robin bradbury 800.355.0410 [email protected]. about re|solution founded in 1998 vha preferred vendor...
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Robin [email protected]
About re|solutionAbout 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 EnergyTime and Energy
When performance is measured, performance improves.
Revenue Cycle Revenue Cycle 101101
Objective measures are always better than subjective measures.
Revenue Cycle 102Revenue Cycle 102
PreviewPreview
• Performance Metrics
• Behavioral Competencies
• Interviewing and Selecting
• Performance Management
Patient Encounter
Charge TicketOrder Entry
Coding
EditBilling
Transmission
Follow up
Payment
Reporting
HOSPITALHOSPITAL
The Revenue CycleThe Revenue Cycle
Performance MetricsPerformance 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
• 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
Key MeasuresKey Measures
Free Benchmark StudyFree Benchmark Studyhttp://www.ereso.comhttp://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
81.5
56
40
0 10 20 30 40 50 60 70 80 90
Sheridan memorial Hospital
Peer Group Average
Best Practices
Cost to Collect per Dollar
$0.047
$0.036
$0.015
$0.00 $0.01 $0.02 $0.03 $0.04 $0.05 $0.06 $0.07 $0.08 $0.09 $0.10
Sheridan memorial Hospital
Peer Group Average
Best Practices
ValueValue PropositionPropositionActual Example
Hospital Peer Group DifferenceCash
Opportunity
AR Days Reduction 82 43 39 $1,476,815
Days over 90 Reduction31.7% 24.4% 7.3%
$217,374
DNFB Reduction
24.2
7.2 17.04 $652,439
Cost to Collect Reduction $ 0.027
$ 0.025 $ 0.002
$33,356
Bad Debt Write off Reduction 8.9% 2.3% 6.6%
$855,290
Charity Write off Reduction 1.9% 6.9% -5.0%
NA
• Front end, middle and back office resources
• Raise performance level awareness
• Align goals
• Creates healthy competition
• Cream will rise to the top
Expectations and Expectations and Performance StandardsPerformance Standards
ExpectationsExpectations
Estimate, Validate, and Estimate, Validate, and AdvocateAdvocate
• 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
PeoplePeople
“Our people are our most important asset!”
How does that manifest itself in your organization?
Improving PerformanceImproving Performance
The best way to build a team is to
hire the right people in the first place!
• 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
7 Keys to Effective 7 Keys to Effective SelectionSelection
Paradigm ShiftParadigm Shift
Since we all have existing staff – we need to be engaged in engaging
them.
OptionsOptions
• 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. BehaviorSkills 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 Performance EvaluationsEvaluations
• Think of some of your last evaluations
• Positive and negative
Interviewing Keys To Interviewing Keys To SuccessSuccess
• Define competencies you desire to promote
• Ask interviewees to give examples of when they exhibited these competencies
• Interviewing versus evaluation
Identify Key Identify Key CompetenciesCompetencies
Sample Competencies and Performance Expectations:
Patient Financial Services Representative
Gather Action ExamplesGather Action Examples
• Key – they must be verifiable
• Have employees gather examples
• Use negative and positive examples
• Tie back to expectations
Discussion MatrixDiscussion Matrix
R+
R=
R-
A- A= A+
Impact of ProcessImpact of Process
5
4
3
2
0Before After 6 Months 12 months 18 months
SummarySummary
• Set expectations
• Metrics and behavior
• Hire people who have demonstrated those expectations
• Review and coach to expectations
• Succeed
Questions?Questions?
how to measure and improve performance in the revenue cyclehow to measure and improve performance in the revenue cycle