Speaker spotlight: Sarah Hanna

Monday, April 26, 2010

Here’s the $64,000 question: What determines the health of your company? The answer: Cash flow, accounts receivable and taking advantage of every revenue stream possible. We consistently read articles and hear on the news the concerns with the economy and how we truly need to run our businesses tighter and save money in order to be a success.  Are we looking at every possible revenue stream? Are we ignoring what is right in front of our face? 

The reimbursement cuts have forced providers to focus on ways to increase their revenue opportunities. Focusing on payments on patient and secondary balances is a way to generate much needed income.  We cannot continue to ignore those tedious patient balances and low revenue secondary claims.   

It is shocking the number of providers in our industry who do not focus on the payment of their secondary claims and ignore the patient collections. If dollars are coming through the door and payroll is covered, we tend not to focus on what is missing until we are forced. It’s the nature of the beast in every business.

Collecting patient balances is not the most attractive project to pursue due to the challenges in communicating with the patient. Companies should focus on patient balances not just at the end of the billing cycle when an occasional statement/invoice is sent, but at the beginning when the services are being delivered. By collecting patient balances at the time of delivery or purchase, your company can increase its collections percentage and decrease the patient amounts on your AR. To assist in gaining payment from patients, your customer service/intake team needs to be educated on your company’s internal plan regarding informing the patients of their financial responsibility.  Focus on front-end “assurance” with accurate demographics, customer financial responsibility information, insurance verification, collection of co-pays and offering credit card options for payment of patient balances. Your collection and payment policy should be reviewed with the patient and/or their caregiver at intake and information can be made available in your admission packet.

In order to improve efficiency within your company become your own consultant and evaluate your customer service/intake team’s knowledge; they are your first line of defense. Start at the beginning of the process and build a foundation of education for your staff and move into coverage criteria training, auditing and error correction. By not properly training your team, you will dramatically increase your chances for high AR. Develop a uniform training process and have an organized workflow from intake through billing. Set time frames for completion of responsibilities to ensure that you can fit in all stages of billing including working your secondary claims and following up on patient collections.  

The older receivable is the hardest to collect, and the importance of managing the secondary billing and patient collections is truly a matter of survival for most. Millions of dollars are written off to bad debt each year in the HME industry due to lack of patient collections and simply not billing secondary payers.

Another area to look into is your percentage of total AR in your various aging buckets. Is your AR at an unacceptable level? Define the process and evaluate your staff. The goal for your 90 and over aging bucket should be less than 20% of the total AR. If secondary billing and patient collection are not a focus, you can exceed that very quickly in a few short months. Your software program can provide you with various reports that can be run in order to optimize all the dollars sitting in your AR. Evaluate your posting department to ensure that payments are being posted accurately to decrease the amount of time that will be wasted chasing money that has already been paid. 

The billing edit report, aging and held report must be the focus of your billing team in order to optimize the dollars sitting in your AR.  If all reports are worked in a productive and timely manner, you will be able to sleep at night knowing that you “managed your reimbursement” to the best of your ability.

Encourage and assist directors and middle management in workflow organization to keep the processes uniform. Does your staff have the tools necessary to do their job? Identify education deficits with your billing program and build on workflow and billing processes. Train and retrain and always ask the next question. Depending on the size of your company and the resources available, you may want to outsource the patient collections to an agency that specializes in the market.

Be proactive not reactive.Beat the problem to the punch by becoming familiar with your reporting mechanisms in your billing program. Utilize your software program to its fullest potential, increase efficiencies in workflows, and review and analyze reports to assist in managing your team and business planning.

Sarah Hanna is the Vice President of ECS Billing & Consulting. She can be contacted at sarahhanna@brightnet or by phone: 419-448-5332.