CFO details positive impact of leveraging revenue cycle technology

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Todd Mallon, Advocare’s chief financial officer, says the organization has a near-perfect net collection ratio.

Improving net collection rates and overall revenue cycle management processes is a priority for revenue cycle managers and adding new solutions and automation to streamline these operations has been a must for many. many organizations.

Todd Mallon, CFO of Defenderone of the largest independent multi-specialty medical organizations owned and run by physicians in Pennsylvania and New Jersey, recently spoke with HealthLeaders about implementing new technology to streamline revenue cycle management operations of the health system.

With more than 650 providers and 3,000 employees across more than 150 independent care centers that facilitate approximately two million patient visits annually, Mallon said simplifying its revenue cycle is key.

Since implementing new technology from eClinicalWorks to facilitate its revenue cycle management operations, Advocare now has a net recovery rate of 99%. As the industry standard ratio for net collections is 95%, Advocare is now operating well above average and is experiencing the positive effects of this change across all of its care centers.

“I spend a lot less time discussing processes and denials with our client account teams. We now have the space and flexibility to focus on expanding our operations and meeting the needs of more patients in our community,” says Mallon.

HealthLeaders: What kinds of issues were you seeing in your revenue cycle that made you realize you needed to implement change? What was your main driving force?

Todd Mallon: Our net recovery rate was the best indicator we needed to change our revenue cycle management solution. The net collection rate measures how effectively our practice collects reimbursement for services from patients and payers. This measure has always been one of the main identifiers of the financial success of healthcare organizations.

However, our net recovery rate was continually declining with our old practice management system. I felt like I spent most of my time at every financial review meeting discussing accounts receivable, denials, and current processes to get to the heart of this issue. This meant that our teams spent most of their time fixing day-to-day operations, which limited our ability to grow and deliver high-quality care to more patients. So our main driver for changing our revenue cycle management was to equip our finance and accounts receivable teams with the support and resources they needed to improve our net collection rate.

HealthLeaders: What was the process for implementing the new technology and who was involved in the decision making in your organization?

Mallon: All members of our management team supported the decision-making process. Between our CEO – who provides a medical perspective, the administrative team and myself – who provide the financial and operational perspective, and our task force – made up of several leading physicians in all of our specialties, we wanted all stakeholders are represented in the decision-making process.

Prior to implementation, we had several meetings with our vendor to define specific goals, metrics and deliverables to improve our net collection rate. Once we aligned with core workflow and back-end operations, the next step was training. The system was new to everyone – from our CEO to suppliers to management staff – so we needed a lot of support to train our employees. Without proper training, it was unlikely that we would see our net recovery rate improve.

Prior to launch, a select group of our staff traveled to Boston for a comprehensive overview and training on the new system. Three months before the launch, our vendor team trained our vendors so that they felt confident with the system. We also provided pre-launch training courses to the rest of our staff. However, even after the training, the team was available for a quick phone call or chat to answer questions or resolve a potential issue with the system or workflow.

HealthLeaders: How long did it take your organization to fully implement the technology, and how did the implementation work since your practice spans so many clinics?

Mallon: Launching the system was difficult and we could not have implemented the technology smoothly without vendor support. We rolled out the new solution to all 150 health centers in one day. We went all-in from the start and we had to start strong.

We had eClinicalWorks trainers in each care center for about a week to two weeks after launch to help with the transition process and to train additional Advocare staff. During the implementation, we trained internal staff as a resource person for the solution so that they can continue the implementation and staff training.

HealthLeaders: Since implementation, what positive results have you noticed?

Mallon: The most notable positive result is our increased net recovery rate. Several factors contributed to this increase.

First, we now have a dedicated eClinicalWorks team that manages our daily collections and follow-ups to ensure we receive claims on time. To create an efficient workflow, the team helped us set up bill-ready rules to ensure care centers complete reports accurately. We may create alerts for missing information or incomplete applications. In addition to these workflow rules, the team notifies us of any issues, giving us plenty of time to gather additional information from vendors or communicate next steps with payers.

Secondly, our provider’s team also handles rejection calls for our care centers. So if a denial comes back for a claim from a specific center that needs to be addressed or amended, they will help that center submit an appeal and track the progress of the claim in our system. Once we receive the payments, they manage the receipts and record them internally so that we can follow our income in real time.

HealthLeaders: What are some keys to success that you could share with another organization that wants to do the same for their facility?

Mallon: The first key to success that I would share with other organizations looking to improve their revenue cycle is knowing where you are right now. Know your net collection rate and the number of days your accounts receivable are past due. Once you have a baseline, you can set goals and implement strategies to improve workflows and increase collections. And once you have those metrics, keep track of them and update them regularly. We have regular meetings with our team to discuss our current metrics, compare them to our revenue and collection goals, and adjust our workflow and operations as needed. Everything must be measurable to be successful, especially in the revenue cycle.

Second, train your team on the new technology. Especially for multi-site healthcare operations, it is imperative to have people in each care center who can monitor the success of the solution and train new staff as needed. From now on, each care center is functioning at its best. It is also easier to open new care centers because we have a unified system.

Finally, choose a health informatics vendor that listens and learns from your organization. Open communication between a health informatics provider and a practice client can benefit both parties. For example, based on our experience with their technology and conversations between our staff and the eClinicalWorks team, they came up with a mass lock button that would lock multiple charts at once to minimize clicks and improve the efficiency of billing. The most valuable part of our partnerships is open communication. We are ready to learn from them and they are ready to learn from us. Through this open communication, our vendors and staff benefit from more efficient workflows and our net collections have increased. Through them, we are also exposed to new opportunities for improving healthcare IT solutions.

Ultimately, patients get a better experience and everyone wins.

Amanda Norris is Revenue Cycle Writer for HealthLeaders.

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