In this business profile, Mike Morris, president of Xtend Healthcare, discusses the value of partnering with a revenue cycle management vendor that has deep experience in delivering strong ROI.
Tell me a bit about your organization.
Xtend Healthcare, a Navient Company, is a comprehensive revenue cycle management firm exclusively focused on helping hospitals and health systems receive prompt and accurate payment for services rendered. We deliver a considerable return on investment through well-designed projects, including complete business office outsourcing, A/R legacy cleanup, self-pay and third-party central business office safety net engagements, coding projects, and consultative arrangements. Xtend Healthcare’s clients range from large health systems and urban medical centers to rural critical access hospitals. We work with non-profit and religious-affiliated health systems, as well as for-profit healthcare organizations.
What are some of the biggest challenges you see affecting healthcare organizations?
As most in the industry will tell you, the healthcare dollar is becoming increasingly challenged. Just by the nature of the services hospitals and health systems provide, they have low margins and significant capital requirements—and are often strapped for cash. In addition, as payment responsibility shifts toward patients, revenue becomes less predictable because organizations are more dependent on individuals and their ability to pay. Adding further complexity is the legislative uncertainty with the ACA (or perhaps a future version of the AHCA) that the healthcare industry is facing. Beyond the legislation, we will certainly see a significant number of regulatory actions that will greatly impact revenue cycle. Suffice it to say that it is difficult to run a business in an environment where you don’t know how various guidelines, rules, and requirements will evolve over time.
To run an effective revenue cycle department, organizations must have a high degree of competency, yet remain nimble and open to change, consistently employing best practices to optimize revenue. Depending on the organization, this may involve seeking outside assistance from a reliable and experienced revenue cycle partner.
How does your service offering(s) address these needs?
We help customers in a variety of ways. For instance, we can improve their back-end revenue cycle operations using our deep domain expertise and workflow tools to seamlessly manage billing, remittance, and follow-up. Because Xtend services customers coast to coast using centralized operations, we can standardize processes and procedures to attain efficiencies, which are difficult for stand-alone business offices to achieve. We also gather and implement best practices to deliver the greatest return on investment.
Our company is also starting to work with healthcare organizations to apply our core competencies to front-end operations, aiming to reduce revenue leakage. A good example relates to denials. Today, when a claim is denied because of incorrect patient demographic information or inexact clinical data, the follow-up associated with correcting a claim to successfully appeal the denial can be time consuming and delay cash flow. However, if we can enhance front-end and mid-cycle performance, such as financial clearance, eligibility verification, clinical documentation improvement, and coding, we can help organizations avoid claim errors and prevent denials in the first place.
What are some key considerations for healthcare leaders when choosing this type of service?
There is a lot of “noise” in the revenue cycle management marketplace. Whether vendors are selling products or services, they all purport to solve the same problems using different models. When trying to decide among the options, it can be challenging to determine the best route. Therefore, it is important that vendors provide strong references that describe their quality of work and the scale they can deliver. Basically, you want to find out who the vendor has worked with in the past and what results they have achieved. I believe that the best indicator of future success is based on what an organization has been able to accomplish in the past.
Before choosing a vendor—or at least as part of the selection process—organizations must understand their current state and where there is leakage or underperformance. That will help to identify the vendors that have the capability of closing the gap. If you don’t have a clear understanding of your current state, it is hard to ascertain which potential partner has the most appropriate services to address your pain points.
Xtend ensures that our clients will better understand their current operations during our due diligence process. Before we enter a relationship with a new client, we go on site to ascertain what the organization’s needs and risk points are, reviewing performance data and observing operations. From this, we generate a detailed assessment that not only outlines revenue leakage points but also shows how we propose to fix them.
Note that Xtend Healthcare also can assist with providers’ more situational needs. For instance, if an organization is moving from one patient accounting platform to another, it may hire us to work down the legacy platform. Our goal with this type of arrangement is to provide the highest return on investment. By driving liquidity on the legacy A/R, we free up the hospital’s team to focus on the new platform.
The last piece of the puzzle is industry know-how. Revenue cycle is one of those areas where experiential knowledge is critical. Our senior leadership team are pioneers in the revenue cycle space with each member having more than 25 years of experience. Together, we have gained knowledge around what works and what doesn’t, allowing us to create a superior service offering.
As healthcare organizations implement use of your service into their day-to-day operations, what advice would you offer so they can best set themselves up for success?
It is important to have an upfront understanding of who is handling what and how the handoffs between the healthcare organization and our staff are going to work. For example, if we are in a contract where we are tasked with resolving third-party A/R, but the hospital handles patient collections, then there needs to be clarity around what happens when the insurance balance is paid off but there is still a balance due from the patient. There must be clear rules around the close-and-return process so the residual balance flows cleanly back into the facility’s self-pay workflow. To overcome this challenge, Xtend has a robust implementation methodology designed to think through the various handoffs so there are no roadblocks to achieving our clients’ targets and goals.
Are there any educational materials you would like to share to help healthcare providers in these efforts?
For more information about Xtend Healthcare, go to http://xtendhealthcare.com.
Xtend Healthcare is one of the fastest-growing revenue cycle solution companies in the industry. Our senior management team has more than 25 years of dedicated hospital revenue cycle experience with hundreds of hospitals and health systems in all 50 states. Xtend Healthcare clients range from large teaching hospitals and urban medical centers to rural critical access hospitals. We have experience working with large non-profit and religious-affiliated hospital systems as well as the largest for-profit healthcare systems. Xtend Healthcare offers cutting-edge technology, experienced staff, and 100 percent customer satisfaction.
Xtend has the ability to place full teams of experienced billing and collection personnel on site with expert consultants in all revenue cycle areas, including patient access, business office, self-pay management, HIM, and IT systems relating to revenue cycle. The result is immediate cash acceleration and accounts receivable resolution combined with long-term revenue cycle improvement through best practices. The fast pace of change in revenue cycle technology systems requires individuals with the skills to identify the current best solutions, and we have individuals who are not only familiar with the best approach but also know how to select the most reliable alternatives.
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