Avoid Vendor Fatigue in the Revenue Cycle:

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1 - Avoid Vendor Fatigue in the Revenue Cycle: Thrive and Survive in the Evolving Healthcare World LITMOS HEALTHCARE DIVISION It s challenging to stay up-to-date with rules and regulations, technology, staffing, and financial pressures while remaining true to your mission: delivering quality care to your patients. If what you re doing is not benefitting the patient, why are you doing it? Two of the largest outsourcing functions in healthcare today are technology and revenue cycle, done in an effort to find expertise and to obtain additional solutions in the market. As a result, healthcare organizations often suffer vendor fatigue from managing too many outside vendors. It can quickly become a cumbersome, full-time job managing your many vendors.

2 Achieving Operational Integrity with Vendors Streamline revenue cycle processes by selecting fewer partners. Examine your revenue cycle partners and choose the most trusted and with optimal resources. Select partners who have multi-faceted abilities and a high level of expertise

3 The Affordable Care Act (ACA) and the Revenue Cycle The ACA has caused a steep increase in patient responsibility by way of higher co-pays and deductibles. These factors have become a bigger part of the revenue cycle and are a challenge for facilities to capture the additional costs. Patients have become savvy consumers by comparing costs for services and selecting providers, clinics, and hospitals that yield the greatest results. The ability to maximize their benefits and reduce costs, while receiving the highest quality of care is a driving force behind consumer healthcare decisions. Does your staff, regardless of their size, understand the key KPI s to remain competitive in this changing healthcare landscape? Create Revenue Cycle Integrity by: Maintaining open communication between the denial management and coding teams. Understanding denials due to documentation versus those due to coding. Preparing to work with payers to overturn denials. Building reporting to identify cash trends and make inpatient case by payer

4 Revenue Cycle KPI s It s imperative to understand the key KPI s of your revenue cycle, as they give you a snapshot into the trends and nuances of the revenue cycle, both pre and post-icd-10. Begin by analyzing your top MSRG s for the two years prior to ICD-10, as well as any post ICD-10 information. If this data isn t accessible to you, obtain this data from outside organizations that analyze revenue cycle trends for facilities like yours. Prevalent trends in your area (or even nationwide), can give you an advantage when building accurate reporting tools. Putting KPI s in Place: So Many Choices, So Little Time! In order to take advantage of the benefit KPI s provide, examine them frequently and adjust as needed. Where do you start? Understanding the components that affect the lifecycle of a claim can be a good place to begin. Some useful KPI s may be: Coding Days Days Not Final Billed (DNFB) Days Not Final Coded (DNFC) Physician Queries Claim Acceptance AR Dollars by Care AR Days by Payer Denials Underpayments Average Payer Response It s critical to analyze the data that drives the revenue cycle in your facility. Whether you re using internal resources or third party vendors, lines of communication must remain open within all departments to eliminate any roadblocks within the revenue cycle process. Often, coding and billing staff don t communicate or clinical and coding staff; however, organizations that have synergy among these departments as well as patient access, typically see a deduction in rework, lower denials, and less cash flow interruption

5 Staffing: Loyalty vs. Adversity to Change? Smaller practices and rural facilities often have staff that wear multiple hats. Your CFO may also be your CIO and/or your Revenue Cycle Management team may also be your Patient Access or Frontline Staff, as well as your billing team. Illness, vacation, or retirement can be devastating to your practice when your internal staff tries juggling multiple responsibilities. But you can t stop billing so how do you survive the impact? To be successful, your staff must: Support the latest healthcare changes. Accept technology advances. Understand increasing compliance and security issues. Outsource areas that are critical to the revenue stream. Staff Communication Synergy within the Revenue Cycle Team: ICD-10 required most facilities to increase their training budget, as well as their staff size. Successful organizations started by reviewing provider documentation and educated physicians, in order to eliminate revenue cycle bottleneck. Online education allows physicians to audit and review documentation best practices in smaller chunks without having to sacrifice clinic or patient hours. Physician communication and engagement is integral to a healthy revenue cycle

6 About Litmos Healthcare Starting with friendly, healthcare-experienced people, Litmos Healthcare breaks the mold when it comes to caring about clients. All processes and procedures are you-centric, fast and efficient. Our patient engagement education, will allow you to align incentives across your organization to build and create efficient behaviors, we strive to introduce courses that matter to your business and allow you to empower your patients and your practice. Our platform offers the latest in instructional design quick, easy, engaging Litmos Healthcare courses deliver the knowledge and empowerment that produce productive and happy employees. Add/subtract from course materials to meet your organization s needs it s easy, with just a few clicks. Deliver training across the country or around the world. Users will love that it s quick and easy to learn, and you can even brand it with your logos. Integrate with HR and EHR systems to save time. If your LMS is tired, if your courses are boring, take a look at Litmos Healthcare today s standard for online learning.