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Healthcare Revenue Cycle Successes

September 10, 2014

In early May 2014, Revenue Cycle Professionals from across North Carolina met at Cone Health to network and discuss current issues. Many of the participants shared their healthcare revenue successes. Following is a synopsis of the discussion:

1. Providers are taking more opportunities to better communicate and inform their patient regarding patient responsibility. Financial counselors have become advocates, assisting them in applying for insurance coverage through the Affordable Care Act. Some providers deny charity care if they have not applied for insurance coverage.

2. More emphasis is being placed on implementing or updating a thorough process for Pre-Admission and Pre-Encounter. Providers find that this reduces denials, increases patient understanding, and provides more opportunity to improve cash flow through point of service collection.

3. Hospitals are centralizing scheduling to improve their pre-encounter process. This has been a difficult transition for some providers, creating some territorial issues, but the pros have outweighed the cons.

4. Some hospitals are paying premiums for the patient that enrolls though the Affordable Care Act. Providers are not being told they cannot pay the premium, but many are being advised against it.

5. Emergency and Outpatient admission/registration areas are improved to allow more private conversations with a patient regarding financial issues.

6. More point of service collection processes are being implemented. Several providers have added a goal and bonus structure for registrars and financial counselors.

7. New technology is taking a front seat, especially in the use of estimators. Hospitals want to communicate estimated insurance payment and patient responsibility. Many are taking advantage of the opportunity to collect balances earlier.

8. In order to offer the patient other options to pay, providers are outsourcing programs such as Medicaid eligibility, financial counseling, and financing options to vendors.

Please feel free to reach out to me if you would like to connect with some of these providers to gain insight regarding their processes.
John Cook
jcook@prorecoveryinc.com

Affiliations Audits & Achievements

  • HFMA: Healthcare, financial, management, association
  • AAHAM: American Association of Healthcare Administrative Management
  • ACA International

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