Have you ever wished for an easier way to obtain financial data to manage your bottom line? Have you stressed over the fact that you cannot access crucial data in a timely manner? Do you have more work-around processes than you would like? Is accuracy a problem? It may be time to think seriously about a change in your revenue cycle management systems.
Thinking about the revenue cycle of the future we can predict early and accurate patient identification that allows for proper registration and a completely automated pre-arrival process. Patients will have access via portals to book their own appointments and to read and review medical records and care instructions. Insurance eligibility can be verified without any staff intervention and authorizations can be requested/obtained and stored prior to the patient arrival. Accurate quotes for needed services can be easily generated and integrated with the patient’s propensity to pay. Referral to insurance exchanges, integrated Medicaid applications and integrated contract management can insure a cash flow that is much more predictable and returned in fewer AR days than in years past. Reliable integration between HIE’s, your revenue cycle and your electronic medical record can also benefit your meaningful use reporting. Does this sound too good to be true?
In a recent engagement for a large health network, Culbert was asked to(1) evaluate acute, ambulatory and post-acute revenue cycle flow, (2) evaluate and identify all of the current technology in use, and (3) identify the areas where improved revenue cycle system features were needed. The initial assessment identified significant workflow breakdowns caused by the inability to accurately share patient registration data between their many separate vendor systems. Whether the breakdown was between facilities, physician practices or in the post-acute setting, the effort to re-work, correct and band-aid processes was no longer working effectively. Redundancy in the patient registration process was a huge patient dissatisfier, a cause for increased duplicate registrations and contributed to inflated staffing levels to constantly monitor and correct the errors.
Culbert Healthcare Solutions has built a successful interview tool that allows for intensive data gathering and data comparison across all aspects of all revenue cycle teams. Interviews were hosted with IT Analysis’, ED Registrars, Billing office managers and staff, Clinic Schedulers, Ancillary Services, Post-Acute care setting staff, Finance, Pharmacy, Customer Service, affiliates and contract management support to name a few. Observations were performed to validate the interview results and Culbert worked closely with IT to call out the many additional add-on vendor products used to support the primary revenue cycle applications. Executive feedback to the future vision and mission of the organization rounded out the footprint used for a Request for Proposal (RFP) to select a new revenue cycle vendor.