Today’s healthcare revenue cycle managers are faced with more work due to increased clinical service offerings at their facilities as well as more rules and regulations from Medicare, Medicaid and other payers; however most healthcare systems have few budget dollars allocated for additional employees to handle the increased workload. One remedy for this dilemma is strategic outsourcing of portions of the revenue cycle from front end to back end. Hollis Cobb Associates offers a wide range of services in all areas of the revenue cycle, and assists clients in pinpointing their weak areas.
Where are Hospitals Missing Money?
1. Pre-authorizations and primary care physician referrals
When required pre-auths and PCP referrals are not obtained, insurance will deny, and if the timely filing limit has expired, the balance must be adjusted.
Hollis Cobb representatives work onsite at client offices or remotely at one of our locations to financially clear patients with scheduled procedures, ensuring that clients do not lose money as a result of missing authorizations and referrals. Clients that use this service have reported a significant decrease in denials resulting from lack of pre-auth or PCP referral.
2. Managing work flows effectively with technology
All accounts are not the same, and cookie-cutter approaches to work flows are ineffective.
Hollis Cobb creates a custom workflow for each client based on patient demographics, age and volume of accounts, specific services provided and client goals for the project. Leading edge technology is leveraged including:
o Inventory scrubs for bankruptcies and deceased patients
o Presumptive charity scrubs for 501r compliance
o Government and commercial insurance scrubs, verification and filing
o Medal scoring for propensity to pay with appropriate letter/call campaigns prescribed for each medal
o Unattended dialer calls for small balances
o Skiptracing for correct patient contact information
o Predictive dialer calls compliant with TCPA regulations
o Strategic settlement campaigns
3. Timely and thorough insurance follow up, particularly on small balances and secondary payers
In the quest for maximum dollars, the small balances and secondary payers are sometimes overlooked, but those volumes of small dollars add up to big dollars at the end of the day.
Hollis Cobb’s dedicated insurance follow up staff has the time, the skill and the resources to follow up on difficult claims, and obtain and provide all the documentation payers request for payment processing. The staff works all balances, regardless of dollar amount, making sure every claim is filed accurately and timely so that our clients receive all the insurance payments due to them.
4. Quality Assurance
Often hospitals do not have adequate staff to analyze accounts that were not paid, determine the reason they did not pay, identify the breakdown in the process and ensure the problem is corrected so that future accounts will be paid.
Hollis Cobb provides Quality Assurance staff onsite at client offices or remotely from one of our locations. The staff researches errors, determines the source and provides feedback to clients so that hospital staff can receive additional training or the tools that they need to make sure all account information is correct and insurance claims pay properly.
5. The Patient Experience
In this age of transparency, patients are also customers, and all providers want their customers to have a positive experience and return again for future healthcare needs. Customer service in the patient accounting area is part of that total patient experience, and can ultimately impact revenue, from patients requesting cost estimates on future procedures to patients who do not understand their bills.
Hollis Cobb offers customer service staffing solutions to clients who otherwise do not have adequate numbers of employees to make sure their customer service process is finely tuned.
Patients who do not receive returned phone calls regarding cost estimates may go down the street to the facility that provided the estimate first. Other patients who do not receive proper attention on billing questions may become frustrated and use a different facility for the next visit. Hollis Cobb’s skilled and highly trained staff is able to handle front and back end customer service calls in a quick and professional manner, providing that positive experience for every patient throughout the revenue cycle.
Plugging the holes in the revenue cycle can be an ongoing challenge. As one leak is stopped, a different one may emerge. Hollis Cobb’s clients know that they can depend on our dedicated staff to step in anywhere along the revenue cycle to help them capture every possible dollar, as they continue to provide excellent care and service to the patients in their communities.
