Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013....
Transcript of Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013....
![Page 1: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/1.jpg)
1
Run the Revenue Cycle like a Business
![Page 2: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/2.jpg)
• Make Money – Profit
• Client delight trumps everything
• AR days is way down on the list of metrics • Employee are most important people in your life
• You have to be a Leader/coach/mentor
• You have to be a strategic thinker or you’ll stall
![Page 3: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/3.jpg)
• Labor – Overtime
– Dollars collected per FTE
– Accounts touched per FTE
– First answer is how we do it more efficiently not add another FTE
– Always be looking for production killers
• Expenses – Is the ROI there?
– Always be looking to cut expenses
The new watch list
![Page 4: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/4.jpg)
You Bill, They Pay, Claim is Not Touched
![Page 5: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/5.jpg)
• Dedicated person to increase clean claim rate
• Triage team trained to look for patterns
• Eliminate paper
• Desk structure – set up for production
• Dissect accounts over the average of touches
• Innovation Program – gather ideas and reward
• Old school or lean – work flow your process
• Printer Location
• Call on accounts 10 days after billing to see if they arrived
Some Ideas
![Page 6: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/6.jpg)
Define Customer
Define and teach
expectations
Check on how your doing
Client survey
Set the example
Keep your commitments
![Page 7: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/7.jpg)
• Patients • Caring • Accuracy • Timely • Respect • Follow through • Make this complex world easy • Be tolerant (walk in my shoes) • A great care episode can be ruined by bad
billing
Who are your clients and what do they want?
• Administration and Providers • Caring • Accuracy • Timely • Respect • Follow through • Make this complex world easy • Be tolerant (walk in my shoes) • A great care episode can be ruined
by bad billing
![Page 8: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/8.jpg)
Other Customers
• Other Departments
• Board of Directors
• Partners
• Stakeholders
• Community
• Think national and global
![Page 9: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/9.jpg)
![Page 10: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/10.jpg)
Partners
• Toyota partnership lesson
• Payers • Not the enemy
• They don’t plot to lose claims
• Share data/meet often
• Vendors • They are extension of your employees
• Train, Monitor, get out of their way
• They need the love
![Page 11: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/11.jpg)
• Accountability
• Have no tolerance for gaps
• Set them realistic
• Monitor and measure
• Post client survey results for all to see
Set Service Standards
![Page 12: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/12.jpg)
Summary Definition Urgent SLA High SLA Low SLA
Phone Call Direct phone call to desk phone or cell
phone where a live person is reached Immediate Resolution
Resolution within
1 business day
Resolution within 3
business days
In Person Visit Direct walk up traffic to discuss an issue Immediate Resolution Resolution within
1 business day
Resolution within 3
business days
Voicemail Message left on desk phone voicemail
Call retuned within 15
minutes and Immediate
Resolution
Call retuned within
1 business hour
and resolution
within 1 business
day
Call returned within 1
business day and
resolution within 3
business days
Email Email message received in HRG Email
account when Out Of Office not activated
Phone call or in person
should be used
Email response
within 1 business
day
Email 3 business days
Service Level Standards Summary Definition Initial Response
OPC Front Desk
or Zero Out VM
Customer calls into HRG Main Switchboard number or zero
out of individual voicemail
Immediate answer during
business hours
Phone Call Direct phone call to desk phone or cell phone Immediate response
Voicemail Message left on desk phone (personal extension) Call retuned w/in 2 business hours
Email Email message received in HRG email account and Out Of
Office is not activated
Email response within 4 business
hours
![Page 13: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/13.jpg)
What do I measure
![Page 14: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/14.jpg)
• Automation
– Clean claim percent
– % of payments posted without touch
– Accounts resolved with zero touch
• Denial Rate
– Avoidable versus unavoidable
– % appealed and successfully won – are we wasting time
– Divide by registration/Billing/Coding
– Use in training
• Production – Touches to resolution
– Accounts touched over the average
– Accounts not touched in 30 days
– Accounts with overdue follow-up dates
– Cost to collect per account
• Quality
Measure efficiency
![Page 15: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/15.jpg)
Revenue Cycle 101 – recent reminders
• Training and QA – Peer Review together – Give them clear expectations – Make them accountable
• Stay in touch – Sit with your team – Reward innovation – Best solutions come from team
• Calm Process – Schedule your week – Consistent expectations
• Seek out the gaps – – manage the exceptions – Insurance to Self pay – Build your reports accordingly
![Page 16: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/16.jpg)
Create a environment where people want to work
Hire the best – start the cycle Make it possible for their success Provide stimulating growth opportunities Give them a mission Give constant feedback Broom them or Groom them Empower, Empower, Empower Don’t tolerate drama The Fluff
• Employee are First…..
![Page 17: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/17.jpg)
• Give them a reason to be passionate
![Page 18: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/18.jpg)
• Establish a mission for the team
• Give them a say on the team and tasks
• Give them opportunity to meet regularly • Acknowledge their strengths
• Give them team goals and team rewards
• Get out of their way but stay involved
• Teach them technical expertise
• Teach them interpersonal skills
We are all owners – create Nirvana
![Page 19: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/19.jpg)
• Most Important and most misunderstood
• Hire the best Hire Character first skill second
Interview – History is the best indicator of future
Screen – Background employment
Team interview
Give yourself right of last refusal – last interview
Hire slow – Fire fast
• Always be looking for talent
Hire the Best
![Page 20: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/20.jpg)
Rate your team – constantly
The difference between A, B, C players
Who are you spending time with?
If you keep C players you’ll be a C organization
Turnover is a positive opportunity
Commitment to education and growth
Employee feedback – Listen and Act
Give them a purpose – big and Important – life changing – society driven
Acknowledge accomplishments and reward often
Build the A Team
![Page 21: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/21.jpg)
• No Tolerance – No Kidding
• Make it fun and protect the fun
• Be indignant of destroyers of the positive
• FISH and other social tools
• Celebrate each others contributions
• Take time to know each other
• Zen rooms and massages
• Fun versus production
• You set the tone
Drama and Fluff
![Page 22: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/22.jpg)
Leadership
![Page 23: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/23.jpg)
• Passion for the job
• Walk the Walk
• Care for the people
• Fair
• Communicate
You set the tone
![Page 24: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/24.jpg)
• Leadership can be felt through an organization. It gives pace and energy to the work and empowers the workforce
• Don’t ever be satisfied • Be a strategist
Sustained success
![Page 25: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/25.jpg)
• Integrity
• Respect and value others
• Self Confidence
• Self Motivated
• Reflective Listening and learning
• Tolerance of uncertainty
• Resilience
• Broad Perspective
• Commitment
• Persistence
• Risk Taker
• Positive attitude
• Self awareness
Leadership Traits
![Page 26: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/26.jpg)
• Interpersonal Communications • Organizational Communications • Coaching • Mentoring • Developing Colleagues • Empowering • Motivating others • Problem solver • Decision making • Team Building • Manages conflict • Planning and organizing • Strategic thinking
Leadership skills
![Page 27: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/27.jpg)
![Page 28: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/28.jpg)
• Never Stop Learning
• Hippie Tree Time
• Take time for your Priorities besides work
• Live your values and the values of your organization
• Acknowledge your accomplishments
• Have Fun
YOU
![Page 29: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/29.jpg)
Jason Coffin Executive Director
Healthcare Resource Group
![Page 30: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/30.jpg)
Jason Coffin
Executive Director for Healthcare Resource Group
(HRG)
Prior to HRG Senior Vice President Financial Services
for 15 years
B.S. Accounting, Advanced Leadership Training and
Several Certifications
•Responsible for Early Out Self Pay, Total Quality Center of Excellence and Cash Posting
•Responsible for Contact Centers, Help Desks, online banking, cash management and politically sensitive projects
•Served on Several Non For Profit and Industry Boards
![Page 31: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/31.jpg)
5 Myths of Self Pay
1. Account Scoring is Good
2. Hard Collections Works
3. AR Days is more Important than Revenue
4. Bad Debt is better than Charity
5. My Patients Would Never Use That Technology
![Page 32: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/32.jpg)
Account Scoring Good?
Account scoring should not be a
positive for a vendor in market place
You should demand that all your accounts
are worked and contacted
Financial Services has customer 5 c’s
customer and scoring not used
There is not a proven tool that works
because it depends on life based
decisions
![Page 33: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/33.jpg)
Hard Collections Doesn’t Work
Patients decide within first 30
seconds
If they are going to pay and which one
Effective listening can
identify other needs:
Charity, Extended
Payment Plans and Secondary
Reputation
Impacts overall reputation and
patient satisfaction
![Page 34: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/34.jpg)
A/R Days Better Than Revenue
Is it better to have $25,000 more in Revenue or 5 less AR Days? Extended payment plan policies drive up AR days but increase overall revenue
What is an acceptable AR Days?
Can it ever get low enough?
What is acceptable cash collections?
Does every penny count?
![Page 35: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/35.jpg)
Bad Debt vs Charity
Bad Debt is an unfortunate fact of Healthcare Revenue
If you have high bad debt amounts should you loosen your charity?
It is all a write off?
Charity promotes goodwill? Community Reputation?
Need to make sure giving it to those that really cannot pay.
![Page 36: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/36.jpg)
Use of Technology
My Patients would never use:
• Text to Pay
• Patient Portal
• Recurring ACH Payment
• Paperless Bill
Banking Industry Once Thought Similar Things
Demographic of Patients that Require This
![Page 37: Run the Revenue Cycle like a Businessaahaminlandempire.org/Sources/runitlikeabusiness.pdf · 2013. 11. 13. · •Dedicated person to increase clean claim rate • Triage team trained](https://reader036.fdocuments.in/reader036/viewer/2022081615/5fdb79b7e9f355474f354db1/html5/thumbnails/37.jpg)
Questions?