Case Study 1 - Eight-Hospital System
An eight-hospital system in New York experienced revenue cycle inefficiencies,
which resulted in extended AR times, billing backlogs, and high credit balances. Additionally, the Client’s Patient
Access workflow hindered efficient processing that contributed to the lackluster positive cash flow and contributed to error
rates as high as 80% in one of the facilities. Although well respected in the medical community, the Client experienced significant
turnover in key management positions and was unable to objectively evaluate process deficits and implement workflow systems
that could improve their bottom line and performance statistics.
Select Health Management, Inc. provided nine revenue cycle consultants in a
combination of interim management roles and consulting roles to assess the situation and implement processes that would turn
the situation around. The Select Health team evaluated all areas of the revenue cycle including Central Business Office, Charge
Description Master, Contract Management, IT Solutions, and Patient Access. The team concurrently reviewed the Client’s
existing work flow and evaluated key areas of charge capture improvements to ensure all services could be charged appropriately.
Through a series of internal and external stakeholder interviews and on-site observations, processes were developed that illustrated
current process deficiencies. A Patient Access redesign was performed resulting in improved process flows, increased front-end
collections, and implementation of new technologies such as scanners, internet use, and card readers. Process flow charts,
combined with detailed reports, provided documentation for future reference and led to greater overall efficiency for internal
and external transactions. A CBO Operational Improvement Plan increased cash collections, developed monitoring tools and performed
departmental reorganization. New staff, including financial counselors and Medicaid application specialists, in addition to
senior managers, were hired and trained for across-the-board continuity in the newly developed policies and procedures.
Select Health improved
employee morale, maximized registration accuracy, reduced AR days, and provided tangible cash results of more than $50 million
in the second year. A more efficient work flow combined with focused employee education enabled Select Health to create more
efficient turnaround times across the entire Revenue Cycle. Select Health also led two key leadership retreats and created
training and procedural documentation to ensure consistency for future staff additions that has led to continued success long
after the consultants’ term of service.
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