rural and community hospital services
TRANSCRIPT
The road to CASH
isn’t paved with
good intentions…
At re|solution, we’ve built our reputation on more than a decade of improving revenue cycle operations for healthcare
providers throughout the country. We provide revenue cycle process and technology solutions that result in both immediate
and sustainable improvements to a provider’s cash flow, profitability and revenue cycle efficiency. In addition to finding the cash
that falls through the cracks in revenue cycle and billing processes, our on-site approach establishes a knowledgeable and
confident business office staff that operates with greater efficiency, higher productivity and better financial results.
Just as healthcare itself must meet the specific needs of each patient, re|solution offers a full spectrum of revenue cycle
services – customized to meet the unique needs and constraints of each of our clients in the communities they serve.
re|solution’s technology solutions and its renowned educational, mentoring approach can improve every aspect of your revenue
cycle. We are proud to say that we have provided an overall net CASH gain to every one of our clients.
• Poor cash flow?
• Days of cash on hand < 20 days?
• High AR over 90 days?
• Recent loss of key personnel?
• Lack of qualified and/or
experienced personnel?
• Cost to collect higher than 3%?
• Recent system conversion?
• APC Index < 3.0?
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The road to CASH is paved with ACTION!
• Revenue Cycle Assessment
• Cash Acceleration
• Interim Staffing
• Virtual Business Office
Outsourcing
• Reimbursement Review
• Self Pay Management
• Charge Capture Review
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• Cash is up
• Receivable days down
• Increased reimbursement
• Education and mentoring
of staff on-site
• Improved processes and
procedures
• Roadmap for long-term
success
• Peace of mind
Call re|solution today at 1.800.355.0410
For a FREE Benchmark Indicator Analysis,
visit us at www.ereso.com
re|solution provides highly effective, tailored solutions to the business
challenges faced by hospitals, outpatient facilities, physician practices,
clinics, DME and home health providers.
363 centennial pkwy – suite 105, louisville CO 80027 • phone 303.530.0396 • toll free 800.355.0410 • www.ereso.com
Map of Engagements
At re|solution, we’ve built our reputation on more than a decade of improving revenue cycle
operations for healthcare providers throughout the country. We provide revenue cycle process and
technology solutions that result in both immediate and sustainable improvements to a provider’s cash
flow, profitability and revenue cycle efficiency. In addition to finding the cash that falls through the
cracks, our on-site approach establishes a knowledgeable and confident staff that operates with greater
efficiency, higher productivity and better financial results. Visit us at www.ereso.com.
re|cover
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Cash Acceleration Cash Acceleration Cash Acceleration
Immediate Cash Immediate Cash Immediate Cash
Other benefits include:
Reduced days in A/R
Improved bottom line
On-site training
Proprietary reporting tools
Improved management information
Sustainable results
Peace of mind
Real Life Results Real Life Results Real Life Results
Carson Tahoe Regional Medical Center (“CTRMC”) is a 140 bed facility just south of Reno, Nevada.
With over 30,000 patient visits per year, CTRMC had a negative adjustment to their net Accounts
Receivable of nearly $6,000,000 when their management embarked on a process to find any and all
opportunities for cash and bottom line improvement.
re|solution was engaged and assigned all insurance accounts over 90 days. During the first quar-
ter of the engagement, cash collections were 40% higher than cash collections for the same quarter
in the prior year.
In addition, re|solution provided added services for CTRMC’s business office staff, such as training
in billing and follow-up techniques and a detailed revenue cycle assessment at no additional cost.
The hospital administration was ecstatic about the increased cash flow. The improvements identi-
fied and implemented by re|solution were continued after the engagement ended.
MethodologyMethodologyMethodology
Experienced and knowledgeable analysts work your aged accounts
On-site training and mentoring of your staff insures long-term improvements
Inefficiencies identified and recommendations made for customized process improvements
Safety net of re|solution resources provide post engagement support
Post engagement quarterly benchmark reports verify your success
“The re|solution team was so helpful and
had so many good ideas that they quick-
ly gained the trust of the full-time staff.
Everyone was happy to have them on
board and soon realized the value of
their expertise.”
John Wilker, Chief Financial Officer
Portneuf Medical Center
For additional information:
toll free 800-355-0410
www.ereso.com
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Interim Staffing Interim Staffing Interim Staffing
Immediate Access to Proven, Immediate Access to Proven, Immediate Access to Proven,
Qualified PersonnelQualified PersonnelQualified Personnel
Other benefits include:
Cash increases with improved staff skills
On-site knowledge transfer produces competent
local employees
On-site training/mentoring increases skill retention
Temporary or long-term placements
Real Life Results Real Life Results Real Life Results
Lavaca Medical Center (“LCMC”) is a 25-bed community hospital in south central Texas providing a
wide range of inpatient and outpatient services. LCMC’s business office manager resigned. Months
of searching for a replacement resulted in no qualified candidates, so LCMC identified an individual
from another department to become the new business office manager.
re|solution was engaged to mentor/train the individual selected. During the first three months of the
engagement, the on-site re|solution interim business office manager managed the business office
while the new business office manager shadowed and learned effective business office manage-
ment. During the second three months, the new business office manager managed the business
office and the on-site re|solution interim business office manager provided support while writing
policies and creating a reporting structure.
During the six month engagement, LCMC also underwent a difficult system conversion. Cash
remained relatively steady even with the turnover and system conversion problems. The new busi-
ness office manager received continued support from the re|solution interim business office
manager who remained a resource after the training/mentoring engagement ended.
MethodologyMethodologyMethodology
You select from our elite reserve of qualified personnel
Mentoring option for training managers or higher level personnel
Implementation of unique reporting and productivity tools with monthly reports to measure
employee performance
Safety net of re|solution resources provide post engagement support
“Your placement of an interim busi-ness office manager helped us begin the process of implementing the rec-ommendations made in your assess-ment. Your continued support in the months following the engagement, including assistance in interviewing candidates for the permanent busi-ness office manager, enabled us to put the blocks in place during this transitional period as we worked to-ward long-term stability.”
Bob Ellzey, President/CEO Laird Memorial Hospital
For additional information:
toll free 800-355-0410
www.ereso.com
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System Conversion A/R Wind DownSystem Conversion A/R Wind DownSystem Conversion A/R Wind Down
OverviewOverviewOverview
Your new system conversion date is nearly here. You and your leadership team and staff have dedicated a
large amount of time to implementation, planning and training while at the same time trying to maintain current
operations. System implementations are complex and at times can be overwhelming, and despite your best
efforts, key performance indicators can begin to move in the wrong direction.
ChallengeChallengeChallenge
You and your staff are working hard, but…
Cash collections are decreasing
A/R days are increasing
Your staff is having difficulty completing their current work while building and training on the new system
Key managers are required to dedicate time preparing for the implementation
There is pressure to retire your old legacy system early to reduce costs
SolutionSolutionSolution
re|solution’s System Conversion A/R Wind Down (re|wind) solution combines our highly trained staff, with
proven experience in A/R liquidation and cash acceleration during system conversions, with the efforts of your
staff.
Our re|wind solution creates a synergy that:
Provides a cost effective alternative to working your post conversion A/R internally
Ensures that your pre and post conversion cash collections remain at or exceed current performance
Allows your revenue cycle leadership and key personnel to focus on successful implementation and training
ResultsResultsResults
Maintaining pre-conversion performance in cash collections, A/R, and bad debt expense is the key to an effec-
tive and ultimately successful system conversion. Our re|wind solution will deliver the following results:
Significantly increases the likelihood of a successful system conversion
Consistent cash collections before, during, and immediately after the conversion
Assists with maintaining other key revenue cycle performance indicators at current levels
Potential reduction of system maintenance costs by early retirement of old legacy system
For additional information:
toll free 800-355-0410
www.ereso.com
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Training and MentoringTraining and MentoringTraining and Mentoring
Improved Skills Increase CashImproved Skills Increase CashImproved Skills Increase Cash
Other benefits include:
Training provided by highly skilled revenue cycle management experts
On-site, one-on-one training insures retention
Create well-trained staff without recruiting new personnel
Application of proprietary software to monitor employee progress and performance
Sustainable business office process improvement
Training ProgramTraining ProgramTraining Program
re|train is a cost-effective way to provide new or less experienced business office staff and manage-
ment with receivables management skills. The service is conveyed one-on-one by a re|solution
revenue cycle operations expert. Throughout the training, your staff completes a series of written
and oral exercises to verify comprehension and retention of the material. re|solution also applies
proprietary software to monitor employee performance.
MethodologyMethodologyMethodology
Review and compare your facility’s key revenue cycle indicators to those of best practice
organizations, with instructions on how to use benchmarking to monitor, manage and improve
business office performance
A re|solution revenue cycle operations expert will provide in-depth instruction on:
Bad debt and contractual reserves
A/R management influences on the income statement and balance sheet
Determining if changes in A/R are due to revenue fluctuations or process breakdowns
Understanding the causes of key indicator variances and options for corrective actions
Utilizing the Aged Trial Balance and other reports as management tools
Create a responsibility matrix that optimizes the skills of individual staff members in assignment
of key business office functions and processes
Develop performance expectations and productivity standards including prioritizing tasks and
developing effective time management strategies. Apply proprietary re|solution management
tools and motivational techniques to improve revenue cycle performance
Daily performance tracking, monthly site visits or calls to review progress and answer questions.
Verbal exit conference and written report for hospital senior management at the conclusion of
the engagement
For additional information:
toll free800-355-0410
www.ereso.com
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Insourced Business Office
Guaranteed Performance Improvement
Other benefits include:
Transparent pricing—no surprises
Guaranteed bottom line increase
No more staffing issues
Improved dashboard reporting
Implementation of new technology
Peace of mind
Real Life Results
“We had been without a
business office manager and our
issues were severe. The
transition was relatively easy, and
the results practically immediate.
re|solution took over only the
necessary positions, trained
those we desired to have stay,
and the billing office began to
function efficiently. I can’t say
enough good things about our
experience with re|solution”
Mike Click, CEO
Brownfield Regional Medical Center
When Brownfield Regional Medical Center (“BRMC”) in NW Texas engaged re|solution, BRMC’s
AR days were at 131, compared to a peer average of 48 days, days of unbilled AR was at 27
compared to the peer average of only 10, and total AR was at $4.5 million. re|solution was selected
to “insource” the business office by hiring all BRMC employees and placing a seasoned business
office manager to lead the revenue cycle.
re|solution assumed responsibility for BRMC’s 21 revenue cycle employees. During the re|store
engagement, re|solution reduced the outstanding AR to less than $2 million and decreased the total
business office staff needed to run the operation by implementing process improvement and
increasing operating efficiencies. After several years, re|solution assisted BRMC in returning to an
in-house Business Office once operations were stabilized and BRMC desired to bring the work back
in-house.
Methodology
All costs of the revenue cycle assumed by re|solution including cost of other revenue cycle
vendors
Pricing set at current costs plus 10%
Guarantee that additional reimbursement will exceed 100% of additional costs or contract may
be terminated
Manage and train current staff
Optimize current patient accounting system
New technology introduced to improve reimbursement
Monthly accountability, productivity and benchmarking reports
For additional information: [email protected] toll free 800-355-0410 www.ereso.com
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Guaranteed Revenue Improvement ProgramGuaranteed Revenue Improvement ProgramGuaranteed Revenue Improvement Program
OverviewOverviewOverview
Using a comprehensive initial assessment of the revenue cycle, re|solution identifies areas where
the facility has not received the reimbursement for which it is entitled. The assessment looks at all
phases of the revenue cycle including: scheduling, registration, charge capture, coding, billing,
collections and reimbursement. The assessment will identify claims to be rebilled, changes in pro-
cess that will generate additional dollars and other opportunities to move towards a best practices
revenue cycle. re|solution guarantees that the cost of the assessment will be covered by opportu-
nities found for additional reimbursement.
Once the initial assessment is completed, re|solution works with two departments each quarter to
assist them in improving charge capture, documentation and coding practices to insure that the
facility is being paid the correct amount for all services that are performed. In addition, for a year
following the assessment, re|solution will monitor the implementation of each recommendation to
insure effective implementation. Once again, re|solution guarantees that the cost of this quarterly
implementation and monitoring is covered by additional reimbursement.
ChallengeChallengeChallenge
The challenges faced by rural and community hospitals are enormous. The same charge capture,
coding and reimbursement issues that plague larger facilities also affect rural and community
hospitals with less resources to insure compliance and appropriate reimbursement for services
provided. re|solution’s re|grip program provides a safety net to insure that the provider receives all
the monies they are due.
BenefitsBenefitsBenefits
Using proprietary technology, interviews and a proven continuous improvement and monitoring pro-
cess, this no-risk program allows personnel at the departmental level to work with the revenue cycle
personnel in optimizing reimbursement. This is the key to an effective revenue cycle when you can
get the clinicians and the business people working together. The process also allows the facility to
explore other opportunities for improvement such as point of service collections, denial manage-
ment, self pay management, contract payment review and EHR implementation for meaningful use.
This safety net gives our clients the peace of mind that all services are being reimbursed at an ap-
propriate level.
For additional information:
toll free 800-355-0410
www.ereso.com
Benchmark Indicator Analysis
How does your facility compare nationally with other facilities of your respective size?
re|solution is a hospital expert, providing superior accounts receivable management, revenue cycle analysis, training, APC and CDM reviews, interim staffing and an array of other business office services. If you are interested in knowing how the efficiency of your business office compares with demographically similar facilities, please complete the form below and return it to us by fax or email. In return, we will provide you with a benchmarking analysis. We will also make ourselves available for discussion and/or explanation of the data.
Please complete the from below and fax to (303) 648-5589 or email to [email protected]. You may also complete this information online at http://www.ereso.com/benchmark/benchmark-indicator-analysis-form. Your information is confidential.
Name
Company
Street Address
City State Zip
Phone Ext. Fax
E-mail Address
1. Bed Size
2. Beds in Service
3. Average Daily Census
4. Total Accounts Receivable $
5. Cash Receipts per Month $
6. Gross Revenue per Month $
7. Accounts Receivable $ Over 90 days $
8. Monthly Cost of Admissions/Registration Staff (including benefit load) $
9. Monthly Cost of Business Office Staff (including benefit load) $
10. Administrative Write Off $ Per Month (not including contractuals) $
11. Bad Debt Write-Off $ per Month $
12. Charity Write-Off $ per Month $
13. Number of Open Accounts
14. Number of FTEs in Business Office (excluding admissions)
15. Percentage of AR in Self Pay > 90 days
16. Number of Days of Cash on Hand
17. Amount of $ Discharged But Not Final Billed (DNFB) $
18. When was your ChargeMaster last updated? (mm/dd/yy)
19. Date Data Compiled (mm/dd/yy)
20. What is your Patient Accounting System
Please feel free to contact us with any questions.
800.355.0410 www.ereso.com
Benchmark Indicator Analysis (BIA)
Category Descriptions
1. Bed Size – The total # of licensed beds.
2. Beds in Service – The total # of operational beds.
3. Average Daily Census – The average daily inpatient census.
4. Total Accounts Receivable – The total dollar amount of any open patient accounts where monies are owed the organization for services provided. This does not include accounts in bad debt status.
5. Cash Receipts Per Month – The actual cash received by the organization as payment for services rendered on any patient accounts for the monthly reporting period.
6. Gross Revenue Per Month – The total amount of charges on accounts for patient services rendered for the monthly reporting period.
7. Accounts Receivable $ Over 90 days – The total dollar amount of all open accounts that are older than 90 days. This does not include the accounts in bad debt status.
8. Monthly Cost of Admissions/Registration Staff – the total of salaries/wages including benefit load (i.e. health benefits, payroll taxes, and other non-direct payroll costs) for ALL individuals (staff and management) that work in admissions/registration Admissions/registration staff and management includes but is not limited to: schedulers, insurance verifiers, financial counselors, pre-registrars, registrars, etc. and all supervisors, managers, and/or directors of this staff.
9. Monthly Cost of Business Office Staff – the total of salaries/wages including benefit load (i.e. health benefits, payroll taxes, and other non-direct payroll costs) for ALL individuals (staff and management) that work in the Business Office. Business office staff and management includes but is not limited to: cash posters, refund specialists, billers, insurance and self-pay collectors, analysts, data entry, charge master specialist (based in business office), receptionists, customer service and all supervisors, managers, and/or directors of this staff.
10. Administrative Write Off $ Per Month (not including contractuals) – the dollar amount of accounts that are written off to codes other than bad debt and charity. An example would be denied accounts that could not be overturned and will not be paid.
11. Bad Debt Write Off $ Per Month – the dollar amount of accounts that are written off to bad debt.
12. Charity Write Off $ Per Month – the dollar amount of accounts that have been approved and written off to charity care.
13. Number of Open Accounts – Number of open accounts being worked by the business office. Do not include those accounts that have been assigned to outside collection agencies or specific financial classes that are assigned to an outsource vendor for follow up.
14. Number of FTEs in Business Office (excluding admissions) – Active number of full time employees that are performing business office functions (i.e. management, supervisors, billers, collectors, posters, etc).
15. Percentage of AR in Self Pay > 90 days – Dollar amount of self pay as a percentage of accounts receivable that are greater than 90 days old. Do not include any accounts that have been referred to an outside collection agency. This can be determined by taking the total dollars in AR > 90 that are self pay and dividing it by the total dollars in AR >90.
16. Number of Days of Cash on Hand – This is the actual amount of cash on hand divided by average cash usage per day for hospital expenses.
17. Amount of $ Discharged But Not Final Billed (DNFB) – Dollar amount of accounts on patients that have been discharged and the billing has not been sent.
18. When was your ChargeMaster last updated? – The last date that your ChargeMaster was completely updated using the latest available code changes and respective pricing?
19. Date Data Compiled – The date the information was compiled on your Information System. (i.e. These numbers are from my March Month End Data – so the date would be 3/31/12).
20. What is your Patient Accounting System? – This is the hospital’s main Health Information System (i.e. Meditech, Dairyland, CPSI, Siemens’s, HBOC, HMS, etc).
800.355.0410
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Prepared: April 8, 2013
Facility Name: Sample Hospital
Your Information:
Facility Bed Size: 250
Average Daily Census: 41.9
Total Accounts Receivable: $7,722,450
Cash Receipts per Month: $1,808,374
Gross Revenue per Month: $2,843,505
A/R Over 90 Days: $3,840,899
Monthly Cost of Admissions Office: $45,000
Benchmark Indicator Analysis
Monthly Cost of B.O. (billing/collections): $40,000
Write Offs per Month - Administrative: $135,675
Write Offs per Month - Bad Debt: $207,817
Write Offs per Month - Charity: $86,487
Write Offs per Month - TOTAL: $429,979
Number of Open Accounts: 9,250
Percent A/R in Self Pay: 20.00%
Discharged Not Final Billed: $1,500,000
Data Provided: Enter Date Compiled
Name of provider: Enter Contact Name
For additional
information:
re|solution
P.O. Box 270903 Robin Bradbury
Louisville, CO 80027 CEO
800.355.0410 303.318.4292 direct
www.ereso.com [email protected]
Sample Hospital
81.47
45.93
39.18
0 10 20 30 40 50 60 70 80 90
Sample Hospital
Peer Group Average
Best Practices
Gross Days in A/R Outstanding
$0.047
$0.023
$0.014
$0.00 $0.01 $0.02 $0.03 $0.04 $0.05 $0.06 $0.07 $0.08 $0.09 $0.10
Sample Hospital
Peer Group Average
Best Practices
Cost to Collect per Dollar
7.31%
2.23%
1.50%
0% 1% 2% 3% 4% 5% 6% 7% 8% 9%
Sample Hospital
Peer Group Average
Best Practices
BAD DEBT Write-Offs as a Percentage of Revenue
`
81.47
45.93
39.18
0 10 20 30 40 50 60 70 80 90
Sample Hospital
Peer Group Average
Best Practices
Gross Days in A/R Outstanding
$0.047
$0.023
$0.014
$0.00 $0.01 $0.02 $0.03 $0.04 $0.05 $0.06 $0.07 $0.08 $0.09 $0.10
Sample Hospital
Peer Group Average
Best Practices
Cost to Collect per Dollar
7.31%
2.23%
1.50%
0% 1% 2% 3% 4% 5% 6% 7% 8% 9%
Sample Hospital
Peer Group Average
Best Practices
BAD DEBT Write-Offs as a Percentage of Revenue
3.04%
1.08%
0.60%
0% 1% 2% 3% 4% 5% 6% 7% 8% 9%
Sample Hospital
Peer Group Average
Best Practices
CHARITY Write-Offs as a Percentage of Revenue
49.7%
24.0%
19.0%
0% 10% 20% 30% 40% 50% 60% 70%
Sample Hospital
Peer Group Average
Best Practices
A/R Greater than 90 Days as a Percentage of Total A/R
15.8
10.1
5.0
0 2 4 6 8 10 12 14 16 18
Sample Hospital
Peer Group Average
Best Practices
Days in Discharged Not Final Billed
Hospital Peer Group Difference Cash Opportunity
AR Days Reduction 81 46 36 $2,142,599
Days over 90 Reduction 49.7% 24.0% 25.8% $995,686
DNFB Reduction 15.8 10.1 5.77 $347,542
Cost to Collect Reduction 0.047$ 0.023$ 0.024$ $272,318
Bad DebtWrite off Reduction 7.3% 2.2% 5.1% $866,441
Charity Write off Reduction 3.0% 1.1% 2.0% $334,663
Opportunity AnalysisSample Hospital
April 8, 2013
Hospital Best Practices Difference Cash Opportunity
AR Days Reduction 81 39 42 $2,549,483
Days over 90 Reduction 49.7% 19.0% 30.7% $1,186,817
DNFB Reduction 15.8 5.0 10.83 $652,554
Cost to Collect Reduction 0.047$ 0.014$ 0.033$ $379,161
Bad DebtWrite off Reduction 7.3% 1.5% 5.8% $990,987
Charity Write off Reduction 3.0% 0.6% 2.4% $416,556
Overview
The need Marshalltown Medical and Surgical
Center needed help to identify key
areas of opportunity to quickly
improve cash flow. The facility wanted
to identify all organizational and
process changes required for best
practice revenue cycle.
The Solution Marshalltown Medical and Surgical
Center deployed re|grip™
complemented by an experienced
re|solution manager to identify missed
opportunities for reimbursement while
providing training to key staff and
implementing sustainable and proven
improvements to the facility’s
processes.
The Benefit Marshalltown Medical and Surgical
Center with the re|grip™ assessment,
assisted by re|solution, quickly billed
over $2,500,000 in missed charges
resulting in over $600,000 in
additional cash for MMSC.
Improvements to process, CDM
and Charge Capture will ensure
long term sustainability.
Marshalltown Medical & Surgical Center finds additional cash
An assessment and redesign of business processes combined with guaranteed cash results leads to improving staff understanding and skills, optimizing the revenue cycle
Marshalltown Medical & Surgical Center (MMSC) is a 125 bed acute care facility nestled in the heart of Iowa. It is the only full-service medical center serving the community and surrounding areas. It provides more than 60,000 residents with 24 hour emergency care, a state-of-the-art Diagnostic Imaging department, Cardiac Catheterization Lab, Rehabilitation Center, and a host of outreach programs. MMSC also owns and operates four primary care medical clinics in Marshalltown, Conrad, State Center, and Toledo. Their mission is to create and continually improve services that respond to health care needs within the community. They are dedicated to teamwork, integrity, and providing compassionate quality care to patients and families.
Safeguarding Community Services MMSC’s leadership, while focused on addressing the needs of the community they served, was concerned with the integrity of their revenue cycle. A lack of cash threatened their ability to meet the healthcare needs of their community. Facing the numerous challenges of current healthcare reform and the threat of decreased reimbursement for Medicare and Medicaid, MMSC needed to quickly identify areas in which they were missing opportunities for optimal reimbursement.
Balancing Community and Revenue Cycle Integrity MMSC leadership selected re|solution to assess their current revenue
cycle and offer recommendations for proven, scalable, improvements to
revenue cycle performance and integrity. In keeping with their
commitment to community and rural healthcare facilities, re|solution
guaranteed to find more cash opportunities than the assessment cost or
the difference would be refunded. The review was completed and
recommendations for improving business and operational processes and
specific key areas of opportunity to optimize reimbursement were
presented to MMSC’s leadership.
Todd Burch –COO for MMSC said, “re|solution’s Guaranteed Revenue
Improvement Program was a huge success for our facility. While we
appreciated the additional cash found and process improvements
implemented, the real benefit was capturing more dollars for the same
services going forward. re|solution was easy to work with and
immediately put our staff at ease. Great program.”
re|g
rip™
“re|solution’s Guaranteed
Revenue Improvement Program
was a huge success for our facility.
While we appreciated the
additional cash found and process
improvements implemented, the
real benefit was capturing more
dollars for the same services going
forward. re|solution was easy to
work with and immediately put
our staff at ease. Great program.”
- Todd Burch – COO, Marshalltown
Medical & Surgical Center
A Solid Foundation Provides Sustainable Measureable
Results MMSC leadership collaborated with re|solution following a full
assessment and the identification of key areas of opportunity for
additional billing assistance needed to move quickly in billing missed
charges. The re|solution team, together with MMSC staff, identified and
billed $2,500,000 in missed charges, resulting in $600,000 in much-needed
additional cash for MMSC.
As part of the re|grip program, re|solution professionals in partnership
with the MMSC team, developed new processes and implemented tools
the facility uses to create and sustain improvements. Along with billing
assistance, re|solution performed the Charge Capture review,
departmental training and education process, and a Chargemaster review
to optimize reimbursement. The on-site, re|solution Project Manager
provided resources, skills, and suggestions for process improvements to
increase cash performance.
re|solution provided a full scope of services during the Guaranteed
Revenue Improvement Program:
Determined deficits and areas of improvement
Provided the resources, tools and training to increase staff
knowledge, confidence and skills
Provided billing and collection of identified accounts to increase
cash
Guaranteed for Peace of Mind Locating unbilled charges and the education of MMSC’s staff while
generating just over $600,000 in additional cash for the hospital is
impressive, but more significant are the process improvements and the
knowledge transferred to Marshalltown Medical & Surgical Center’s
business office staff for long term sustainable results.
For more information Visit us at www.ereso.com, or call us at 1.800.355.0410
Overview
The need Dallam Hartley was facing serious
financial impact from significant
revenue cycle operational issues;
revenues had declined, DNFB was
unstable, and long standing coding
issues and training needs had gone
unaddressed. Deficits in staffing added
to the challenging situation.
The Solution In partnership with re|solution, Dallam
Hartley deployed re|store™.
re|solution placed a Revenue Cycle
Manager onsite to assist with training
current staff, securing additional
staffing, stabilizing the DNFB and
billing. The staff worked aggressively to
meet milestone goals.
The Benefit Dallam Hartley realized a net benefit of
nearly $500,000, eliminated billing
compliance exposure, and increased
cash by approximately 4% on flat
revenue. The engagement continues to
focus on moving all key performance
indicators even closer to best practice
levels. Dallam Hartley has requested
that re|solution also assume
responsibility for clinic billing
operations due to superior
performance.
Dallam-Harley Counties Hospital District increases cash and reduces expenses
Insourcing partnership reduces billing and follow up costs,
increases cash flow and compliance, providing the benefits of
outsourcing without eliminating staff or taking processes
offsite.
Dallam Hartley Counties Hospital District (DHCHD) is located in the
northwest corner of the Lone Star state and is committed to being the
primary quality healthcare resource for Dallam-Hartley counties and the
surrounding areas. DHCHD is a 25-bed acute care facility offering Level IV
trauma services, inpatient and outpatient services, 24-hour emergency
room, surgery, nursing, laboratory and radiology. They are dedicated to
excellence in patient care, offering a wide spectrum of clinical expertise,
supported by an exceptional range of technology and staff.
Ensuring Community Services Like many rural and community providers, DHCHD faced serious financial
impact from significant revenue cycle operational issues. Executive
leadership recognized that staffing deficits, new and changing healthcare
regulations, economic challenges, a lack of billing and compliance training
and coding issues were directly impacting cash. They were seeking a
meaningful long term solution to decrease waste and improve efficiency.
Executive Leadership reviewed a variety of options to quickly and
positively resolve operational issues and improve cash flow. They
determined partnering with re|solution for a full insource with
transparent pricing would best support these goals.
Making a Smooth Transition DHCHD’s leadership and re|solution collaborated to create an
Engagement Management Action Plan for an efficient insource transition.
The plan outlined a variety of milestones and goals designed to optimize
revenue cycle operations. DHCHD employees were transitioned to
re|solution, retaining jobs in the community.
Leroy Schaffner – CEO for DHCHD said, “re|solution’s focus on process
improvement and best practices has improved and streamlined our billing
and follow-up, while at the same time increasing our cash flow.”
re|s
tore
™
“re|solution started the project and
quickly assessed our operation.
Then they created a comprehensive
management action plan to
address the issues they found and
drive improvements. Their
monthly reporting package is great
and we’re seeing data and analyses
that we’ve never had access to
before. They implemented their
claims management technology
which helped to increase cash
collections for us. They also
brought in other revenue cycle
experts (coders, charge capture
specialists, etc.) as needed to help
train our staff. We’re very happy
with re|solution and greatly value
our partnership with them.”
- Donny Pettit– CFO, Dallam Hartley
Counties Hospital District
Quickly deploying productivity initiatives and training
creates a solid foundation for future performance While a typical outsource removes jobs from the community and does
nothing to reduce expenditures, re|store™ insourcing eliminates these
dilemmas. re|solution assumed responsibility for the day to day
operations and immediately began work on implementing the
Engagement Management Action Plan. An experienced re|solution
revenue cycle manager was placed onsite to support training and
mentoring the current staff and also took responsibility for managing the
additional re|solution team brought on-site to assist in swiftly improving
cash flow.
Highlights of the best practice plan included:
Immediate compliance training/testing to staff
Reduce and stabilize DNFB
Resolve long standing coding issues
Conduct a charge capture review
Train ER registrars and clinic staff
Revise Self-pay letters and statements
Implementation of re|discover claims management technology
Guaranteed Performance – Peace of Mind re|solution quickly provided additional staff upon transition to ensure
revenue cycle improvements proceeded quickly. The business office staff
immediately completed compliance and billing training and testing
eliminating billing compliance exposure by utilizing best practices. Cash
increased nearly 4% on flat revenue.
re|solution collected additional cash and DHCHD realized a net benefit of
nearly $500,000. DHCHD has requested that re|solution also assume
responsibility for clinic billing operations due to superior performance.
The engagement continues to focus on moving all key performance
indicators even closer to best practice levels.
For more information Visit us at www.ereso.com, or call us at 1.800.355.0410
Overview
The need An outstanding AR of $2,926,000, of
which $1,179,000 was over 90 days
and Gross Days in AR exceeding 117,
Muenster Memorial needed help to
reduce their AR. Another immediate
need was to address Discharged Not
Final Billed (DNFB) which had climbed
to $735,000 or nearly 29 days of gross
revenue.
The Solution Muenster Memorial deployed
re|cover™ complemented by an
experienced re|solution manager to
assist in assessing staff, providing
training and re|solution tools left
behind for ongoing improvement and
success.
The Benefit
Muenster Memorial with processes
implemented by re|solution’s
experienced staff and use of
proprietary tools reduced their AR
over 90 days from $1,179,000 to
$474,000 and DNFB decreased from 29
days of gross revenue to 5 days, an
83% reduction. The AR clean-up
generated over $700,000 in cash
collections while the DNFB reduction
accelerated another $300,000 in cash
for the hospital, and increase of over
$1MM in an 18 bed facility
Muenster Memorial Hospital achieves a significant reduction of Accounts Receivable and DNFB
Assessment, training and a reduction in Accounts Receivable completed, increasing both staff confidence and performance.
Muenster Memorial is an 18 bed, Critical Access Hospital located in Cooke County, Texas. Since 1964, MMH has served Muenster and surrounding communities with the same philosophy; the value of patient care depends on the outcomes achieved and resources used. MMH’s dedication to serve the community with integrity, compassion, public service, efficiency, and support create an atmosphere of trust, and open communication.
The Muenster Hospital District’s staff and Board are driven by a vision to work with the community to provide total healthcare needs as well as to inform and educate to improve the wellness of the community.
Ensuring Community Services Like many Critical Access healthcare providers today, MMH faced an
immediate need to reduce $2,926,000 in Accounts Receivable of which
$1,179,000 was over 90 days with Gross Days in AR exceeding 117.
Addressing the Discharged Not Final Billed (DNFB) which had climbed to
an unacceptable amount, nearly 29 days of gross revenue had become
critical. MMH’s Board and leadership determined that to accomplish these
goals they needed to improve organizational structure, identify staff
deficits and implement a training program to address working procedures
and standards while quickly reducing the AR and DNFB. They realized that
changes were needed to ensure their continued success in Cooke County.
Balancing Community and Revenue Cycle Integrity Needing immediate improvement, leadership partnered with re|solution
to assess the situation, provide training and improve processes while
augmenting MMH staff to reduce the nearly 3MM in outstanding AR and
minimizing bad debt. Providing local staff with additional training kept
jobs in the community while increasing employee skills and confidence.
Lynn Heller – Former CEO for MMH said, “Our accounts receivable had
grown to a level that was unmanageable by our staff. My options were to
hire additional staff or bring in someone who knew what needed to be
done, and had the expertise to get it done. The return on investment has
been outstanding. A major benefit was to reduce the volume of accounts
receivable accounts to a level that is manageable by our staff. Of course,
collecting a bucket full of additional payments has been good too!”
re|c
ov
er
™
“Our accounts receivable had
grown to a level that was
unmanageable by our staff. My
options were to hire additional staff
or bring in someone who knew
what needed to be done, and had
the expertise to get it done. The
return on investment has been
outstanding. A major benefit was
to reduce the volume of accounts
receivable accounts to a level that is
manageable by our staff. Of course,
collecting a bucket full of
additional payments has been good
too!”
- Lynn Heller – Former CEO, Muenster
Memorial Hospital
A Solid Foundation through Training, Mentoring and
Proprietary Tools is Key to Measureable Sustainable Results MMH leadership worked closely with re|solution focusing on each item
identified to make the necessary improvements. An experienced
re|solution project manager (RPM) was placed onsite to assist in training
and mentoring the current MMH staff and also took responsibility for
managing the additional re|solution team brought on-site to assist in the
critical cash acceleration project. re|solution immediately began work on
implementing improvements, providing the resources, skills, and
processes necessary to quickly increase cash performance.
The goal was to reduce accounts receivable as quickly as possible and to
provide the guidance and tools necessary for MMH to measure staff
productivity and create sustain improvements.
re|solution provided a full scope of services during the cash acceleration:
Interviewing leadership and staff to determine deficits
Providing the resources, tools and training to increase staff
knowledge, confidence and skills
Collecting on assigned accounts to quickly decrease aged accounts
receivable
Reducing the DNFB for additional cash
Guaranteed Performance – Peace of Mind Reduction of MMH’s AR over 90 days from $1,179,000 to $474,000 and
DNFB decreased from 29 days of gross revenue to just 5 days, an 83%
reduction, generating just over $1,000,000 in cash for the hospital. The
improved performance indicators are impressive, but more significant are
the process improvements and the knowledge transferred to Muenster
Memorial’s business office staff.
For more information Visit us at www.ereso.com, or call us at 1.800.355.0410