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Increase AR Efficiency | Reduce Error Rates

Case Study 1 - Eight-Hospital System        

Problem
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.

Solution
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.

Results
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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