Transcript Resolution Consulting, LLC

Robin Bradbury
800.355.0410
[email protected]
About re|solution
• Founded in 1998
• VHA Preferred Vendor
• Services include:
-Cash Acceleration
-Revenue Cycle Assessments
-A/R Management Training
-Interim Management and Staffing
-Virtual Business Office
-Payment Reviews
-Self Pay Cleanup
Time and Energy
Revenue Cycle 101
When performance is measured,
performance improves.
Revenue Cycle 102
Objective measures are always better
than subjective measures.
Preview
• Performance Metrics
• Behavioral Competencies
• Interviewing and Selecting
• Performance Management
The Revenue Cycle
Reporting
Patient Encounter
Charge Ticket
Order Entry
Payment
HOSPITAL
Coding
Follow up
Transmission
Edit
Billing
Performance Metrics
• HFM Toolbox – Key Revenue Cycle Metrics
• Sample Benchmark Indicator Analysis from
re|solution
• Revenue Cycle KPI and Standards
• Take it down to the individual level
• Keep it simple
• Monitor, train and achieve
Key Measures
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Days in Revenue Outstanding
Cash Collections
Cash as a % of Net Revenue
Write-offs as a % of Revenue
Aged AR Greater than 90 Days
Days in Discharge to Final Bill
Up-front Cash Collections
Free Benchmark Study
http://www.ereso.com
Sample Information:
Facility Bed Size:
122
Average Daily Census:
38
Total Accounts Receivable:
$8,000,000
Cash Receipts per Month
$900,000
Gross Revenue per Month:
$2,000,000
A/R Over 90 Days:
$3,500,000
Monthly Cost of BO:
$45,000
Write Offs per Month:
$150,000
Number of Open Accounts:
19,000
Number of FTE's in BO:
12
Percent A/R in Self Pay:
40%
Gross Days in A/R Outstanding
40
Best Practices
56
Peer Group Average
81.5
Sheridan memorial Hospital
0
10
20
30
40
50
60
70
80
90
$0.08
$0.09
$0.10
Cost to Collect per Dollar
$0.015
Best Practices
$0.036
Peer Group Average
$0.047
Sheridan memorial Hospital
$0.00
$0.01
$0.02
$0.03
$0.04
$0.05
$0.06
$0.07
Value Proposition
Actual Example
Hospital
Peer Group
Difference
AR Days Reduction
82
43
39
Days over 90
Reduction
31.7%
24.4%
7.3%
24.2
7.2
17.04
DNFB Reduction
Cost to Collect
Reduction
$ 0.027 $
0.025
$
0.002
Bad Debt Write off
Reduction
8.9%
2.3%
6.6%
Charity Write off
Reduction
1.9%
6.9%
-5.0%
Cash
Opportunity
$1,476,815
$217,374
$652,439
$33,356
$855,290
NA
Expectations and
Performance Standards
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•
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Front end, middle and back office
resources
Raise performance level awareness
Align goals
Creates healthy competition
Cream will rise to the top
Expectations
Estimate, Validate, and
Advocate
• Estimate Charges, insurance coverage and
patient portion
• Validate the information
• Advocate for the patient to deal with the
obligation
–
–
–
–
–
Cash, Check or Credit Card
Payment plan
Medicaid Eligibility
Charity Care
Reschedule?
• Software is available to do this
People
“Our people are our most
important asset!”
How does that manifest itself in
your organization?
Improving Performance
The best way to build a
team is to hire the right
people in the first
place!
7 Keys to Effective Selection
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Conduct a job analysis
Create a structured job-related interview
Use past-event interview questions
Use interview panels
Control our biases and first impressions
Use a rating guide
Use consensus rating
Paradigm Shift
Since we all have existing staff –
we need to be engaged in
engaging them.
Options
• Fire everyone and start over
• Hire employees away from your
competitors
• Browbeat the ones you have to get
results
• Train and educate the employees you
have
• Set expectations and measure results
• Shift the paradigm
Skills vs. Behavior
• Fired anybody recently?
• Why?
• Resume and skills questionnaires will
determine skill set
• How do we get people to play in the
sand box nicely?
Performance Evaluations
• Think of some of your last
evaluations
• Positive and negative
Interviewing Keys To Success
• Define competencies you desire to
promote
• Ask interviewees to give examples
of when they exhibited these
competencies
• Interviewing versus evaluation
Identify Key Competencies
Sample Competencies and
Performance Expectations:
Patient Financial Services Representative
Gather Action Examples
• Key – they must be verifiable
• Have employees gather examples
• Use negative and positive examples
• Tie back to expectations
Discussion Matrix
R+
R=
RA-
A=
A+
Impact of Process
5
4
3
2
0
Before After 6 Months 12 months 18 months
Summary
• Set expectations
• Metrics and behavior
• Hire people who have demonstrated
those expectations
• Review and coach to expectations
• Succeed
Questions?
how to measure and improve performance in the revenue cycle