Improve your collection rates, reduce A/R
Ongoing training, QA keys
In order to improve collection rates, thereby reducing A/R days, several revenue cycle initiatives are utilized at University of California, Los Angeles Hospital System. These include:
Ongoing training with all patient access and business office staff on the contract terms with managed care health plans.
"This assures that required notifications, authorizations, insurance verification, and benefit checks are completed on or before service for 100% of our scheduled cases, and completed either the same day or next business day for urgent or emergent cases," says Bernadette Lodge-Lemon, director of revenue cycle.
Weekly meetings with the managed care contracting team cover upcoming contract renewals, and new or revised contract terms. "Any changes within our contracts is a trigger to update our billing and collection representatives," says Lodge-Lemon.
Staff are updated during weekly unit staff meetings and daily unit huddle meetings. Additionally, payer representatives have been scheduled to come on-site to complete staff in-servicing.
Staff training needs are identified at weekly staff meetings, A/R payer trending, and individual contract inquiries. In addition, weekly quality assurance reviews will identify incorrect contractual adjustments being posted by a representative, which could mean either they do not understand the contract terms or they are working from outdated information.
Patient responsibilities are identified.
The department is equipped with the hospital's top 20 managed care contracts grid. "This is utilized to estimate reimbursement for up-front collection and pricing data to inform our patients of approximate costs for their services," says Lodge-Lemon.
Patients are asked to pay their portions on or before the service to minimize delayed collections. "We assure that the account is fully financially secured prior to releasing the account to the business office," says Lodge-Lemon. Financial counselors screen uninsured patients for funded program eligibility and follow-up with patients to assist them with the application processes for these eligible funding sources.
Targets are set.
Goals are set for turnaround times for each revenue cycle process of insurance verification, pre-admission, billing electronically, collection follow-up, and patient statement timing. Key performance indicators are tracked on a weekly basis on performance objectives for revenue cycle management.
"Additionally, we engage external expertise for identified areas of weakness toward resolving our root causes," says Lodge-Lemon. "We have an effective multidisciplinary denial management process. We publish our progress, hits and misses, and we reward and recognize individual, group, and team achievements."
In order to improve collection rates, thereby reducing A/R days, several revenue cycle initiatives are utilized at University of California, Los Angeles Hospital System.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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