communicate root causes to issues can result in problems continuing to perpetuate throughout the organization. Organizations that do not utilize a workflow management solution find it difficult to accurately report the status of their accounts receivable and effectively manage staff.

Proposed Solution


Sona ProMISe is a web-based accounts receivable and denials workflow management solution developed by the Vee Healthtek Information Services team. It is comprised of three modules – Core, WORPP and MIS. Core manages the master database, system configurations, and users. WORPP is the workflow engine where work queues are built for different roles and support A/R claims-related tasks. This component is also where quality checks and communication between users occur. The MIS module supports reporting and dashboards.

While Sona ProMISe provides work queues and productivity reporting, its real benefit comes from automating and prioritizing the work into logical clusters. Leveraging machine-learning and analytics tools, Sona ProMISe prioritizes work into different categories, such as high dollar, critical to timely filing limits, recent denials, cross filed limits, and others as needed to support client requirements. This information is used to prioritize the work inventory and assign the most appropriate and effective resources to the work that needs their expertise. The result for our clients is more cash collected faster.

Proposed Solution Graph

Communication and transparency are important pillars of the culture at Vee Healthtek. Through the MIS module of Sona ProMISe, our clients have access to customizable dashboards that provide real-time reporting information. These dashboards allow users to drill down into detailed information about the A/R, the entire claim life cycle, and productivity data. An example of dashboards we have created include:

  • Accounts Receivable Summary – summarizes A/R inventory into categories, such as age, financial class, denial codes, and work assignment
  • Inventory Status – summarizes the inventory into the following categories: Worked, to be worked, and non-workable to assist in monitoring progress
  • Resolution Summary – compares age trial balances between two periods to determine the number of claims resolved, the dollar value and percentage of claims that were resolved
  • Inflow Summary – compares age trial balances to determine the number of claims added, the dollar value and percentage of new claims
  • Monthly Collection Summary – compares the age, financial class, and transaction type during the last six months
  • Trend Chart Summary – compares six-month trending of the A/R, collections and adjustments

These reports are all customizable and available to our clients, offering transparency and accountability for the entire A/R process.

Conclusion


The development of Sona ProMISe by Vee Healthtek is enhancing our ability to deliver the high-quality solutions our clients expect from us today. At the same time, we provide a solid platform to enhance the accounts receivable process by utilizing more sophisticated technologies well into the future. We are leveraging this technology and shifting from a descriptive reporting tool to predictive automation that prioritizes the A/R inventory to optimize cash receipts. In a short time, Vee Healthtek will utilize artificial intelligence to convert Sona ProMISe into a prescriptive tool that automates the revenue cycle management workflow and advances Accounts Receivable services to unprecedented levels.

Mark Kausel

Meet the Author

Mark Kausel - Director of Client Services

Mark Kausel applies over 30 years of experience from healthcare operations, information technology, and sales and account management roles to deliver strategic solutions to client challenges resulting in positive outcomes with long-term relationships.