Integrating the Health System Revenue Cycle
As healthcare CFOs work to protect the fiscal strength of their organizations, they are increasingly aware of the need to engage clinicians from across the continuum of care in the revenue cycle process.
This article appears in the March 2014 issue of HealthLeaders magazine.
Although there has long been a divide between the finance and clinical departments in many hospitals, those days may be coming to an end. As healthcare CFOs work to protect the fiscal strength of their organizations, they are increasingly aware of the need to engage clinicians from across the continuum of care in the revenue cycle process.
Collecting better documentation
In 2012, Southwest General Health Center, a 358-bed institution in Middleburg Heights, Ohio, completed several clinical integration initiatives for a total revenue improvement of $2.8 million. Southwest General reported patient revenues of $291 million that same year.
Mary Ann Freas, the system's vice president and chief financial officer, says the initiatives are important because "so much of the revenue cycle is in the hands of our frontline staff and providers."
Freas says the clinical team often does not gather all the information needed for billing because they are busy managing many other tasks and may not realize the importance of complete and accurate charge capture.
"We want to make sure they know we understand what they are going through and that their priorities are around taking care of patients, but at the same time, we need to collect dollars for the services we provide," Freas says. "One way to do that is to connect the dots and make sure they understand there is a connection between the documentation and our payment."
Among the initiatives Southwest General started in 2012 is the capture of IV administration documentation for observation and emergency department patients. Although many patients in its ED get an IV for drugs or hydration, Southwest General was not always able to bill for this service because nurses were not collecting enough information. "If you don't have the start and stop time, for us particularly the stop time, you can't get paid for the IV," says Jill Barber, Southwest General's director of managed care operations.
- How Top-Ranked MA Plans Earn Their Stars
- Readmissions: No Quick Fix to Costly Hospital Challenge
- How Hospitals Can Become 'Upstreamists'
- 4 Ways to Lower the Cost to Collect from Self-Pay Patients
- House Calls Key to Pioneer ACO Success
- How Telehealth Pays Off for Providers, Patients
- 4 Tips for Managing Employed Physicians
- WellPoint Dominates Nearly Half of Markets, AMA Says
- Defensive Medicine Still Prevalent Despite Tort Reform
- CMS Offers Some ACOs $114M for 'Upfront' Costs