Challenge

To reach quality and cost savings goals, many healthcare organizations are merging and installing integrated care management systems. Without standardized, disciplined processes to support operations, implementation can wreak havoc on revenue cycle management. For one multi-state ambulatory care network, the financial and customer service consequences were substantial, including $64 million in aging revenue.

Holistic approach

Engaged to support the organization’s new shared revenue service center, Point B revealed the depth of their accounts receivable problem and set a course for rapid process standardization—from patient access through claim submission, payment posting and bad debt collections. We led a process improvement team which created a plan for reaching their desired state—and managed projects for the following year.

Point B included the following components in their plan for lasting success:

  • Engaged critical perspectives: patients, physicians and business goals. 
  • Looked across the organization to understand the challenges at each stage and hand-off.
  • Prioritized low effort/high benefit actions. This organization worked first on 10 rapid improvement opportunities, then moved on to bigger managed projects.
  • Made the system and feeder processes as simple as possible. Complexity is the enemy of timeliness and consistency.
  • Provided clear rules and enforced them. Explained measurements, goals and initiatives so staff feel capable to meet expectations.
  • Defined processes to bring new sites on-board quickly. With this preparation, the organization can keep revenue flowing and reduce bottlenecks after the transition.
  • Took action on available data. Waiting for perfect data sets as new systems come on board wastes opportunities to fix known issues before they got worse.

Early and ongoing results

Within six weeks of plan implementation the organization was on path to recover over $10 million of aging accounts by year end. After one year, the average time in accounts receivable was reduced by 15 days.

The early wins helped the program gain traction through collaboration and new ideas. The organization continues to reduce aging accounts, improve cash flow and recover more revenue achieving critical business goals.