Insights from Forum Sponsor Dell Services Revenue Cycle Solutions

By Stephen Outten

You've got one shot to execute a seamless conversion.

Because it will impact your clinical, financial, and IT organizations, a hospital leader will often ask:

How can I divide my business office team to resolve legacy A/R while getting a fast start on the new system?

The bad news is that it's very hard to go through a conversion and maintain cash at pre-conversion levels.

The good news is that you can avoid a cash dip if you're willing to make strategic staffing decisions.

"Carefully study the well-being of your men [and women], and do not overtax them," Sun Tzu said. "Concentrate your energy and hoard your strength" (The Art of War, XI.22).

To start, consider all that your business office team has to address during the conversion:

  • Continue resolving incoming A/R on the legacy system until the conversion date
  • Liquidate backlogged legacy A/R so that you can sunset the system as soon as possible
  • Train thoroughly on the new system to maximize all the promised features
  • Resolve go-forward A/R on the new system after go-live
  • Continue resolving legacy A/R (because you know it will still be there)

Instead of dividing your team's time, energy, and mental focus during the conversion, consider in-sourcing an expert team to augment your staff by focusing exclusively on the resolution of legacy A/R. Many hospitals have had great success resolving legacy A/R to greater than 95 percent within 120 days of go live, which allowed them to sunset their legacy systems quickly.

For you, this means you have your internal team focused on learning the new system and maximizing all of the promised features, and you have a much shorter window of time in which you have to pay to maintain two patient accounting systems.

If you do decide that partnering with a focused task force would be beneficial to your hospital, here are a few things to keep in mind:

  1. Decide early whether an onsite, blended onsite/offsite, or remote model is appropriate for your needs
  2. Find a partner with flexibility and scale that can deploy resources early to start resolving legacy A/R at least 150 days prior to conversion
  3. Determine when to deploy a partner on the legacy A/R: Your business office will spend significant time preparing for the new system in the months leading up to conversion. Bringing in a partner early to start working older claims on the legacy system will reduce any cash dips post-conversion.
  4. Evaluate and budget accordingly, taking into consideration the bad debt implications of cleaning out the A/R in the legacy system

It's hard to walk the fine line between maximizing your business office team's talent and overextending them to the point of negatively impacting your bottom line. Take a close look at your conversion strategy and decide if a strict in-house approach or a partnership will lessen employee frustration and turnover, lower expenses and bad debt, and help you optimize the new system.


Stephen Outten is senior solution development analyst, Dell Services Revenue Cycle Solutions, Nashville, TN. Read Stephen's blog, TheRevCyclist

This article also appears in the April 2012 Rainbow Connection, published by Hawaii HFMA.