Category: For Laboratories

When the day does not end until lockbox receipts are balanced, you need the power of remittance management tools. Smart remittance processing starts by splitting remittance files and comingled funds to the right system so deposits can be balanced, payments posted, and the A/R reduced.

Gatekeepers to your cash flow, healthcare operational staff—front and back office—can make or break your bottom line. If one member of the team drops the ball, it can result in significant revenue losses for your organization. Fielding a strong revenue cycle operations team is your best strategy for securing a winning financial future. How do you attract, grow, and retain these healthcare All Stars?

You can begin by acknowledging the dedicated men and women who ensure your compliance and profitability. Fully integrated into your healthcare revenue cycle—from patient access management, where insurance eligibility is verified and pre-claim requirements such as prior authorization and medical necessity are met, to claims submission, remittance handling, payment posting, statement processing, denials management, and appeals follow-up—your operations team provides your organization end-to-end service and support. They work hard to make sure you get paid the full amount you are owed as quickly as possible.

As a provider of Business Process Outsourcing (BPO) for labs, we know how important it is to have an All Star revenue cycle operations team. We have experienced some of the same recruiting, training, and retention joys and frustrations as you. Based on our experience and the advice of other industry experts, we are confident of one thing: to be the best, you need to employ the best.

Know Where to Look

Finding the right employees is everyone’s job. Getting the right people on the field needs to be an enterprise-wide commitment.

• Start by clarifying job expectations. The job posting needs to go beyond the job’s title to frame the specific traits and abilities you are seeking based on the type of work that needs to be done and how.
• Though industry experience is always a plus, it may be helpful to consider candidates with experience in other related industries to increase your potential talent pool. We have found that backgrounds in finance, accounting, and customer service offer skillsets transferable to healthcare revenue cycle management.
• Current staff can help recruit. Offer incentives, such as a referral bonus or extra PTO, to employees who refer job candidates who become new hires.
• Search the local community colleges and technical schools—particularly those schools with continuing education and certification programs.
• While posting on online job boards, don’t forget to include regional online recruiting sites as well.

Training and Learning Management

Smart technology and optimized workflow are powered by knowledgeable staff. A well-organized employee training program is critical and ongoing employee development and learning managementa must.

• New hire onboarding that goes beyond orientation. Prepare new employees to become fully engaged, productive members of the team. New hires to our revenue cycle operations staff go through an extensive 3-week CORE training program to learn the software and process workflow.
• Job shadowing produces the best training results. New team members witness real case work in a controlled approach to further advance their understanding and build experience. We strongly value job shadowing and provide 3-days of Specific Process and Responsibility Coaching (SPARC) for all job changes.
• Standardize best practices. Document procedures for use as reference and to help communicate changes. Our BPO teams can reference detailed, client-specific Standard Operating Procedures (SOP) to optimize revenue cycle processing.
• Communicate updates. Weekly team huddles on the floor help our staff keep pace with industry changes.

Find Ways to Keep Great Staff

Great employees are hard to find, and even harder to replace. Skillsets can be found, but it is the lost experience that only time and effort can rebuild.

• Recognize achievement and reward good work. When our teams go above-and-beyond on special projects, we show our appreciation (pizza parties, monetary gift cards, flex time, etc.).
• Engage creativity with enriching work. Our operations staff understand how what they do fits into the big picture.
• Nurture positive, caring relationships. Realizing that flexible schedules can help keep great staff, our managers get to know our staff and work with them to meet their needs.
• Provide opportunities for growth and advancement. We are proud of our employees and try to promote from within whenever possible.
• Communicate what’s happening – keep employees in the loop. Internal team meetings, department roadmaps, and monthly newsletters are just a few of the ways we stay informed.

Hiring for today’s healthcare is its own challenge. As healthcare reimbursement becomes even more complex, critical thinkers are required at every level in every area of the organization. With the proper investment in time, effort, and money, it is possible to field an All Star healthcare operations team that can produce profitable returns well into the future.

Patient responsibility has always been a liability for providers. Unlike automated claims processing that submits electronic 837s to an established group of payers, the ability to collect on patient responsibility requires individual patient billing and often involves manual processing and time-intensive follow-up.

While the upfront dollar value of patient responsibility continues to increase across all plan types (HMO, PPO, POS, and HDHP) – now averaging $1,478 – the escalating adoption rate of high deductible health plans (HDHPs) means that a growing segment of the patient population is now responsible for greater payment amounts before insurance coverage begins. According to the Kaiser Family Foundation 2016 Employer Health Benefits Survey, 29% of covered workers are enrolled in an HDHP – up from 20% in 2014 – and the average HDHP deductible is $2,199.

As the financial liability shifts, the best way to reduce your exposure to uncompensated care is to expedite the collection of your patients’ responsibility—co-pay, co-insurance, and deductible.

Successfully collecting payment directly from the consumer rather than a payer may require a shift on the part of the provider: consider introducing a B2C payment processing model. Targeting patient payment processing solutions, both pre- and post-billing, this new B2C model should be patient-friendly and provide convenient and efficient automation with self-help payment options. The goal is to make it easy for patients to pay so you can collect patient payment as soon as possible.

Here are four steps you may want to consider.

1. Assist patients in making informed decisions.

Start by confirming your patient’s eligibility for the services to be rendered. While verifying your patient’s insurance and coverage, identify if there are any pre-claim requirements such as prior authorization and medical necessity documentation. Then calculate upfront your patient’s out-of-pocket cost, informing your patient of his/her responsibility. To learn more, visit A Smart Start to Your Revenue Cycle.

2. Collect patient payment information.

Think B2C. In addition to obtaining correct patient demographic information, consider gathering credit card information. Remember, HDHPs shoulder patients with a greater upfront cost burden. To get paid, providers need to be able to collect payment directly from the patient.

3. Make it easy for patients to pay.

Begin by communicating to patients easy-to-understand charges. Then offer convenient, accurate, secure B2C payment processing options—in today’s world, consumers expect online. In addition, consider offering payment plan options for select services. Smaller, easy-to-pay installments can help patients meet their responsibility. To learn more, visit Patient Responsibility Made Easy.

4. Coach your patient-facing staff.

Your patient-facing staff excels at helping patients with their healthcare needs. Now, coach your staff on how to help patients manage their payment responsibility. With assistance from your staff, your patients will come to understand their HDHPs and will learn to anticipate and know their responsibility in paying for healthcare services.

Most providers are already collecting a patient’s co-pay and co-insurance at time of service. With HDHPs, this model needs to be expanded to address a patient’s total out-of-pocket cost as it relates to the patient’s unpaid deductible. Finding ways to expedite your patient payments can help optimize your revenue cycle and accelerate your revenue cash flow.