While increases in the use of genetic testing have been good news for Myriad Genetics, a 30-year-old company that develops and provides genetic tests, it also led to an increasingly complex reimbursement system. Due to the company’s growth, Myriad’s RCM capabilities no longer met its needs, resulting in the kinds of challenges that have become increasingly common in life sciences and other companies that venture into the third-party payment realm.
Front- and middle-office operations were using labor-intensive eligibility and authorization workflows, which struggled to meet growing demands. As a result, rates of third-party reimbursement denials were elevated, along with billing inquiries that frustrated customers and slowed down collections. Vendor and cash management became more complex, making it increasingly difficult for employees to resolve account balances.
Also in the front office, customers were finding Myriad’s ordering platforms and order-management capabilities difficult to navigate, leading to operational challenges. Of note, those inbound ordering challenges spawned data and workflow issues downstream in RCM workflows.
In the C-suite, Myriad executives were asking for clearer insights into the growing challenges, but gaps in RCM reporting made these insights difficult to gain.
Understanding that RCM challenges were impacting its bottom line—and worse, its ability to help more patients gain access to genetic insights—Myriad became committed to a “Connected” RCM transformation.
Outgrowing RCM capabilities impacts revenue and customer experience
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With new, connected reporting capabilities spanning Myriad’s front, middle and back offices, a request for testing sets off a smooth, more efficient RCM process. It begins at the front office, where workflows will determine patient eligibility and liability, secure more authorizations up front, and gather valuable customer data. In the middle and back offices, employees are empowered with exception-based, automated workflows and vendor controls. And in the C-suite, executive leadership is able to harness data, advanced analytics, and actionable insights to gain a real-time understanding of performance and make informed business decisions.
Freed from rote tasks and supplied with greater insights into everything from expected reimbursement to daily cash flow, Myriad’s team members are able to focus their skills and intelligence where they matter most. As a result, both productivity and satisfaction are on the rise. So are cash collections, and—most importantly—Myriad’s ability to serve its patients. RCM improvements translate not only to increased authorizations for current tests, but also to more available cash for developing new ones.
Myriad’s RCM investment has transformed the 30-year-old company at its core, reinforcing its position as a bold, forward-thinking leader helping to usher in a new era in healthcare.
RCM operational improvements produce gains in revenue and customer satisfaction
Myriad Genetics is looking at the future of RCM and customer experience in new ways. As the company gears up to enhance its Salesforce Customer Relationship Management (CRM) platform, there’s a new emphasis on how CRM and RCM should integrate and can enhance one another.
The company’s improved cash collections and stronger financial foundation will help enable it to continue pursuing innovative technologies that could help bring new genetic tests to the healthcare market. As a leading player on the cutting edge of genetic research and testing, and having a stronger financial position, the company’s increased capabilities can help patients in ways that are not currently available. The win-win-win helps the company, patients, and investors.
Better financial results, improved service levels, and expanded markets
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