As a team that has actually walked in hospitals and run revenue cycle operations, we help you to invest in the arts of advanced data literacy and data-based decision making. We have a light touch, so you‘re not forced to over-invest time and capital in times of uncertainty. Trust us to coach and equip leadership and focus on the cost and cash through the lens of Analytics, Accountability, Change Management, and Continuous Improvement.

Expert Partners, Responding to Your Needs

Strategy: Understand Denials, Increase Point-of-Service Collections, and Reduce Costs

Background: Rural non-profit hospital.

Objectives

  • Provide key findings and opportunity assessment regarding operational improvements and strategic sustainability alternatives.
  • Evaluate current state performance of revenue cycle functional areas (front, middle, and back) based on available data, key performance indicators, staffing, and workflows.
  • Assess current organizational structure to determine if it supports and promotes efficiency and growth

Approach

  • 10+ staff interviews and focus groups with key stakeholders
  • 35+ job shadowing observations
  • 100+ sample accounts reviewed during root cause analysis
  • 40+ source documents reviewed for effectiveness
  • Analyzed data assets (ATB, POS Collections, 835s, Denials, Write-offs, and KPIs)

Results

  • Identified $2.36M in potential growth year over year
  • Formation of pre-access unit will mitigate the denials originating from registration and eligibility which makes up 44.3% of total denials as well as eliminate unnecessary double work the organization was unaware of.
  • Educate and train staff on point-of-services collections to drive organization and increase collections by $515K.
  • Streamline manual follow-up processes to prevent 21% of open account receivable to be aged by 120+ days.
  • Develop denials management information so c-suite staff are aware of the current state, managers can implement initiatives, and frontline staff are aware of what causes denials.

Organization’s Ongoing Opportunity

  • Identified opportunity to increase the organization’s net patient revenue by 3.9%

Strategy

  • Future State Blueprints
  • Patient Collections
  • Financial Clearance
  • Payroll and Vendor Cost Containment
  • Denials Management
  • Vendor Selection
  • Process Optimization
  • Strategic Planning
  • Implementation
  • Employee Retention and
    Satisfaction

Assessment

  • Process Workflow
  • Revenue Leakage
  • Account Review/Audit
  • Patient and Staff Satisfaction
  • Vendor Effectiveness
  • Staff Productivity

Training & E-Learning

  • Competency Measurement
  • Employee Certifications
  • Talent Development
  • Financial Assistance
  • POS Collections
  • Patient Negotiations
  • Local Policies
  • Decision Making
  • Data Literacy