Andrea Stark: Head off receivables crisis

Wednesday, April 30, 2008

More often than not, HME providers who turn to Andrea Stark for help are in crisis. Cash flow is critically low. Denials are piling up. Their accounts receivable departments have spun out of control. Finally, when all looks lost, they turn to a reimbursement consultant like Stark hoping for a miracle.
This scenario is fixable, says Stark, but it's also preventable, by putting some basic accountability measures in place before a crisis occurs. That's the advice she'll take to providers in her Medtrade Spring session "How to Establish Accountability for Effective Denial Management." She offered us this preview.
HME News: How do you define accountability?
Andrea Stark: Most important is being able to obtain measurable data so you can hold people accountable. There have to be checks and balances to be sure claims are reaching their destination. Providers may see their rejections increasing but they don't seek independent verification that claims are making it through. Also, pushing more of your claims to go electronically is a cost saver in addition to being an accountability measure.
HME: How do you establish accountability company-wide? Should you use a carrot or a stick approach?
Stark: Use the reports that are available so there's a check and balance. When you're pushing staff to download the verification reports, it's better to use a stick. There's no room for negotiation. In other areas, you can create incentives for working accounts receivable, trying new methods to get better results.
HME: On a scale of 1-10, how are providers doing when it comes to creating accountability?
Stark: I would say a four or five for the typical provider. There are some outstanding providers, but they are the exception rather than the rule. Many providers who are struggling aren't embracing the technology. Going electronic is scary to people. They feel that reimbursement tools aren't where they want to spend their money. But that's unfounded if you consider the success rate of those tools.
HME: You say providers often reach a point of being overwhelmed.
Stark: It comes back to not investing the time to streamline operations. It requires a commitment of time to work denials. It can get out of control when AR associates are asked to wear too many hats.
HME: What traits do the most successful providers share?
Stark:They're proactive on process improvement; they embrace technology; they offer ongoing training and make resources available to the AR team.
HME: If providers walk away from your session with just one piece of advice, what would it be?
Stark: You have step up to the plate and make AR a true priority in your actions as opposed to just on paper. Give AR its due respect. HME