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Teamwork key to enhancing revenue cycle

Hospitals execs say financial, clinical, IT units must collaborate

Improving revenue cycle performance at a hospital or health system often requires changes to processes and technology, but also demands a renewed sense of teamwork, said officials at New Jersey’s Atlantic Health System.

Nancy Kaminski, Atlantic’s corporate director of patient financial services, and Kevin Heglar, financial systems manager at the health system, described their organization’s revenue cycle revamp at the 2013 HFMA ANI conference.

Kaminski said cross-departmental collaboration was key to boosting both revenue cycle metrics as well as patient satisfaction.

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“The purposeful collaboration of many departments contributed to our revenue cycle success.” Kaminski said. “We took a hard look at our internal team in patient financial services. First of all we needed to better define our business goals using data provided by our IT staff. But marketing was also involved, as we have to communicate effectively with patients and the communities we serve.”

In addition to the business office staff and teams in health information and CDM management, Kaminski said hospital-based clinical teams also made a great contribution, particularly in helping to align physicians with health system goals.

The goals of the collaborative effort were not just to improve financial outcomes, but also to boost customer access and enhance overall patient experience.

“We wanted to find more ways for patients to access our services and to improve the patient experience,” Heglar said. This required a focus on point-of-service collections, and patient pre-service financial counseling, he noted.

“The process started in the pre-service area,” he said. “We optimized processes on the front end – everyone is aware of how important financial clearance is. A registration-auditing tool allows us to check the accuracy of the patient data we’re collecting. Pre-bill edits were always a very painful process for us, so we had to address that.”

A number of technology and process improvements impacted the health system’s ability in point of service collections. All areas that have direct patient contact can now accept payments via a web pay system, Heglar said. This includes an electronic signature pad, to remove some of the pain of filling out endless paper forms.

And of course, patients can also pay online through a patient portal after leaving the facility. Kaminski said this has proved very popular.

“Self-pay receivables continue to grow, which is a very telltale sign,” she said. “Our online collections increased from 8 percent in 2011 to 25 percent in 2012.”

Next steps for the health system include an increase in the utilization of an eOrder system, improving overall analytics and workflow processes, and being ready for the transition to ICD-10 coding by the end of 2013.