Leveraging Predictive Analytic and Artificial Intelligence Technology for Financial and Clinical Performance

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Leveraging Predictive Analytic and Artificial Intelligence Technology for Financial and Clinical Performance"

Transcription

1 Leveraging Predictive Analytic and Artificial Intelligence Technology for Financial and Clinical Performance Matt Seefeld CEO & Co-Founder (404) HFMA Fall Institute 2011

2 Agenda Purpose of Leveraging Predictive models and Artificial Intelligence Root Cause Analysis Defining Predictive Analytics Case Studies Revenue Modeling and Resulting Net Revenue Impact Financial Reserve Process Example Analytic Models Revenue Cycle Reserve & Hindsight Health Reform Marketing and Strategy Payor Mix Clinical Analytics Defining Artificial Intelligence Technology and Example Models Example Data Systems to Integrate with and Data Points to Extract from 2 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

3 Why Use Predictive Models and Artificial Intelligence Analysis? Today s rapidly changing healthcare landscape is forcing providers to look at IT solutions that drive advanced planning and understanding to make informed decisions. High demand for understanding how today s decision can impact future financial outcomes Rapid growth in digital data capture systems and the ability to link these systems to a centralize data warehouse creates unparalleled analysis flexibility Protecting every dollar in good revenue is imperative for long term financial viability Positive clinical outcomes will require the ability to look at decisions and outcomes in new and dynamic ways (especially to change Physician behavior) Lack of time to data mine and try to figure out why things are happening Go beyond Dashboards and Scorecards that tell you things are good vs. bad but don t tell you the why Bottom line is advanced technology models and root cause analysis engines can help your organization make informed business decisions. 3 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

4 Advanced Technology with Predictive Analytics / Forecasting Predicative Analytic models when built on a scalable and dynamic technology platform can pull data from an existing data warehouse or consolidate data from multiple stand alone systems. What are some key components to consider in the design of a Predictive Analytic technology: Allows the user to interact with the data points to generate what if scenarios Shows a trend line of historical data points compared to the future based on informed decision making Ability to drill down into the data (e.g. Inpatients, Medicare, Admit from ER) Ability to data cube to look at different dimensions (e.g. by payor, service, department) Identify the rate of change over time (e.g. at what rate is Medicare denials improving) Provide flexibility with setting time periods (e.g. Q3 compared to last Q3) Allows the user to apply various mathematical algorithms to assist in understanding the past, since the end user is likely to be more familiar with the current data These models will allow your team to Forecast future financial, operational and clinical impacts based on your knowledge today and using the appropriate historical data set. 4 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

5 The Old Way of Predicting Using Excel to run models time consuming and not flexible and have to be manually updated to change views (e.g. what if we wanted to look at Anthem Blue Cross for Neurology Inpatients admitted from the Emergency Department?) 5 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

6 A New Way of Predicting Using a dynamic and scalable technology to develop predictive models allows the user to run scenarios instantly saving time and improving insight into data that will help the decision making process. 6 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

7 The Old Way of Predicting the Reserve Process Using Excel to run reserve and liquidation models time consuming and not flexible and have to be manually updated each month or quarter depending on how often your organization updates the reserve process. Ability to change views would take too much time in Excel or Access (e.g. what if we wanted to look at Aetna insurance plans bad debt write-offs for Inpatient, Cardiology patients?). Reserve Modeling Payor Hindsight A/R Balance % Contractural % Bad Debt % Charity % Denied Current A/R Balance Est Contr. Allowance Est Bad Debt Est Charity Est Denials Blue Cross (4) $25,110, % 1.2% 0.6% 0.6% $25,379,117 $13,276,134 $301,331 $150,665 $143,132 Champus (7) $5,120, % 0.1% 0.1% 1.4% $4,987,949 $3,830,989 $7,168 $6,144 $71,172 Commercial/Managed Care (3) $32,115, % 2.3% 1.2% 3.5% $32,100,192 $11,969,538 $738,662 $378,966 $1,124,051 Medicaid (2) $27,682, % 0.8% 2.5% 0.1% $13,528,779 $18,724,603 $210,389 $692,068 $19,378 Medicare (1) $51,204, % 0.1% 0.3% 1.4% $55,591,557 $34,521,872 $46,084 $143,372 $721,979 Self Pay (5) $37,715, % 14.0% 15.2% 0.4% $46,140,949 $0 $5,280,140 $5,744,037 $147,090 Workers Comp (8) $2,029, % 0.1% 0.0% 0.0% $1,567,858 $1,028,342 $1,624 $0 $406 Total $180,979,029 $179,296,401 $83,351,478 $6,585,397 $7,115,253 $2,227,208 The old way of reserving usually results in a time consuming process where you can only look at one view limiting flexibility and often times accuracy. 7 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

8 Defining the Variables Impacting the Reserve Process The changing healthcare landscape, specifically patient mix and payor behavior is putting tremendous pressure on Finance departments to have more dynamic ability to reserve appropriately: Rising uninsured and utilization of Emergency Services as their primary care medium Increase insurance premium cost being shifted to the patients (e.g. rising bad debt on commercially insured patients) Retrospective reviews (RACs) and other means of payors to delay payment, partially or completely deny services after they have occurred Appropriate classification of transaction codes so you have a complete and accurate liquidation of Gross Revenue Improving process at your hospitals are showing financial dividends much quicker than prior years (e.g. ABN processing, Medical Necessity screening, POS collections) Maintaining an accurate Contract Management system The bottom line is all these changes have a dramatic impact on predicting how much of each gross revenue dollar needs to be reserved for non cash write-offs. 8 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

9 A New Way of Managing the Reserve Process Dynamic reserve models (A) provide the insight to make more informed decisions on what you should reserve for each deduction to revenue. The ability to interact with your schedule (B) allows you to forecast beyond historical performance. Bullet 1 A B 9 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

10 A New Way of Managing the Reserve Process Using a dynamic and scalable technology to develop predictive reserve models allows the user to run scenarios instantly saving time and improving insight into data that will help the decision making process on how to reserve A/R appropriately. Be able to look back at Revenue liquidation for any period of time (e.g. 6, 9, 12 months) and segment the deductions to revenue for cash and adjustments Go beyond Financial Class views and be able to drill into specific insurance plans along with being able to set filters on other dimensions (e.g. patient types, services) Understand how well you are tracking to your expected reserve schedule from your prior analysis (e.g. Self Pay A/R is reserved for bad debt at150 days at 100% but your trend shows you will be at 100% bad debt write-off at day 120) Be able to save, share and collaborate within your technology medium with other key finance personnel for planning and executing the reserve process Be able to interact with the reserve model so you can change the projected reserve percents and see what the new reserve amount on current A/R should be These dynamic models allows your team to interact and forecast future financial reserve requirements and quickly adapt when required based on your knowledge today and using the appropriate historical data set. 10 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

11 Revenue Cycle Analytics What is the impact of changes in Payor Mix? What if we see a 5% increase in Medicaid volume? What if we see a10% increase in Medicare volume? What is the impact of changes in Cash Factor/Reimbursement? What if BCBS lowers it s fee schedule by 10% What if BCBS lowers it s fees on Procedure X? What if all payors lower fees on Procedure X? What is the impact of reducing denials by 10%? What is the impact of reducing bad debt by 15%? What is the impact of reducing A/R over 90 by 10%? What is the impact of reducing DNFB over 4 days by 20%? Other? 11 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

12 Reserve and Liquidation Analytics What is the impact of changes in Patient Type? What if we see a 10% in Emergency Room Self Pay Volume? What if we see a 15% increase in patient liability collections for elective same day surgeries at the point of service? What is the impact of claims for UHC being paid on average 10 days quicker? What if a group of Physicians are doing procedures that are being denied by Medicare? What is the impact if financial counselors are securing more charity care patients? What is the trending of my contractual allowance percents for iplan B01 zero balance accounts for the last 3 months? How about 6 months? What should I reserve for denials for medical necessity if I improve my level of care screening in the Emergency department? Other? 12 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

13 Health Reform Analytics What will be the impact of pending health reform proposals? What is the impact of an increase in government sponsored plans? Assume % of uninsured s move to government plan Assume % of commercially insured s move government plan Assume combination of both What will be the impact if Medicare moves to Value-Based Purchasing? What will be the potential impact of bundled payments? What will be the impact of reductions in certain DRGs? Other? 13 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

14 Marketing & Strategy Analytics Where are our patients coming from? Which communities have the preferred patient mix? What if we increase our volume from preferred communities by 10%? What service lines generate the highest revenue? Which communities should we target our marketing? Which services should be marketed in those communities? Should we build more Medical/Surgical Beds? What is the P&L impact of closing the Neurosurgery service line? Other? 14 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

15 Payor Mix Analytics Changes in the local market place What is the financial impact of a local employer closing? What service lines will see less volume because of the closing? What if Company X reduces their workforce by 10%? What if Company Y increases workforce by 10% What if self-pay increases by 10% due to rise in unemployment? Changes in the State Budget What is the impact of proposed changes to certain insurance plans? What if there is an increase in Medicaid numbers? What if Medicaid reduces reimbursement? What will be impact of an increase in Medicare beneficiaries due to Baby Boomers? What if more retirement communities are developed? Other? 15 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

16 Clinical Analytics What is the impact of Bystolic vs. Lisinopril in treating blood pressure reduction in males over 40 with benign hypertension? What is my RAC audit risk if my chest pain inpatients admitted from the Emergency room that stay less than 24 hours increases from 20% to 30%? If my medical necessity denial overturn rate increases 10% over the next quarter what is the net revenue impact? If I reduce my length of stay by.25 for top 3 DRGs when compared to the GMLOS for Cardiology patients how much bed capacity will be opened? Will it impact my off service placement rate? Other? 16 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

17 Advanced Technology with Artificial Intelligence Artificial Intelligence technology models will bring the answers root cause to the pressing questions you are faced with the constantly changing face of healthcare. These models are designed to run on their own and alert you to the key reasons on why your financial, operational, and clinical landscape is changing. What are some key components to consider in the design of a Artificial Intelligence Technology: Design models that have a direct impact to financial performance or clinical quality (e.g. changes in outstanding receivable; changes in length of stay; changes in payor mix) Implement automated alerts sent to PDAs and when your landscape is changing in a negative or positive manner Stratify the variables that are driving the highest change for the areas you build Artificial Intelligence models around (e.g. AR is increasing Medicare IP over 90 days increasing) Build templates that help with the design of action plans based on what the models are telling your organization (e.g. reduction strategy for denials; improvement of cash factor) 17 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

18 Artificial Intelligence Root Cause Models Artificial Intelligence models should be aimed at identifying the variables that impact financial, operational or clinical efficiency and performance. Why are my A/R days and A/R over 90 levels increasing for commercial payors? Has my denial rate increased? Is my billing lag (discharge to claim submit date) increasing? Is my average days to pay increasing? Why is my length of stay going up? What are the top 3 DRGs, Physicians and Medical Services that are increasing the length of stay over CMS benchmark? Why is my cash flow over the last quarter down 6% compared to goal? Is my self pay revenue increasing? What are the top 3 services? Am I writing off more commercially insurance patient liability to bad debt? If so what payors? Why are my denial overturns declining? What are the top 3 denial codes driving the reduction in overturns? Is the volume of denials increasing causing workflow issue? 18 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

19 What Types of Data Sources to Extract from? Some critical data systems that will help improve financial performance, clinical quality, operations and overall strategic decision making for both predictive analytic and artificial intelligence technology models. Patient Accounting Cost Accounting Labor Management Non Labor Supply Chain Clinical Documentation Electronic Health Record Bed Management Standard Data Sets (835/837, 270/271) CPOE Decision Support Physician Practice Management 19 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

20 What Types of Data Dimensions should be Extracted Whether you are pulling from a centralized data warehouse or pulling from multiple disparate data sources it is imperative to think through what data fields will drive the most value. It is not recommended to pull every data point as that adds unneeded complexity and could cause confusion and impact user adoption. Some examples: Medical Service Patient Type Financial Class Department / Location Attending Physician DRG Diagnosis Codes Procedure Codes Insurance Plans Admit Source Patient Zip Code / City Admit & Discharge Nurse Stations Discharge Disposition Present on Admission Facility Code Supply Item Supply Cost Units Transaction Codes GL Code Charge Code Revenue Code Chief Complaint / Admit Diagnosis Total Charges Total Insurance Payments Total Patient Payments Total Adjustments Admit & Discharge Date & Time 20 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

21 Value Proposition of Leveraging Advanced Technology Building these interactive and automated technology models will help drive performance, awareness and accountability across your organization. Some key areas of immediate value: Improve Cash Flow Reduce accounts receivable Improve net revenue Increase gross revenue Improved Reserve Prediction Reduce bad debt expense Maximize outsourcing vendor commissions Protect every dollar of good revenue Decrease in FTE expense by automation Improve quality of care Reduce variation in Physician practice patterns Target marketing 21 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

22 Business Areas that Utilize these Models to Drive Performance Many business segments within your organization will utilize these interactive tools: Patient Access Patient Accounting HIMS Marketing Case Management Nursing Strategy and Operations Decision Support Procurement Labor Management 22 Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

23 Questions? Matt Seefeld (404) Leveraging Predictive Analytic and Artificial intelligence Technology for Financial and Clinical Performance Nov 10, 2011 Confidential

Top Ten Questions. Time and Energy. Robin Bradbury 800-355-0410 robin@ereso.com

Top Ten Questions. Time and Energy. Robin Bradbury 800-355-0410 robin@ereso.com Robin Bradbury 800-355-0410 robin@ereso.com Top Ten Questions 1. What are the key measures for the Revenue Cycle? 2. How do you document and share this information with the Revenue Cycle staff? 3. What

More information

HFMA MAP Keys Patient Access Measure:

HFMA MAP Keys Patient Access Measure: HFMA MAP Keys Patient Access Pre-Registration Rate Trending indicator that patient access processes are timely, accurate, and efficient Indicates revenue cycle efficiency and effectiveness N: number of

More information

Retrospective Denials Management

Retrospective Denials Management Retrospective Denials Management Weaving together the Clinical, Technical, and Legal Components Glen Reiner, RN, BSN, VP of Clinical Operations Nicole Guido, VP Business Development Our goals for our time

More information

Revenue Cycle Objectives Challenges Management Goals and Expected Benefits Sample Metrics Opportunities Summary Solution Steps

Revenue Cycle Objectives Challenges Management Goals and Expected Benefits Sample Metrics Opportunities Summary Solution Steps Common Findings Revealed: Revenue Cycle Review John Bartell, RN, BSN, Partner Tina Nazier, MBA, Director Wipfli LLP Topics for Discussion Revenue Cycle Objectives Challenges Management Goals and Expected

More information

6 Critical Impact Factors of Health Reform on Revenue Cycle Management Pyramid Healthcare Solutions Thought Leadership Series

6 Critical Impact Factors of Health Reform on Revenue Cycle Management Pyramid Healthcare Solutions Thought Leadership Series 6 Critical Impact Factors of Health Reform on Revenue Cycle Management Pyramid Healthcare Solutions Thought Leadership Series The healthcare industry is undergoing significant change in the face of the

More information

Revenue Cycle Management

Revenue Cycle Management Revenue Cycle Management ~Becoming a patient focused but metrics driven Revenue Cycle team~ Presented by: Kimberly Moore Director, Health Care Revenue Cycle Consulting 701.239.8673 kmoore@eidebailly.com

More information

6 Critical Impact Factors of Health Reform on Revenue Cycle Management

6 Critical Impact Factors of Health Reform on Revenue Cycle Management 6 Critical Impact Factors of Health Reform on Revenue Cycle Management Pyramid Healthcare Solutions Thought Leadership Series The healthcare industry is undergoing significant change in the face of the

More information

6 Critical Impact Factors of Health Reform on Revenue Cycle Management

6 Critical Impact Factors of Health Reform on Revenue Cycle Management 6 Critical Impact Factors of Health Reform on Revenue Cycle Management Pyramid Healthcare Solutions Thought Leadership Series The healthcare industry is undergoing significant change in the face of the

More information

Transformational Data-Driven Solutions for Healthcare

Transformational Data-Driven Solutions for Healthcare Transformational Data-Driven Solutions for Healthcare Transformational Data-Driven Solutions for Healthcare Today s healthcare providers face increasing pressure to improve operational performance while

More information

Ten Overlooked Opportunities For Significant Performance Improvement and Cost Savings

Ten Overlooked Opportunities For Significant Performance Improvement and Cost Savings Ten Overlooked Opportunities For Significant Performance Improvement and Cost Savings Ten Overlooked Opportunities For Significant Performance Improvement and Cost Savings Huron Healthcare s Performance

More information

Conifer Health Solutions Tenet Investor Webinar

Conifer Health Solutions Tenet Investor Webinar Conifer Health Solutions Tenet Investor Webinar May 16, 2012 Stephen Mooney President, Conifer Health Solutions 1 2012 Conifer Health Solutions, LLC. All Rights Reserved. Forward Looking Statements Certain

More information

Better Analysis of Revenue Cycle and Value-Based Purchasing Data Improves Bottom Line

Better Analysis of Revenue Cycle and Value-Based Purchasing Data Improves Bottom Line Better Analysis of Revenue Cycle and Value-Based Purchasing Data Improves Bottom Line Written by Katy Smith Senior Business Analyst Health Care DataWorks Better Analysis of Revenue Cycle and Value-Based

More information

Our Journey to the MAP Award. Thursday, March 19, 2015

Our Journey to the MAP Award. Thursday, March 19, 2015 Our Journey to the MAP Award Thursday, March 19, 2015 Mission As a Catholic Healthcare Ministry, we provide comprehensive and compassionate care that improves the health of the people we serve. Snapshot

More information

NEVADA RURAL HOSPITAL BENCHMARKING INITIATIVE AND NEVADA RURAL HOSPITAL REVENUE CYCLE INITIATIVE

NEVADA RURAL HOSPITAL BENCHMARKING INITIATIVE AND NEVADA RURAL HOSPITAL REVENUE CYCLE INITIATIVE NEVADA RURAL HOSPITAL BENCHMARKING INITIATIVE AND NEVADA RURAL HOSPITAL REVENUE CYCLE INITIATIVE Nevada Rural Hospital Benchmarking Two core, cross cutting initiatives undertaken by Nevada Flex Program

More information

Using Six Sigma Concepts to Improve Revenue Cycle

Using Six Sigma Concepts to Improve Revenue Cycle Using Six Sigma Concepts to Improve Revenue Cycle Presented by Joseph Koons, MHSA, FHFMA, CRCE-I Managing Director, Revenue Cycle Centra Health Lynchburg Virginia March 4, 2014 Agenda Introduction to

More information

The Power of Business Intelligence in the Revenue Cycle

The Power of Business Intelligence in the Revenue Cycle The Power of Business Intelligence in the Revenue Cycle Increasing Cash Flow with Actionable Information John Garcia August 4, 2011 Table of Contents Revenue Cycle Challenges... 3 The Goal of Business

More information

Protect and Improve Profitability in Your Practice. Positioning Your Organization for a RAC Audit

Protect and Improve Profitability in Your Practice. Positioning Your Organization for a RAC Audit Protect and Improve Profitability in Your Practice Positioning Your Organization for a RAC Audit 2011 Annual Educational Seminar March 9, 2011 Presented By: Cindy Tipton-Cain, Exec. Director Physician

More information

University Healthcare Administrative Policy

University Healthcare Administrative Policy Page 1 of 6 APPROVED BY: Signatures on File FINANCIAL POLICY (UH) is a not-for profit teaching hospital committed to providing quality health care services. In order to provide necessary medical services

More information

5 KPIs That Require Revenue Cycle Managers' Attention. Devendra Saharia FEATURE STORY. healthcare financial management association www.hfma.

5 KPIs That Require Revenue Cycle Managers' Attention. Devendra Saharia FEATURE STORY. healthcare financial management association www.hfma. SEPTEMBER 2014 healthcare financial management association www.hfma.org FEATURE STORY 5 KPIs That Require Revenue Cycle Managers' Attention Devendra Saharia Devendra Saharia REPRINT September 2014 healthcare

More information

December 2011 PRACTICE CHECK-UP. XYZ Anesthesia Group. AdvantEDGE Healthcare Solutions www.ahsrcm.com info@ahsrcm.

December 2011 PRACTICE CHECK-UP. XYZ Anesthesia Group. AdvantEDGE Healthcare Solutions www.ahsrcm.com info@ahsrcm. December 2011 PRACTICE CHECK-UP XYZ Anesthesia Group AdvantEDGE Healthcare Solutions www.ahsrcm.com info@ahsrcm.com (908)-279-8120 AdvantEdge Healthcare Solutions Anesthesia Practice Check-Up I. Introduction:

More information

Cycle Dashboard. G2N, Inc. Honest & Healthy Bottom Lines

Cycle Dashboard. G2N, Inc. Honest & Healthy Bottom Lines Managing Operations By A Revenue Cycle Dashboard Mission of G2N We work to ensure America s healthcare providers have honest & healthy bottom lines in order to continue to fulfill their mission of improving

More information

Westchester Medical Center. 2014 Operating Budget

Westchester Medical Center. 2014 Operating Budget Westchester Medical Center 2014 Operating Budget December 4, 2013 WESTCHESTER COUNTY HEALTH CARE CORPORATION Operating Budget 2014 Table of Contents Page Executive Summary 1 Detailed Discussion of Revenue

More information

REVENUE CYCLE MANAGEMENT : A DEEPER DIVE

REVENUE CYCLE MANAGEMENT : A DEEPER DIVE REVENUE CYCLE MANAGEMENT : A DEEPER DIVE 2016 TABLE OF CONTENTS Introduction The Participants Revenue Cycle Steering Committee Personnel Accounting Platform Service Outsourcing Performance Metrics Accounts

More information

Back 2 Basics: Revenue Cycle: KPI, Risk Factors, and Compliance

Back 2 Basics: Revenue Cycle: KPI, Risk Factors, and Compliance Back 2 Basics: Revenue Cycle: KPI, Risk Factors, and Compliance March 25, 2010 Claudia Birkenshaw Garabelli, MSA President Modern Management Muse, Inc -- the ART of HealthCare Finance 1 Our Time Together

More information

Rejection Prevention. How Actionable Data Can Drive Results in Your Revenue Cycle

Rejection Prevention. How Actionable Data Can Drive Results in Your Revenue Cycle Rejection Prevention How Actionable Data Can Drive Results in Your Revenue Cycle Objectives Build a data collection strategy in denials and rejections that drives action and ultimately improved results

More information

Healthcare Revenue Cycle and Collection Considerations

Healthcare Revenue Cycle and Collection Considerations Healthcare Revenue Cycle and Collection Considerations Vince Marzula, BNY Mellon Paul Ishizuka, University of Washington January 30, 2012 UW Medicine School of Medicine, 4 hospitals, 30 primary care clinics,

More information

Provider Revenue Cycle Management (RCM) and Proposed Solutions

Provider Revenue Cycle Management (RCM) and Proposed Solutions Provider Revenue Cycle Management (RCM) and Proposed Solutions By: Ranjana Maitra General Manager, Manufacturing & Healthcare Vertical Executive Summary It takes more than world-class service to be competitive

More information

Patient Finance Services Policy

Patient Finance Services Policy Patient Finance Services Policy CONEMAUGH HEALTH SYSTEM FINANCIAL ASSISTANCE POLICY I. PURPOSE Conemaugh Health System is a community of persons committed to being a transforming, healing presence in the

More information

A Primer on Ratio Analysis and the CAH Financial Indicators Report

A Primer on Ratio Analysis and the CAH Financial Indicators Report A Primer on Ratio Analysis and the CAH Financial Indicators Report CAH Financial Indicators Report Team North Carolina Rural Health Research and Policy Analysis Center Cecil G. Sheps Center for Health

More information

Granville Health System

Granville Health System Approved by: Granville Health System FINANCIAL POLICY Effective Date: Revised Date(s): FINANCIAL POLICY - DRAFT 09-16-2014 Granville Health System is a not-for profit hospital committed to providing quality

More information

The Road to Performance. Evaluating Metrics and Benchmark Trends in the Revenue Cycle June 2012

The Road to Performance. Evaluating Metrics and Benchmark Trends in the Revenue Cycle June 2012 The Road to Performance Evaluating Metrics and Benchmark Trends in the Revenue Cycle June 2012 1. philosophy 2. resources 3. framework 2 Confidential Services 3 Confidential Services 4 Confidential Services

More information

healthcare services, provided that a member, in good standing, of SJMH s medical staff determines the need for such medical care treatment.

healthcare services, provided that a member, in good standing, of SJMH s medical staff determines the need for such medical care treatment. St. James Mercy Hospital Policy Section: General Information Policy Name: Charity Care/Financial Assistance Developed by: Dave Capone Date: 2/1/07 Page 1 of 13 PURPOSE St. James Mercy Health (SJMH) is

More information

Revenue Cycle Responsibilities. Revenue Cycle. Objectives 4/9/2013

Revenue Cycle Responsibilities. Revenue Cycle. Objectives 4/9/2013 Revenue Cycle Kathryn DeVault, RHIA, CCS, CCS-P AHIMA 2013 Objectives Identify responsibilities within the Revenue Cycle Focus on management of the revenue cycle process Discuss the revenue cycle process

More information

treating technology as a luxury?

treating technology as a luxury? FEBRUARY 2007 healthcare financial management Steven H. Berger treating technology as a luxury? 10 necessary tools If you ve been thinking that technology for improving healthcare financial management

More information

Beyond the Basics: Accelerating the Revenue Cycle Through Advanced KPI s

Beyond the Basics: Accelerating the Revenue Cycle Through Advanced KPI s Optimizing the business of healthcare Beyond the Basics: Table of Contents Overview 1 The Importance of Metrics 1 Taking the Next Step 1 Baseline KPI s 2 Why Advanced KPI s 2 Advanced KPI s In Action 3

More information

University of Mississippi Medical Center. Access Management. Patient Access Specialists II

University of Mississippi Medical Center. Access Management. Patient Access Specialists II Financial Terminology in Access Management University of Mississippi Medical Center Access Management Patient Access Specialists II As a Patient Access Specialist You are the FIRST STAGE in the Revenue

More information

Exploring the Impact of the RAC Program on Hospitals Nationwide. Results of AHA RACTRAC Survey, 4 th Quarter 2012

Exploring the Impact of the RAC Program on Hospitals Nationwide. Results of AHA RACTRAC Survey, 4 th Quarter 2012 Exploring the Impact of the RAC Program on Hospitals Nationwide Results of AHA RACTRAC Survey, 4 th Quarter 2012 March 8, 2013 RAC 101 Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractors

More information

POLICY. Title: Financial Assistance (Charity Care/Uncompensated Care) Approver: Kootenai Health Board Date: 09/29/2014

POLICY. Title: Financial Assistance (Charity Care/Uncompensated Care) Approver: Kootenai Health Board Date: 09/29/2014 Title: Financial Assistance (Charity Care/Uncompensated Care) Approver: Kootenai Health Board Date: 09/29/2014 Kootenai Health is committed to excellence in providing high quality health care services

More information

Revenue Cycle Management

Revenue Cycle Management Revenue Cycle Management Manage and Improve Your Results with Origin RCM Financial pressures are escalating for both healthcare providers and patients. In this challenging climate, a wellmanaged revenue

More information

Capacity Management: Patient Throughput and Case Management Improvement. February 25, 2015

Capacity Management: Patient Throughput and Case Management Improvement. February 25, 2015 Capacity Management: Patient Throughput and Case Management Improvement February 25, 2015 Agenda Introduction Impetus for Change Approach to Improving Case and Capacity Management Client Case Study Key

More information

Key Performance Indicators for Physician Practices. Sam Eddy Director, Physician Practice Consulting, QHR

Key Performance Indicators for Physician Practices. Sam Eddy Director, Physician Practice Consulting, QHR Key Performance Indicators for Physician Practices Sam Eddy Director, Physician Practice Consulting, QHR You can ask a question by clicking the blue? icon or through the orange speech bubble icon. 2 Evaluate

More information

Financial Accounting and Management Reports

Financial Accounting and Management Reports Financial Accounting and Management Reports To manage a medical practice effectively, whether it be a solo or a group practice, the practitioner and its managers and advisors must have continual access

More information

The Big Data Dividend

The Big Data Dividend The Big Data Dividend Enhancing Revenue in an Era of Change May 7, 2015 Agenda Big Data Sample Healthcare Big Data Sets Healthcare Applications of Big Data Revenue Enhancement Opportunities Rate Benchmarking/Rate

More information

Clinical Integration Concepts for Successful Population Health

Clinical Integration Concepts for Successful Population Health Annual Conference November 12, 2015 Presented by: Jane Jerzak, RN, CPA, Partner Clinical Integration Concepts for Agenda Population Health and the Movement Toward Clinical Integration Consumerism Patient

More information

A Measure of Success Using KPIs to Accelerate Revenue Cycle Performance

A Measure of Success Using KPIs to Accelerate Revenue Cycle Performance A Measure of Success Using KPIs to Accelerate Revenue Cycle Performance Sandy Richman, Director of Advisory Services Daniel Bergantz, Director of Advisory Services PNC Healthcare March 23, 2015 Today s

More information

Measurable Results: Establish service excellence. Reduce errors by 50% The choice for progressive medical centers.

Measurable Results: Establish service excellence. Reduce errors by 50% The choice for progressive medical centers. The choice for progressive medical centers Delivering tailored solutions to modern healthcare organization complexities by integrating a unique blend of strategies with wide-ranging industry experience.

More information

Our clients count on us, and we deliver.

Our clients count on us, and we deliver. Experts in Revenue Cycle Management For Medical Practices and Imaging Centers For over 20 years, we have forged successful partnerships with medical practices and imaging centers to improve their revenue

More information

Patient Account Services. Patient Reference & Frequently Asked Questions. Admissions

Patient Account Services. Patient Reference & Frequently Asked Questions. Admissions Patient Account Services Patient Reference & Frequently Asked Questions Admissions Each time you present for a new medical service, a new account number will be assigned. You will be asked to pay any patient

More information

Current Trends in Revenue Cycle Performance Benchmarks, Outsourcing and Reform

Current Trends in Revenue Cycle Performance Benchmarks, Outsourcing and Reform Current Trends in Revenue Cycle Performance Benchmarks, Outsourcing and Reform 1 Discussion Outline Discussion Objectives and Approach Process Definition Leading Practice Comparison Trends in Outsourcing

More information

MANAGING THE REVENUE CYCLE WITH BUSINESS INTELLIGENCE: June 30, 2006 BUSINESS INTELLIGENCE FOR HEALTHCARE

MANAGING THE REVENUE CYCLE WITH BUSINESS INTELLIGENCE: June 30, 2006 BUSINESS INTELLIGENCE FOR HEALTHCARE MANAGING THE REVENUE CYCLE WITH BUSINESS INTELLIGENCE: June 30, 2006 BUSINESS INTELLIGENCE FOR HEALTHCARE Hospital manager and leadership positions face many challenges in today s healthcare environment

More information

The New Gold Standard in PASC s and Regional Service Centers RSC s: Best Practices for Centralizing Operations that Improves Revenue Cycle

The New Gold Standard in PASC s and Regional Service Centers RSC s: Best Practices for Centralizing Operations that Improves Revenue Cycle The New Gold Standard in PASC s and Regional Service Centers RSC s: Best Practices for Centralizing Operations that Improves Revenue Cycle Today s Learning Lab Panel Mary Anne Pace Vice President, Consulting

More information

The Changing Landscape of Healthcare and What it means to you!

The Changing Landscape of Healthcare and What it means to you! The Changing Landscape of Healthcare and What it means to you! Marc Leighton Imagination at work. How do hospitals/providers get paid? Introduction to Payment Mechanisms DRG- or APDRG-based mechanisms

More information

Having Trouble Explaining and Predicting Net Revenue?

Having Trouble Explaining and Predicting Net Revenue? Having Trouble Explaining and Predicting Net Revenue? Crowe Revenue Cycle Analytics Audit Tax Advisory Risk Performance The Crowe Revenue Cycle Analytics Solution As shown below in use by hundreds of hospitals

More information

Empowering healthcare organizations with data, analytics and insight

Empowering healthcare organizations with data, analytics and insight Empowering healthcare organizations with data, analytics and insight Integrated patient access, claims and contract management and collections products and consultative services for redefining your healthcare

More information

Revenue Integrity Strategies

Revenue Integrity Strategies Agenda Discuss the key activities performed, risks and typical deficiencies that exist, and various process improvement strategies within the following revenue cycle components: Patient Access Utilization

More information

ENGAGING PHYSICIANS FOR ICD-10: ALL ABOARD Engaging Physicians for ICD-10: All Aboard

ENGAGING PHYSICIANS FOR ICD-10: ALL ABOARD Engaging Physicians for ICD-10: All Aboard ENGAGING PHYSICIANS FOR ICD-10: ALL ABOARD Engaging Physicians for ICD-10: All Aboard ICD-10 Lisa Kozakoff Principal Consultant Siemens Healthcare Lisa Kozakoff Principal Consultant Agenda Introduction

More information

CHAPTER 17 CREDIT AND COLLECTION

CHAPTER 17 CREDIT AND COLLECTION CHAPTER 17 CREDIT AND COLLECTION 17101. Credit and Collection Section 17102. Purpose 17103. Policy 17104. Procedures NOTE: Rule making authority cited for the formulation of regulations for the Credit

More information

Revenue Cycle Management

Revenue Cycle Management UNITED COLLECTION BUREAU, INC. 5620 Southwyck Blvd. Toledo, OH 43614 866.209.0622 ucbinc.com The Business Case for Outsourcing Revenue Cycle Management Getting reimbursed for services rendered is more

More information

The Joint Commission Page 1 of 6

The Joint Commission Page 1 of 6 The Joint Commission Page 1 of 6 PURPOSE The Regional Medical Center recognizes that as part of its mission, there will be instances where care is provided to individuals that do not have healthcare insurance,

More information

AMN Healthcare Investor Presentation

AMN Healthcare Investor Presentation AMN Healthcare Investor Presentation Q2 2015 The Innovator in Healthcare Workforce Solutions and Staffing Services Forward-Looking Statements This investor presentation contains forward-looking statements

More information

Financial Assistance Program AKA Charity Care/Uncompensated Care Program

Financial Assistance Program AKA Charity Care/Uncompensated Care Program Policy POLICY NO. 100. 85300.600 EFFECTIVE 12/90 REVISED 03/2014 Page 1 of 12 SUBJECT: APPLICATION: PURPOSE: POLICY: Financial Assistance Program AKA Charity Care/Uncompensated Care Program All Departments

More information

Successfully Implementing a Revenue Cycle Self-Pay Solution by Marty Callahan

Successfully Implementing a Revenue Cycle Self-Pay Solution by Marty Callahan This article appeared in the September 2008, issue of hfm, published by the Healthcare Financial Management Association. Successfully Implementing a Revenue Cycle Self-Pay Solution by Marty Callahan At

More information

Rural Hospital Performance Improvement (RHPI) Project

Rural Hospital Performance Improvement (RHPI) Project Rural Hospital Performance Improvement (RHPI) Project Best Practice Concepts in Revenue Cycle Management August 8, 2014 600 East Superior Street, Suite 404 Duluth, Minnesota 55802 Phone: 218-727-9390 info@ruralcenter.org

More information

Purpose Statement Outlines purpose of and guidelines for receiving charity care or financial assistance at Valley Children s Hospital.

Purpose Statement Outlines purpose of and guidelines for receiving charity care or financial assistance at Valley Children s Hospital. Policy/Procedure Number AD-3004 Policy/Procedure Name Charity Care Financial Assistance Type of Policy/Procedure Administration Date Approved 12/14 Date Due for Review 12/17 Policy/Procedure Description

More information

Transfer DRGs: Approaches to Revenue Recovery. A BESLER White Paper

Transfer DRGs: Approaches to Revenue Recovery. A BESLER White Paper Transfer DRGs: Approaches to Revenue Recovery A BESLER White Paper June 2014 Copyright 2014 BESLER Consulting. All rights reserved. *HFMA staff and volunteers determined that Transfer DRG Revenue Recovery

More information

Recovery Auditors and Fee-for-Service Medicare DIVISION OF RECOVERY AUDIT OPERATIONS CENTERS FOR MEDICARE & MEDICAID SERVICES

Recovery Auditors and Fee-for-Service Medicare DIVISION OF RECOVERY AUDIT OPERATIONS CENTERS FOR MEDICARE & MEDICAID SERVICES Recovery Auditors and Fee-for-Service Medicare 1 DIVISION OF RECOVERY AUDIT OPERATIONS CENTERS FOR MEDICARE & MEDICAID SERVICES What is a Recovery Auditor? The Recovery Auditors are CMS contractors who

More information

CHANGING YOUR CASE MANAGEMENT MODEL OF CARE. Jan Lear, RN, CMC Director of Case Management MedStar Franklin Square Medical Center

CHANGING YOUR CASE MANAGEMENT MODEL OF CARE. Jan Lear, RN, CMC Director of Case Management MedStar Franklin Square Medical Center CHANGING YOUR CASE MANAGEMENT MODEL OF CARE Jan Lear, RN, CMC Director of Case Management MedStar Franklin Square Medical Center 1 Program Objectives To be able to describe the compliance and regulatory

More information

Solution Overview. Fusion Health Advantage Big Data Accelerator Platform

Solution Overview. Fusion Health Advantage Big Data Accelerator Platform Solution Overview Fusion Health Advantage Big Data Accelerator Platform Improve Patient Outcomes And Manage Them Cost Effectively Healthcare reform measures have intensified governmental scrutiny, thereby

More information

Westchester Medical Center. 2012 Operating Budget

Westchester Medical Center. 2012 Operating Budget Westchester Medical Center 2012 Operating Budget December 7, 2011 WESTCHESTER COUNTY HEALTH CARE CORPORATION Overview Westchester Medical Center s (WMC) 2012 Operating Budget reflects significant reductions

More information

9/28/2015. HFMA s Patient Friendly Billing Focus. Initiatives: Best Practices. Agenda. Iowa Hospital Association Annual Meeting October 6, 2015

9/28/2015. HFMA s Patient Friendly Billing Focus. Initiatives: Best Practices. Agenda. Iowa Hospital Association Annual Meeting October 6, 2015 HFMA s Patient Friendly Billing Initiatives: Best Practices Iowa Hospital Association Annual Meeting October 6, 2015 Sandra Wolfskill, FHFMA Director Healthcare Finance Policy HFMA Agenda Meet Jack! HFMA

More information

COLLABORATIVE CARE MANAGEMENT. throughout the continuum

COLLABORATIVE CARE MANAGEMENT. throughout the continuum COLLABORATIVE CARE MANAGEMENT throughout the continuum OPTIONAL modules Morrisey helps hospitals and other healthcare providers achieve measurable clinical, process and financial outcomes. Our products

More information

Management Reporting Part I: Standard Reports and Measurements. by Patricia A. Kroken, FACMPE

Management Reporting Part I: Standard Reports and Measurements. by Patricia A. Kroken, FACMPE Management Reporting Part I: Standard Reports and Measurements by Patricia A. Kroken, FACMPE Monitoring practice performance indicators at regular intervals enables physician and administrative leadership

More information

EFFECTIVE DATE: 6/01/2015 LAST REVISED DATE: 06/01/2015

EFFECTIVE DATE: 6/01/2015 LAST REVISED DATE: 06/01/2015 TITLE: Financial Assistance/Charity Care SEARCH WORD: Charity; Indigent; Assistance DEPARTMENT: Patient Access Services, Business Office, Accounting, Administration, Mission Services VP APPROVAL: Marty

More information

Creating a Virtual CBO while guaranteeing AR performance. University of Maryland Medical System Case Study

Creating a Virtual CBO while guaranteeing AR performance. University of Maryland Medical System Case Study Creating a Virtual CBO while guaranteeing AR performance University of Maryland Medical System Case Study Today s objectives Do you really need to convert your hospital information system?» Alternatives

More information

The Changing Face of Medical Necessity under ICD-10

The Changing Face of Medical Necessity under ICD-10 The Changing Face of Medical Necessity under ICD-0 Sponsored by 95 N. Fine Ave #04 Fresno CA 93720-565 Phone: (559) 25-5038 Fax: (559) 25-5836 www.californiahia.org Program Handouts Monday, June 8, 205

More information

Outsourcing Revenue Management Can Pay Big Dividends for Clinical Labs

Outsourcing Revenue Management Can Pay Big Dividends for Clinical Labs Outsourcing Revenue Management Can Pay Big Dividends for Clinical Labs A report by Donna Beasley, DLM (ASCP) McKesson Revenue Management Solutions, Laboratory Effective management of a clinical laboratory

More information

The ROI of IT: Best Billing Practices

The ROI of IT: Best Billing Practices The ROI of IT: Best Billing Practices 1 R O S E M A R I E N E L S O N M G M A H E A L T H C A R E C O N S U L T I N G G R O U P The information and materials provided and referred to herein are not intended

More information

Certified Healthcare Financial Professional

Certified Healthcare Financial Professional Certified Healthcare Financial Professional Certification Basics Friday, February 25, 2016 Courtney Stevenson, MSA WA/AK HFMA Certification Committee Co-Chair Agenda Module I The Business of Healthcare

More information

Exploring the Impact of the RAC Program on Hospitals Nationwide. Results of AHA RACTRAC Survey, 2 nd Quarter 2015

Exploring the Impact of the RAC Program on Hospitals Nationwide. Results of AHA RACTRAC Survey, 2 nd Quarter 2015 Exploring the Impact of the RAC Program on Hospitals Nationwide Results of AHA RACTRAC Survey, 2 nd Quarter 2015 September 10, 2015 RAC 101 Centers for Medicare & Medicaid Services (CMS) Recovery Audit

More information

Regular monitoring and reporting of key financial indicators are

Regular monitoring and reporting of key financial indicators are Information Bulletin #3 F inancial Management Information Bulletin #3 FM National Association of Community Health Centers, Inc. FINANCIAL MANAGEMENT SERIES For more information contact: Eric S. Holzberg

More information

Aged Accounts Receivable

Aged Accounts Receivable Aged Accounts Receivable Agenda Introduction Objectives About Us Overview Benefits Process Analysis Reporting Investment Next Steps Introduction John Boland John Boland is vice president at MedSynergies

More information

A Roadmap for Modernizing the Health Care Revenue Cycle

A Roadmap for Modernizing the Health Care Revenue Cycle A Roadmap for Modernizing the Health Care Revenue Cycle 1 March 2016 Timothy Panks Senior VP, Finance and Revenue Management Douglas Hires Senior VP, Strategic Client Relationships Conflict of Interest

More information

SUBJECT: CHARITY AND UNCOMPENSATED CARE 1 of 13 DEPARTMENT: BUSINESS OFFICE REVISED: 10/2012

SUBJECT: CHARITY AND UNCOMPENSATED CARE 1 of 13 DEPARTMENT: BUSINESS OFFICE REVISED: 10/2012 REFERENCE # SUBJECT: CHARITY AND UNCOMPENSATED CARE 1 of 13 DEPARTMENT: BUSINESS OFFICE REVISED: 10/2012 CHARITY AND UNCOMPENSATED CARE Purpose To provide definition of health care assistance to eligible

More information

HITAM. Business Intelligence for Hospitals: Empowering Healthcare Providers to Make Informed Decisions through Centralized Data Analysis

HITAM. Business Intelligence for Hospitals: Empowering Healthcare Providers to Make Informed Decisions through Centralized Data Analysis Business Intelligence for Hospitals: Empowering Healthcare Providers to Make Informed Decisions through Centralized Data Analysis Healthcare providers today are impacted by an acute combination of rising

More information

Making Revenue Cycle Outsourcing an Organization Wide Responsibility

Making Revenue Cycle Outsourcing an Organization Wide Responsibility Making Revenue Cycle Outsourcing an Organization Wide Responsibility Michael S. Browning Chief Financial Officer Madison County Hospital Jeffrey Ellerbrock Consultant (formerly with The Outsource Group)

More information

Ascension Health Alliance

Ascension Health Alliance and Results of Operations The following information should be read with Ascension Health Alliance s audited consolidated financial statements and related notes to the consolidated financial statements.

More information

The Patient Contact Center: Finding My Way!

The Patient Contact Center: Finding My Way! The Patient Contact Center: Finding My Way! Presented by James Hawkins SVP, Patient Contact Center Convergent 1 For Today s Discussion Market Conditions ANI Survey Results Patient Contact Center Overview

More information

Revenue Cycle Management Excellence Easily improving bottom line!!!!!

Revenue Cycle Management Excellence Easily improving bottom line!!!!! Revenue Cycle Management Excellence Easily improving bottom line!!!!! SN Academy Seminar 9 th May 2014 PRR 5/5/14 Revenue Cycle Management ; Are you doing it right? Are you earning what you deserve? Do

More information

Healthcare Reform: An Analysis of the Impact on Healthcare Providers

Healthcare Reform: An Analysis of the Impact on Healthcare Providers Healthcare Reform: An Analysis of the Impact on Healthcare Providers Background The financial impact from the Affordable Care Act on providers from changes in Medicare reimbursement have been well documented

More information

Hospital Denials Management In-source, Outsource or Both?

Hospital Denials Management In-source, Outsource or Both? Page 1 Hospital Denials Management In-source, Outsource or Both? by Holly Pelaia Summary A strong revenue stream case is made for intelligent outsourcing of hospital denials up to 20% more effective in

More information

The University of Texas Southwestern Medical Center Denials Management Audit University Hospitals. Internal Audit Report 14:10B

The University of Texas Southwestern Medical Center Denials Management Audit University Hospitals. Internal Audit Report 14:10B Office of Internal Audit The University of Texas Southwestern Medical Center Denials Management Audit University Hospitals Internal Audit Report 14:10B November 19, 2014 Table of Contents I. Executive

More information

Memorial Hospital Administrative Policy

Memorial Hospital Administrative Policy Administrative Policy TITLE: PURPOSE: Accounts Receivable Billing and Collections The following policy and procedure is to be followed for billing and collecting of patient accounts. The purpose of the

More information

Management Report Services. Staff Training and Education Services

Management Report Services. Staff Training and Education Services Management Report Services Your management team will receive reports that are clear, well defined and serve as a tool for increased performance. These include a brief description emphasizing how the information

More information

Not all NLP is Created Equal:

Not all NLP is Created Equal: Not all NLP is Created Equal: CAC Technology Underpinnings that Drive Accuracy, Experience and Overall Revenue Performance Page 1 Performance Perspectives Health care financial leaders and health information

More information

Reducing Readmissions with Predictive Analytics

Reducing Readmissions with Predictive Analytics Reducing Readmissions with Predictive Analytics Conway Regional Health System uses analytics and the LACE Index from Medisolv s RAPID business intelligence software to identify patients poised for early

More information

SAFEGUARD YOUR REVENUE IN AN ERA OF CHANGE

SAFEGUARD YOUR REVENUE IN AN ERA OF CHANGE SAFEGUARD YOUR IN AN ERA OF CHANGE Regulatory, economic and technological changes have made running a hospital, urgent care center, or medical practice increasingly difficult today. The complexity of revenue

More information

Top Ten Financial Measurement s for a Healthcare Organization

Top Ten Financial Measurement s for a Healthcare Organization Top Ten Financial Measurement s for a Healthcare Organization If you can t measure it, you can t manage it. By Sheri Blaho 5272 S. LEWIS, SUITE 100 TULSA, OK 74105 918.496.1600 TOLL FREE: 877.496.1600

More information

Self-Pay in an ACA World: Optimizing Resources with Soarian Tools, Workflows and Partners

Self-Pay in an ACA World: Optimizing Resources with Soarian Tools, Workflows and Partners Self-Pay in an ACA World: Optimizing Resources with Soarian Tools, Workflows and Partners Kathy Peterson, FHFMA Director of Patient Financial Services October 11, 2015 Our focus today Marketplace changes

More information

WHITE PAPER. Payment Integrity Trends: What s A Code Worth. A White Paper by Equian

WHITE PAPER. Payment Integrity Trends: What s A Code Worth. A White Paper by Equian WHITE PAPER Payment Integrity Trends: What s A Code Worth A White Paper by Equian June 2014 To install or not install a pre-payment code edit, that is the question. Not all standard coding rules and edits

More information

ORIGINATION DATE: 11/01/86 TOMAH, WI 54660 PAGE: 1 of 6

ORIGINATION DATE: 11/01/86 TOMAH, WI 54660 PAGE: 1 of 6 POLICY AND GUIDELINES DIVISION: Business Management TOMAH MEMORIAL HOSPITAL, INC. ORIGINATION DATE: 11/01/86 TOMAH, WI 54660 PAGE: 1 of 6 Approved By: Author Administrative Team Leader Board of Directors

More information