1

Run the Revenue Cycle like a Business

• Make Money – Profit

• Client delight trumps everything

• AR days is way down on the list of metrics • Employee are most important people in your life

• You have to be a Leader/coach/mentor

• You have to be a strategic thinker or you’ll stall

• Labor – Overtime

– Dollars collected per FTE

– Accounts touched per FTE

– First answer is how we do it more efficiently not add another FTE

– Always be looking for production killers

• Expenses – Is the ROI there?

– Always be looking to cut expenses

The new watch list

You Bill, They Pay, Claim is Not Touched

• Dedicated person to increase clean claim rate

• Triage team trained to look for patterns

• Eliminate paper

• Desk structure – set up for production

• Dissect accounts over the average of touches

• Innovation Program – gather ideas and reward

• Old school or lean – work flow your process

• Printer Location

• Call on accounts 10 days after billing to see if they arrived

Some Ideas

Define Customer

Define and teach

expectations

Check on how your doing

Client survey

Set the example

Keep your commitments

• Patients • Caring • Accuracy • Timely • Respect • Follow through • Make this complex world easy • Be tolerant (walk in my shoes) • A great care episode can be ruined by bad

billing

Who are your clients and what do they want?

• Administration and Providers • Caring • Accuracy • Timely • Respect • Follow through • Make this complex world easy • Be tolerant (walk in my shoes) • A great care episode can be ruined

by bad billing

Other Customers

• Other Departments

• Board of Directors

• Partners

• Stakeholders

• Community

• Think national and global

Partners

• Toyota partnership lesson

• Payers • Not the enemy

• They don’t plot to lose claims

• Share data/meet often

• Vendors • They are extension of your employees

• Train, Monitor, get out of their way

• They need the love

• Accountability

• Have no tolerance for gaps

• Set them realistic

• Monitor and measure

• Post client survey results for all to see

Set Service Standards

Summary Definition Urgent SLA High SLA Low SLA

Phone Call Direct phone call to desk phone or cell

phone where a live person is reached Immediate Resolution

Resolution within

1 business day

Resolution within 3

business days

In Person Visit Direct walk up traffic to discuss an issue Immediate Resolution Resolution within

1 business day

Resolution within 3

business days

Voicemail Message left on desk phone voicemail

Call retuned within 15

minutes and Immediate

Resolution

Call retuned within

1 business hour

and resolution

within 1 business

day

Call returned within 1

business day and

resolution within 3

business days

Email Email message received in HRG Email

account when Out Of Office not activated

Phone call or in person

should be used

Email response

within 1 business

day

Email 3 business days

Service Level Standards Summary Definition Initial Response

OPC Front Desk

or Zero Out VM

Customer calls into HRG Main Switchboard number or zero

out of individual voicemail

Immediate answer during

business hours

Phone Call Direct phone call to desk phone or cell phone Immediate response

Voicemail Message left on desk phone (personal extension) Call retuned w/in 2 business hours

Email Email message received in HRG email account and Out Of

Office is not activated

Email response within 4 business

hours

What do I measure

• Automation

– Clean claim percent

– % of payments posted without touch

– Accounts resolved with zero touch

• Denial Rate

– Avoidable versus unavoidable

– % appealed and successfully won – are we wasting time

– Divide by registration/Billing/Coding

– Use in training

• Production – Touches to resolution

– Accounts touched over the average

– Accounts not touched in 30 days

– Accounts with overdue follow-up dates

– Cost to collect per account

• Quality

Measure efficiency

Revenue Cycle 101 – recent reminders

• Training and QA – Peer Review together – Give them clear expectations – Make them accountable

• Stay in touch – Sit with your team – Reward innovation – Best solutions come from team

• Calm Process – Schedule your week – Consistent expectations

• Seek out the gaps – – manage the exceptions – Insurance to Self pay – Build your reports accordingly

Create a environment where people want to work

Hire the best – start the cycle Make it possible for their success Provide stimulating growth opportunities Give them a mission Give constant feedback Broom them or Groom them Empower, Empower, Empower Don’t tolerate drama The Fluff

• Employee are First…..

• Give them a reason to be passionate

• Establish a mission for the team

• Give them a say on the team and tasks

• Give them opportunity to meet regularly • Acknowledge their strengths

• Give them team goals and team rewards

• Get out of their way but stay involved

• Teach them technical expertise

• Teach them interpersonal skills

We are all owners – create Nirvana

• Most Important and most misunderstood

• Hire the best Hire Character first skill second

Interview – History is the best indicator of future

Screen – Background employment

Team interview

Give yourself right of last refusal – last interview

Hire slow – Fire fast

• Always be looking for talent

Hire the Best

Rate your team – constantly

The difference between A, B, C players

Who are you spending time with?

If you keep C players you’ll be a C organization

Turnover is a positive opportunity

Commitment to education and growth

Employee feedback – Listen and Act

Give them a purpose – big and Important – life changing – society driven

Acknowledge accomplishments and reward often

Build the A Team

• No Tolerance – No Kidding

• Make it fun and protect the fun

• Be indignant of destroyers of the positive

• FISH and other social tools

• Celebrate each others contributions

• Take time to know each other

• Zen rooms and massages

• Fun versus production

• You set the tone

Drama and Fluff

Leadership

• Passion for the job

• Walk the Walk

• Care for the people

• Fair

• Communicate

You set the tone

• Leadership can be felt through an organization. It gives pace and energy to the work and empowers the workforce

• Don’t ever be satisfied • Be a strategist

Sustained success

• Integrity

• Respect and value others

• Self Confidence

• Self Motivated

• Reflective Listening and learning

• Tolerance of uncertainty

• Resilience

• Broad Perspective

• Commitment

• Persistence

• Risk Taker

• Positive attitude

• Self awareness

Leadership Traits

• Interpersonal Communications • Organizational Communications • Coaching • Mentoring • Developing Colleagues • Empowering • Motivating others • Problem solver • Decision making • Team Building • Manages conflict • Planning and organizing • Strategic thinking

Leadership skills

• Never Stop Learning

• Hippie Tree Time

• Take time for your Priorities besides work

• Live your values and the values of your organization

• Acknowledge your accomplishments

• Have Fun

YOU

Jason Coffin Executive Director

Healthcare Resource Group

Jason Coffin

Executive Director for Healthcare Resource Group

(HRG)

Prior to HRG Senior Vice President Financial Services

for 15 years

B.S. Accounting, Advanced Leadership Training and

Several Certifications

•Responsible for Early Out Self Pay, Total Quality Center of Excellence and Cash Posting

•Responsible for Contact Centers, Help Desks, online banking, cash management and politically sensitive projects

•Served on Several Non For Profit and Industry Boards

5 Myths of Self Pay

1. Account Scoring is Good

2. Hard Collections Works

3. AR Days is more Important than Revenue

4. Bad Debt is better than Charity

5. My Patients Would Never Use That Technology

Account Scoring Good?

Account scoring should not be a

positive for a vendor in market place

You should demand that all your accounts

are worked and contacted

Financial Services has customer 5 c’s

customer and scoring not used

There is not a proven tool that works

because it depends on life based

decisions

Hard Collections Doesn’t Work

Patients decide within first 30

seconds

If they are going to pay and which one

Effective listening can

identify other needs:

Charity, Extended

Payment Plans and Secondary

Reputation

Impacts overall reputation and

patient satisfaction

A/R Days Better Than Revenue

Is it better to have $25,000 more in Revenue or 5 less AR Days? Extended payment plan policies drive up AR days but increase overall revenue

What is an acceptable AR Days?

Can it ever get low enough?

What is acceptable cash collections?

Does every penny count?

Bad Debt vs Charity

Bad Debt is an unfortunate fact of Healthcare Revenue

If you have high bad debt amounts should you loosen your charity?

It is all a write off?

Charity promotes goodwill? Community Reputation?

Need to make sure giving it to those that really cannot pay.

Use of Technology

My Patients would never use:

• Text to Pay

• Patient Portal

• Recurring ACH Payment

• Paperless Bill

Banking Industry Once Thought Similar Things

Demographic of Patients that Require This

Questions?