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By Lola Butcher
When the four acute care hospitals in the Crozer-Keystone Health System operated their own patient access departments, consistency was hard to find.
"The patient would show up, stop in our registration area, and go through a process so we could revalidate the demographic information," says Richard Madison, vice president of revenue cycle operations, Crozer-Keystone, Upland, Pa. "It was an underutilization of the staff that we had, it was an inconsistent approach to preregistering patients, and it was a disservice to the patient."
In 2009, Crozer-Keystone developed an off-site pre-encounter unit called the Patient Services Center that centralized registration activities for the health system's four hospitals. The pre-encounter unit-which comprises 24 employees who were patient access staff members at Crozer-Keystone's hospitals-handles preregistration, insurance eligibility and benefit verification, payer authorizations, and preservice collections for all scheduled diagnostic testing and surgery patients.
"There's nothing small about this," says Madison. "This was a cultural transformation that the organization never experienced before."
Preregistration and financial clearance now occurs at least five days-and sometimes as far out as three weeks-before the patient arrives for a procedure. Payer authorization or preregistration snafus no longer cause last-minute cancellations, which has improved patient flow and patient satisfaction, according to Madison.
Other results include:
"The patient experience has improved by removing the mystery out of how our registration process works," he says. "We developed a brochure that is provided to our patients that details what they can expect after services are arranged. Patients are now informed about their financial responsibilities prior to obtaining service. This way, they are not taken by surprise when asked for their copayments or deductibles."
Shortly after moving to the Patient Services Center, patient access staff embarked on an extensive training program that covered basic patient access skills and knowledge.
"We had a lot of naysayers with 30 years of experience who thought, 'I know how to do this,'" says Madison. "We brought them back to the rudimentary processes of the registration system and elementary-level insurance coverage."
A comparison of pre-test and post-test scores showed how valuable the training was: An audit conducted 90 days after "go live" found more than 50 percent of patient access staff had 100 percent error-free work, and no representative fell below 85 percent.
Madison also developed a set of principles to guide the patient access redesign process and a set of operating characteristics so staff knew what was expected.
"Whenever we tended to stray from those principles or characteristics, we would go back to those documents and say, 'It doesn't fit this characteristic or this principle. We need to get back on course,'" says Madison.
The patient access guiding principles include:
The operating characteristics include:
Since the Patient Services Center opened, Madison says the unit has received fewer complaints from patients about preregistration and scheduling services and has realized a reduction in cancelled services.
"That means patients are aware of when they should expect to come in," he says. "Whether they come to Springfield Hospital or Crozer-Chester Medical Center, patients should experience the same preregistration process and be informed of any issues related to their registration."
That also means pre-encounter staff are doing their jobs well. Madison says the organization's emphasis on goal-setting, high expectations, and performance measurement has increased staff productivity and satisfaction.
For example, Patient Services Center leaders posted each representative's performance indicators-data-quality scores, number of cases they worked on, and their point-of-service collections-publicly and invited top health system leaders to visit the unit to witness the employees' productivity.
"The staff loved it," says Madison. "They have a sense of accomplishment rather than just the never-ending spinning of the wheel that they were experiencing at the hospitals."
One tactic that proved successful for Crozer-Keystone: Implementing an intensive communication campaign so that health system employees, physician offices, and patients understand the new centralized system. In the months before and immediately after the transition, Crozer-Keystone placed an article in its systemwide journal that is distributed with employee paychecks. The article explained how the change would improve service to patients and help the health system operate more efficiently.
Members of Madison's staff met in person with administrative staff from the top 30 physician offices that feed into the health system. "We gave them the brochure that we developed for patients that says, 'Here's the Patient Services Center, and this is what you should expect and anticipate when scheduling the service,'" says Madison.
Madison shares three additional lessons learned from Crozer-Keystone's transition to centralized registration.
While the process of converting to a centralized registration system is challenging, Madison expects to see the model adopted with increasing frequency as more hospitals consolidate and health systems seek ways to increase the efficiency of their administrative operations. "As systems grow and more hospitals attach themselves to one another, I think it's going to become more common," he says.
Lola Butcher is a freelance writer and editor based in Missouri.
Interviewed for this article:
Richard Madison is vice president of revenue cycle operations, Crozer-Keystone Health System, Upland, Pa., and a member of HFMA's Metropolitan Philadelphia Chapter (email@example.com).
Publication Date: Wednesday, January 11, 2012
A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
Emad Rizk, MD, president and CEO of Accretive Health, discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management.
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
Jim Bohnsack, vice president, solution & corporate development for Conifer Health Solutions, explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements.
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
Steve Scibetta, senior director of channel sales for Ontario Systems' healthcare product line, shares insights into effectively managing receivables.
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Elena White, vice president of risk, quality, and network solutions for Optum, discusses how healthcare providers can leverage data and technology as they enable risk in their organization.
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Somnia President and CEO Marc Koch, MD, MBA, explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes.
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
PMMC President Roger L. Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC's products help clients adapt to a changing financial environment.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
Greg Burgess, Founder and Chief Product Officer at Burgess Group shares insights and opportunities for payment integrity in the rapidly changing healthcare IT landscape.
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
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