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The health system uses an agency scorecard to assess how well agencies resolve accounts. The scorecard measures:
These measures are similar to the overall effectiveness ratings that are used to evaluate internal billing staff at Duke. This consistency in measures allows Duke to compare the performance of each agency and to benchmark agency performance against their staff collectors' performance.
"We hold them to the same measures as we hold ourselves, and we always compare how we are performing versus the vendor," says Scott Hawig, divisional CFO, Duke Patient Revenue Management Organization.
To monitor the tone of the collection efforts, agency and staff collectors are subject to quality reviews. "For our internal staff, we record patient collection phone calls, and we specifically selected vendors that offer the same recording capabilities," says Hawig. "For our staff, we audit a number of those phone calls every month, and we do the same for the collection agencies."
The approach, designed to ensure that bill collectors represent Duke in the proper manner, is costly. Hawig says both the recording software and the data storage requirements require significant investment, but are worthwhile. Even though collectors know they are being recorded, the quality reviews do reveal the need for continual training.
"We still occasionally have issues with how collectors answer a technical question, but there are very few relative to the softer skill attributes like their tone or how a patient was greeted," says Hawig. "If a particular patient is upset, we look to the collector to be able to calm the patient down and address the patient's concerns."
The quality reviews for bill collectors are part of Duke's quality assurance program for all revenue cycle functions.
"We believe that performing quality reviews throughout the entire revenue cycle-not just for customer service, preregistration, and admissions, but also for charge capture and coding, billing, collections, credit balance resolution, and payment posting-is the right way to go," says Hawig.
The ongoing reviews allow Duke managers to identify problems more quickly, provide more timely feedback and training when needed, and identify potential process improvement opportunities.
"There is ROI in terms of more stable cash flow and operating performance," says Hawig.
Publication Date: Friday, May 01, 2009
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Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
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