HFMA: Revenue Cycle, Reimbursements Share the Spotlight

Rene Letourneau, for HealthLeaders Media , June 17, 2013

A few months ago I spoke with Richmond about his organization's pre-service center, which launched in Q4 2012. The idea is to move much of the collection work that is typically done on the back end to the front of the revenue cycle process. The pre-service center's 12 full-time employees verify insurance information, get pre-authorizations from payers, determine the patients' out-of-pocket cost before a procedure is performed, and try to collect payment up front.

"The reason I am so passionate about the pre-service center is [because] it is part of the front end of the revenue cycle. The focus has always been on the back end. If we can get it right on the front, it mitigates any surprises on the back. If you can minimize the rework, you are able to reduce costs," he told me at the time, adding that the upfront collections have also been a financial boon.

"[If you] secure payment on the front end, you are reducing your cost to collect, and you are reducing your bad debt exposure… High-performing revenue cycle departments have shifted from back-end to front-end processes."

His excitement about the pre-service center was evident during that conversation, and I would bet good money that his presentation will represent the kind of progressive thinking providers need to embrace.

Also scheduled to speak on Tuesday is Charles Kolodkin, executive director, enterprise risk and insurance at the Cleveland Clinic. He will speak at a session called, "Cleveland Clinic and Enterprise Risk Management: From Compliance to a Strategic Tool."

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