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Improve Your Revenue Cycle Management

Your 6-step guide to optimizing Waystar RCM for faster cash flow.
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Improve Your Revenue Cycle Management
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Optimize Revenue Cycle in Waystar for Faster Cash Flow

Our platform helps you uncover hidden inefficiencies in your revenue cycle management process. You can identify bottlenecks causing payment delays, improve denial prevention, and address compliance challenges. We guide you through practical steps to enhance cash flow and reduce errors, streamlining operations for better financial performance.

Download our pre-configured data template and address common challenges to reach your efficiency goals. Follow our six-step improvement plan and consult the Data Template Guide to transform your operations.

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Why Optimize Your Revenue Cycle in Waystar?

Revenue Cycle Management, RCM, is the backbone of financial health for healthcare organizations. It encompasses all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. Efficient RCM ensures steady cash flow, minimizes financial losses, and supports the overall sustainability of healthcare providers. However, despite leveraging advanced systems like Waystar for claims management, denial prevention, and patient payments, many organizations still encounter significant inefficiencies.

The complexities of RCM, involving numerous stakeholders, intricate billing rules, and regulatory requirements, often create hidden bottlenecks. These inefficiencies translate directly into delayed payments, increased operational costs due to rework, higher days in accounts receivable, and potential compliance risks. Optimizing your Revenue Cycle Management processes is not just about reducing costs, it is about enhancing patient satisfaction, improving financial predictability, and ensuring your organization remains robust and compliant in a dynamic healthcare landscape.

Unlocking RCM Efficiency with Process Mining in Waystar

Process mining offers a unique, data-driven approach to understanding and improving your Revenue Cycle Management within Waystar. By treating each 'Billing Event' as a case, process mining meticulously reconstructs the actual end-to-end journey of every claim and payment. This goes beyond traditional reporting, which often shows aggregated data, to reveal the precise sequence of activities, decision points, and deviations that occur in practice.

Imagine an X-ray view of your RCM process: process mining visualizes the true flow from initial service order to final account closure. It highlights where claims spend excessive time, which activities are frequently repeated, and where processes diverge from the intended path. For Waystar users, this means uncovering exactly how claims are managed, where denials originate, and how patient payments are processed, identifying specific points of friction that impact your cash flow and operational efficiency. This capability is crucial for process optimization, providing an unparalleled level of detail to help you understand how to improve Revenue Cycle Management effectively.

Key Areas for RCM Process Improvement

Applying process mining to your Waystar RCM data illuminates several critical areas for improvement:

  • Denial Prevention and Management: Identify the most common root causes of claim denials and rejections. Process mining can pinpoint specific activities or data entry points in Waystar that consistently lead to denials, allowing you to implement targeted preventive measures and reduce the need for costly rework.
  • Payment Velocity and Cycle Time Reduction: Discover where delays occur in the journey from service provision to payment posting. Whether it is in charge capture, invoice generation, payer submission, or payment reconciliation, process mining highlights bottlenecks that extend your Revenue Cycle Management cycle time. Reducing this cycle time directly accelerates cash flow.
  • Billing Accuracy and Compliance: Uncover inconsistencies or errors in charge capture and invoice processing. Ensure that your billing practices within Waystar consistently adhere to internal policies and external regulatory requirements, mitigating compliance risks and improving clean claim rates.
  • Resource Utilization: Analyze activity durations and resource involvement to identify where staff may be over or underutilized, or where certain process steps consume disproportionate resources. This insight supports more effective resource allocation and training.
  • Automate manual steps: Identify frequently repeated, rule-based manual steps that are candidates for automation to free up staff and increase processing speed.

Realizing Tangible Benefits: The Outcomes of RCM Optimization

Optimizing your Revenue Cycle Management processes through process mining yields significant, measurable benefits:

  • Accelerated Cash Flow: By reducing the Revenue Cycle Management cycle time and improving payment velocity, you will see a faster realization of revenue.
  • Reduced Operational Costs: Minimizing reworks, denials, and manual interventions directly lowers the cost of managing your RCM operations.
  • Improved Compliance Posture: Proactive identification and correction of process deviations ensure better adherence to healthcare regulations, reducing audit risks.
  • Enhanced Patient and Payer Satisfaction: Smoother billing and payment processes lead to a better experience for patients and more efficient interactions with payers.
  • Increased Clean Claim Rates: Identifying and addressing root causes of denials leads to a higher percentage of claims processed correctly the first time.

Ultimately, understanding how to improve Revenue Cycle Management and how to reduce Revenue Cycle Management cycle time through process optimization translates into a more robust financial foundation for your healthcare organization, all while leveraging your existing investment in Waystar technology.

Begin Your Journey to Waystar RCM Excellence

Ready to transform your Revenue Cycle Management? Process mining provides the clarity and actionable insights you need to pinpoint exact inefficiencies in your Waystar RCM process. This comprehensive guide empowers you to move beyond guesswork and implement data-driven improvements that lead to faster cash flow, reduced operational costs, and stronger compliance. Explore how you can leverage your Waystar data to achieve unparalleled process excellence.

Revenue Cycle Management Billing Claims Processing Denial Management Patient Payments Healthcare Finance Cash Flow Optimization Compliance Monitoring

Common Problems & Challenges

Identify which challenges are impacting you

Patients or payers often delay payments, leading to extended accounts receivable days and a significant impact on an organization's liquidity. This creates financial strain and hinders reinvestment in critical healthcare services or infrastructure.
ProcessMind analyzes the exact pathways and durations of payment cycles, from invoice generation to payment posting, identifying specific bottlenecks that prolong collection times within your Revenue Cycle Management in Waystar. We reveal where and why delays occur, enabling targeted interventions to accelerate cash flow.

High rates of initial claim denials by payers significantly reduce expected revenue and increase administrative rework. Each denial requires investigation, correction, and resubmission, consuming valuable staff time and extending the revenue cycle.
ProcessMind visualizes the complete journey of denied claims in Revenue Cycle Management, tracing back to the root causes such as incorrect coding, missing information, or timing issues within Waystar. We pinpoint the exact process steps contributing to denials, allowing you to implement preventative measures and improve first-pass resolution rates.

Delays in resolving invoice disputes tie up outstanding balances and strain patient or payer relationships. Inefficient handling of disputes can lead to payment deferrals, increased collection costs, and potential loss of revenue if disputes are not managed promptly and effectively.
ProcessMind maps out the entire dispute resolution workflow within Revenue Cycle Management, from initial dispute logging to final re-issuance or adjustment in Waystar. We highlight bottlenecks and deviations from the standard path, revealing where resolution processes stall and enabling faster, more consistent handling of contested claims.

A lack of clear visibility into the end-to-end billing process can lead to miscommunications, errors, and difficulties in identifying the status of a specific billing event. This opacity can result in compliance risks and an inability to accurately forecast revenue or manage outstanding balances effectively.
ProcessMind provides an x-ray view of your Revenue Cycle Management process in Waystar, visually representing every step a billing event takes from service initiation to account closure. This transparency allows you to track invoice status, payment progress, and identify any unauthorized process deviations, ensuring clarity and control over your financial operations.

Inefficiencies in capturing all billable services can lead to significant unbilled revenue, directly impacting the organization's financial health. Missed charges not only represent lost income but also complicate financial reporting and compliance efforts.
ProcessMind analyzes the 'Charges Captured/Recorded' activity in Revenue Cycle Management, identifying patterns where services are initiated or provided but not fully or accurately billed within Waystar. By comparing actual service delivery against recorded charges, we expose gaps in your charge capture process, helping you recover lost revenue and improve financial integrity.

Failure to adhere to healthcare billing regulations, such as HIPAA or specific payer rules, can result in severe penalties, fines, and reputational damage. Ensuring every step of the revenue cycle is compliant requires constant vigilance and detailed process oversight.
ProcessMind monitors your Revenue Cycle Management processes in Waystar against predefined compliance rules, automatically flagging deviations or unapproved activities that could lead to regulatory violations. This proactive approach helps you identify and mitigate risks before they escalate, ensuring continuous adherence to industry standards and legal requirements.

A high volume of collection activities indicates underlying issues in early-stage payment collection or dispute resolution. These activities are labor-intensive and expensive, draining resources that could be better utilized elsewhere and potentially harming patient relations.
ProcessMind identifies the specific triggers and paths leading to 'Collection Activity Started' within your Revenue Cycle Management in Waystar. By analyzing the preceding steps, we uncover inefficiencies that necessitate collections, such as delayed invoice sending or poor initial payment communication, enabling you to optimize upstream processes and reduce collection expenses.

Over-reliance on manual interventions and corrections within the revenue cycle leads to higher error rates, increased processing times, and inflated operational costs. Each manual touchpoint introduces a risk of human error, impacting billing accuracy and payment timeliness.
ProcessMind identifies redundant steps, rework loops, and manual adjustments in your Revenue Cycle Management process within Waystar by observing activity sequences like 'Invoice Disputed' followed by 'Invoice Re-issued' multiple times. This visibility allows for process standardization and automation opportunities, reducing errors and improving efficiency.

Delays in accurately posting received payments can create discrepancies in patient accounts, leading to incorrect outstanding balances, unnecessary collection calls, and difficulties in reconciling financial records. This impacts both customer satisfaction and financial reporting accuracy.
ProcessMind analyzes the time taken between 'Payment Received' and 'Payment Posted' activities in your Revenue Cycle Management process in Waystar. We identify bottlenecks in the posting workflow, whether due to system limitations, manual processes, or resource allocation, enabling you to accelerate reconciliation and improve data accuracy.

Significant variability in the time taken from service delivery to invoice generation can create unpredictable cash flow and administrative challenges. It often points to inefficiencies in charge capture or billing department workflows, leading to delayed revenue recognition.
ProcessMind measures the lead time from 'Service Provided/Completed' to 'Invoice Generated' for all billing events in your Revenue Cycle Management in Waystar. By highlighting high variance or outliers, we reveal where delays or inconsistencies occur in your billing initiation process, allowing for standardization and faster billing.

A high volume of 'Account Adjusted' activities can indicate underlying issues with initial billing accuracy, coding, or contract management. Each adjustment can reduce the billed amount, impacting net revenue and requiring additional administrative effort.
ProcessMind analyzes the frequency and context of 'Account Adjusted' events within your Revenue Cycle Management in Waystar. By linking adjustments back to preceding activities and attributes like 'Dispute Reason Code,' we can identify the root causes of these adjustments, helping you prevent future revenue erosion and improve initial billing precision.

Typical Goals

Define what success looks like

Shortening the time it takes to receive payments is crucial for improving cash flow and financial health. This goal aims to identify and eliminate delays throughout the Revenue Cycle Management process, ensuring quicker access to funds. Faster payment cycles directly impact liquidity and operational stability for Waystar users.ProcessMind uncovers bottlenecks in the payment process flow, identifying specific activities or departments causing delays. By visualizing actual process paths, it highlights deviations that extend payment times, enabling targeted improvements to accelerate cash collection and optimize cash flow.

High claim denial rates lead to significant revenue loss and increased administrative costs. Achieving this goal means identifying the root causes of denials, such as incorrect coding or missing information, and implementing corrective actions to prevent them. A lower denial rate ensures more claims are processed successfully the first time, protecting revenue.ProcessMind maps the entire claims submission and denial management journey within Waystar, revealing common denial patterns and their origins. It pinpoints exactly where errors occur in the process, allowing organizations to implement targeted training or system changes to drastically reduce denials.

Slow resolution of invoice disputes ties up revenue and frustrates customers. This goal focuses on streamlining the dispute handling process, ensuring that issues are addressed quickly and efficiently. Faster resolution improves customer satisfaction and accelerates the collection of outstanding balances in Revenue Cycle Management.ProcessMind visualizes the lifecycle of invoice disputes, highlighting unnecessary steps, reworks, or handoffs that prolong resolution times. It identifies inefficient paths and provides data-driven insights to standardize and optimize the dispute resolution workflow, significantly reducing average resolution time.

An opaque billing process leads to confusion for both patients and internal staff, increasing queries and potential disputes. This goal aims to make the Revenue Cycle Management billing journey clear and understandable, from service provision to final payment. Greater transparency reduces errors and improves trust.ProcessMind provides an unbiased, end-to-end view of the actual billing process, revealing all hidden activities and deviations. By mapping process variants, it helps standardize the billing workflow, making each step visible and understandable, thereby eliminating ambiguity within Waystar RCM operations.

Incomplete or inaccurate charge capture directly results in lost revenue and compliance risks. This goal focuses on ensuring that all services provided are correctly documented and billed. Improving charge capture maximizes revenue potential and ensures all efforts are appropriately compensated in Waystar.ProcessMind analyzes the 'Service Provided/Completed' to 'Charges Captured/Recorded' flow, identifying instances where services are rendered but not billed. It highlights gaps in the charge capture process, enabling organizations to implement controls and training to ensure every service is accurately recorded and billed.

Non-compliance with healthcare regulations can lead to substantial fines, legal issues, and reputational damage. This goal focuses on proactively monitoring and enforcing adherence to all relevant rules and standards throughout the Revenue Cycle Management process. Continuous compliance mitigates risks and builds trust.ProcessMind compares actual process execution against predefined compliance models, automatically detecting any deviations from regulatory requirements. It provides real-time alerts and detailed reports on non-compliant activities, allowing Waystar users to address issues before they escalate and ensure consistent adherence.

Engaging in collection activity for accounts that could have been resolved earlier or through other means incurs unnecessary costs and strains resources. This goal aims to optimize the timing and necessity of collection efforts by addressing upstream process issues. Reducing unwarranted collections saves money and improves efficiency in Waystar RCM.ProcessMind analyzes the entire payment journey leading to collection activities, identifying common triggers for collections that could be avoided. It highlights cases where earlier intervention or improved initial billing processes could have prevented the need for costly collection steps, optimizing the RCM workflow.

Manual rework in Revenue Cycle Management is a significant source of errors, delays, and increased operational costs. This goal focuses on identifying repetitive manual tasks that are caused by upstream inefficiencies and automating or streamlining them. Eliminating rework improves accuracy and accelerates process completion.ProcessMind precisely identifies process loops and recurring activities that indicate manual rework within Waystar operations. By mapping the frequency and impact of these reworks, it uncovers their root causes, allowing organizations to implement targeted automation or process redesign to achieve a frictionless workflow.

Slow payment posting delays account closure, leading to inaccuracies in outstanding balances and potential patient confusion. This goal aims to streamline and accelerate the process of applying received payments to patient accounts. Faster posting ensures accurate financial records and quicker account resolution.ProcessMind analyzes the 'Payment Received' to 'Payment Posted' sequence, pinpointing any delays or inefficiencies in this critical step. It reveals actual processing times and identifies bottlenecks, enabling organizations to optimize the payment posting workflow and reduce the time to account closure.

Inconsistent timing between service delivery and invoice generation can lead to payment delays and billing inaccuracies. This goal seeks to establish a predictable and efficient interval, ensuring timely invoicing for all services. Standardized timing improves cash flow predictability and enhances financial accuracy for Waystar users.ProcessMind visualizes the variations in the duration between 'Service Provided/Completed' and 'Invoice Generated' activities. It identifies factors contributing to inconsistencies, enabling organizations to define and enforce standard operating procedures that ensure uniform and efficient invoice generation across all cases.

Frequent account adjustments often indicate errors or inefficiencies in upstream billing, coding, or payment processing, ultimately reducing expected revenue. This goal aims to identify and address the root causes leading to these adjustments. Minimizing adjustments improves revenue integrity and process stability in Waystar.ProcessMind maps the pathways leading to 'Account Adjusted' activities, analyzing the preceding events and attributes that trigger adjustments. It uncovers common patterns and reasons for adjustments, providing insights to rectify upstream processes and significantly reduce the need for such revenue-impacting changes.

The 6-Step Improvement Path for Revenue Cycle Management

1

Download the Template
2

Export Your RCM Data
3

Upload Your Dataset
4

Analyze RCM Workflows
5

Implement Key Changes
6

Monitor RCM Performance
1

Download the Template

What to do

Get the pre-formatted Excel template designed for Revenue Cycle Management. This template guides you on the required data structure for optimal analysis.

View Data Template Guide Download Template
Why it matters

A standardized data structure ensures accurate mapping and comprehensive analysis, laying the groundwork for reliable insights into your RCM process.

Expected outcome

A clear, organized Excel template ready to be populated with your Waystar RCM data.

WHAT YOU WILL GET

Uncover Hidden Efficiencies in Your Waystar RCM

ProcessMind reveals the true flow of your Revenue Cycle Management in Waystar through interactive visualizations. Pinpoint exact payment delays, denial root causes, and compliance gaps to drive immediate improvements.
  • Visualize end-to-end RCM process flows
  • Identify payment delays and denial patterns
  • Spot compliance risks in Waystar operations
  • Optimize cash flow and reduce manual errors
Discover your actual process flow
Discover your actual process flow
Identify bottlenecks and delays
Identify bottlenecks and delays
Analyze process variants
Analyze process variants
Design your optimized process
Design your optimized process

TYPICAL OUTCOMES

Achieving Superior Revenue Cycle Performance with Waystar

Our process mining solutions for Revenue Cycle Management identify hidden inefficiencies and bottlenecks in your Waystar billing events, revealing clear paths to optimize financial workflows and accelerate cash realization. These outcomes illustrate the tangible benefits organizations typically achieve by transforming their revenue operations.

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Faster Payment Cycle

Overall revenue acceleration

Process mining identifies bottlenecks in payment processing, significantly reducing the time from invoice generation to payment posting. This improves cash flow and operational efficiency.
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Reduced Claim Denials

Decrease in initial claim rejections

By pinpointing root causes of claim denials, organizations can proactively address issues, leading to a substantial decrease in the rate of rejected claims. This improves revenue assurance and reduces rework.
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Quicker Dispute Resolution

Accelerated invoice dispute handling

Process mining helps streamline the dispute resolution workflow, reducing the average time taken to resolve invoice disputes. This minimizes delays in revenue realization and enhances patient satisfaction.
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Improved Charge Capture

Higher revenue capture completeness

Gaps in charge capture are identified and closed, ensuring that all services provided are accurately billed. This directly leads to an increase in realized revenue and reduced leakage.
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Enhanced Compliance

Adherence to payment posting SLAs

Process mining monitors payment posting activities against predefined SLAs and regulatory requirements. This ensures timely processing, mitigating compliance risks and potential penalties.

Results vary based on the specific complexities of your revenue cycle and the quality of your Waystar data. The figures presented here reflect typical improvements observed across various implementations.

FAQs

Frequently asked questions

Process mining analyzes your Waystar billing event data to visualize the actual RCM process. It uncovers bottlenecks like prolonged payment cycles and frequent claim denials, helping identify root causes for inefficiencies. This leads to targeted improvements for faster cash flow and reduced costs.

To effectively analyze your Revenue Cycle Management, we primarily need event logs from your Waystar system. Key data includes billing events, payment postings, claim submissions, denials, and adjustments, ensuring each record has a case ID, activity, and timestamp. This data allows for reconstruction of the full RCM journey.

You can expect significant improvements such as a reduction in overall payment cycle time and a decrease in claim denial rates, potentially by 20% or more. The analysis helps accelerate invoice dispute resolution, improve charge capture accuracy, and minimize manual rework. Ultimately, this leads to better cash flow, enhanced compliance, and operational efficiency.

Integrating Waystar data generally requires secure access to your system's data exports, often through APIs, database connections, or flat file exports. The process mining tool will then ingest and transform this data into an event log format. Minimal IT involvement is typically needed once the initial data connection is established.

Process mining precisely maps out every step of your RCM process, highlighting where claim denials frequently occur and identifying the root causes of prolonged payment cycles. By visualizing deviations from the optimal path, it provides actionable insights to streamline workflows and implement targeted interventions. This allows you to address these common problems directly and effectively.

Initial setup for Waystar RCM process mining typically involves data extraction and transformation, which can take a few weeks depending on data volume and complexity. The analytical insights become available quickly thereafter, often within days of data ingestion. This allows for rapid identification of improvement areas without a prolonged setup phase.

Yes, process mining allows you to monitor your RCM processes against defined compliance rules and standards. It can detect deviations or exceptions that might indicate non-compliance, such as incorrect billing procedures or delayed submissions. This proactive monitoring helps in identifying and rectifying compliance gaps before they lead to fines or audits.

No, most modern process mining platforms are designed with user-friendly interfaces, often featuring drag-and-drop functionality and visual dashboards. While an understanding of your RCM process and data is beneficial, extensive coding skills are generally not required to analyze and interpret the results. Training is typically provided to enable effective use.

Organizations typically see a significant ROI through reduced operational costs, improved cash flow, and increased revenue capture. This is achieved by reducing manual rework, minimizing claim denials, accelerating payment cycles, and ensuring better compliance. The value often becomes apparent within months of implementing the insights.

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