By: Sandy Sage RN, Revenue Analyst
I’ve worked in the healthcare revenue cycle for 18 years. I’ve seen hospitals bought, sold, closed and I’ve seen them struggle and flourish. With regulations being imposed daily, and weekly, hospital staff have soldiered on and worked hard to keep their hospitals open. The one thing that every person I have met, that works in a hospital, have in common is that they want to keep their hospital open so that they can provide good care to the family, friends, and community they serve.
The question is always, how do we do it better? The answer is, one process at a time. Does that mean that you can only work on one area at a time? Not at all. You need to create an environment of purpose with one shared goal, to succeed and continue to provide care for your community. Come together as a team from every department and work together to improve your revenue cycle because if it is efficient, compliant, and well run, you will meet that goal.
Bring your team together and discuss strategy. Find your top 3-5 processes that need to be improved. You may not know what those are, so here are some ways to determine priorities.
1. Start at the back-end of the revenue cycle in the business office.
2. Determine why claims are not being processed or paid.
3. Identify where in the revenue cycle the process breaks down.
4. Choose the processes that are negatively affecting your cash flow.
Once you have chosen the top processes that need improvement, create a team to work on each. Here are some tips for creating those teams.
1. Have a manager or director that knows the process to lead the team. They can break down any barriers the team encounters. (time to meet, time to collect data, staff resistance etc.)
2. Include staff that are involved in the day to day working of the process.
3. Include staff affected by the process.
4. The number of staff involved will vary for each team, don’t put so many people on the team that you are unable to make good decisions on process improvements.
5. Choose staff with positive attitudes and a willingness to make changes.
Have each team identify issues and goals for their process improvement. Set deadlines and expectations. Each team should report their progress to the Revenue Cycle committee each time it meets. Any difficulties the team encounters can be discussed in your meeting and successes can be celebrated.
Once a process is changed, don’t forget to continue to monitor the process to ensure the changes are making the desired improvements. If more changes should be made, continue to have the original team participate and add others as needed.
Breaking down walls between departments, working together, having a common goal and purpose will help you improve your cash flow, decrease your AR days, and keep your hospital in your community.