Transcript Patient Experience - AAHAM Chapters Index

“Enhancing the patient experience by
examining the Revenue Cycle”
Nola Wyatt
VP of Revenue Cycle
St. Thomas Health
Which activity would best improve
your healthcare experience?
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Wait times
Better patient/cafeteria food
Upgraded hospital rooms and facilities
Web-based access to medical records
Test results to providers quicker
Improved landscaping
Improved Billing
September 2013 Survey Results
 Which activity would best improve your healthcare
experience?
#1 Response – Improved billing transparency and
accuracy of bills
#2 Response – Patient website for easy access to all of
their medical records
# 3 Response – 15 minute or less wait time at physician
practices
Objectives of Presentation
 Understand each Revenue Cycle area’s impact on a
patient’s experience
 Document and communicate the commitment and
role of all Revenue Cycle colleagues
 Value of Standard Work in Revenue Cycle operations
The Revenue Cycle
SCHEDULING AND
PRE -REGISTRATION
CUSTOMER
SERVICE
PRE CERT AND
INSURANCE
VERIFICATION
REGISTRATION
AND POINT OF
SERVICE
COLLECTION
SELF PAY
COLLECTIONS
FINANCIAL
COUNSELING
PAYMENT REVIEW
(Voucher
Processing)
REVENUE INTEGRITY /
CHARGE CAPTURE
CASH
POSTING
CASE
MANAGEMENT
THIRD PARTY
FOLLOW- UP
MEDICAL
RECORDS CODING
BILLING
Revenue Cycle Operations
Complex and Confusing
 Managed Care Grocery
 Payer Communications
The Beginning – Advocacy
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Scheduling
Pre-registration
Pre Cert and Insurance Verification
Registration and Point of Service Collections
Financial Counseling/Financial Clearance
The Middle – Authenticity
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Revenue Integrity/Charge Capture
Case Management
Clinical Documentation
Medical Records/Release of Information
Coding
The End - Accuracy
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Billing
Follow-up
Cash Posting
Payment Review(under and over)
Patient Balance Collections
Customer Service
Revenue Cycle Management
Responsibility
 Measure Performance
 Observation of Staff
 Patient Satisfaction Scores
 Communication of Performance
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Daily Huddles by functional area-15 minute max
Plan for the day
Staffing
Results from previous day
Identify training, education and equipment needs
Revenue Cycle Associate
Responsibility
 Primary Goal is to Enhance each customers
experience using an easily adopted practice.
 Utilize a meaningful acronym such as A.I.D.E.T.
 Develop personal expectations for all patient
interactions
 Understand and communicate your organizations
policies and payment guidelines
 Know the types of insurance coverage and benefits
 Be responsive to patient requests
Value of Standard Work in Revenue
Cycle
 Our Organization’s Adoption
 Medicare No Pay Denial
 Registration QA and MDI Created
What is Process Improvement?
 Six Sigma
 Data-driven
 Customer-focused
 Lean
 Waste elimination
 Process flow scrutiny
Why Process Improvement in
Revenue Cycle
 Patient Experience
 Competition
 Satisfaction
 Legislation
 ICD10
 Affordable Care Act
How to Achieve Continuous
Improvement
 Humility
 Throw away old thinking
 Structure
 Manage by numbers
 Respect
 “The greatest waste…is failure to use the abilities of
people…to learn about their frustrations and about the
contributions that they are eager to make.” -Deming