Drew Smith, director of revenue cycle at MainStreet Family Care, talks implementing text-based bill pay and creating a positive patient financial experience.
Digital payment options are becoming increasingly important for revenue cycle leaders as they seek to bolster their technology and better secure revenue. Perfecting and expanding these options should be a priority, especially since the same challenges that made 2022 the worst financial year since the start of the pandemic haven’t abated.
With patients increasingly demanding convenient, digital payment methods, healthcare providers must adapt to meet changing expectations to stay ahead of the competition, and this is what Drew Smith, director of revenue cycle, at MainStreet Family Care is trying to achieve with its new, text-based bill pay.
“We reduced the volume of paper statements mailed to patients by 11%—and this represents significant savings for our 46-facility system. We’ve also saved five hours in manual work per week for our revenue cycle team, or 260 hours a year,” Smith said.
During his conversation with HealthLeaders, Smith touch more on this and chatted about implementing this new technology, what it means for the systems’ patients, and how it significantly decreased accounts receivable days.
HealthLeaders: Why was it imperative to improve the patient billing experience?
Drew Smith: MainStreet Family Care serves a primarily rural population in Alabama, North Carolina, Georgia, and Florida, and often, we are patients’ only option for care. Even though we’re an urgent care center, people in our communities often turn to us for primary care because of the lack of providers available locally. Some of the areas we serve have a county hospital people can turn to for care, but many do not. Without access to care for conditions like diabetes, which impacts people in rural areas more severely than those in urban areas, the health of these communities would severely decline.
So, it’s vital that we have a healthy balance sheet. This means we depend on patients to pay their out-of-pocket costs of care in a timely manner. But research shows 40% of patients are often confused by their bills. Moreover, consumers believe healthcare providers can make it difficult for them to pay their bills. And in rural areas in particular, we’re finding that inflation is affecting residents’ decisions on whether to seek care or delay treatment. This makes clear communication around how much patients owe for their care after insurance and their options for payment crucial.
Pictured: Drew Smith, director of revenue cycle at MainStreet Family Care. Photo courtesy of LinkedIn.
HealthLeaders: How did you determine there was a need for text-based pay?
Smith: We chose text-based bill pay because we wanted to make it easy for patients to understand their financial responsibility for care and simple to pay their bill. Our goal was not only to speed payment but also reduce cost to collect. Paper statements cost $6 per statement for our organization based on paper and postage costs, the time it takes to post physical checks and respond to returned mail and the need for a lockbox. When we improve cash flow and reduce our cost to collect, we strengthen our ability to open new facilities and extend care to underserved areas—and that promotes better health.
One of the things that was attractive to us about text-based bill payment is that we could reach patients through the device they use most: their cell phone. In the rural communities we serve, most adults own a smartphone. We also don’t get charged when we have an inaccurate mobile number for the patient or the text hasn’t been successfully delivered. And the experiences of AccessOne, the vendor we work with, indicated patients pay their medical bills faster when they receive text notifications for payment. We estimated we could save thousands of dollars a week just by avoiding paper statements for a portion of our population while speeding cash flow.
HealthLeaders: How did your patient population respond to the change?
Smith: We saw an immediate impact on our ability to collect payment sooner through text-to-pay. Since rolling out mobile pay in 2019, 14% of our patients pay their medical bill using our secure text payment feature. Among patients who use mobile pay, 95% pay their balances within two weeks. More than 80% of this bucket make a payment before a paper statement is ever printed. We also offer patients the opportunity to self-enroll in a payment plan using their mobile phone. This makes the process of payment plan enrollment much more convenient. It also adds an element of privacy by enabling patients to take this step from the comfort of home.
Initially, there was some skepticism among our staff about how patients would respond to text-based payment. However, for us, the initial response to text-based medical bill payment was strong. We’ve found that by branding text-based communications to have the same look and feel as other MainStreet Family Care communications, patients more readily accept mobile pay as a valid vehicle for payment.
But that doesn’t mean we haven’t had to modify aspects of our approach. Even as mobile pay exceeded our expectations, when we reached out to patients for feedback, we discovered some people felt the language used in our communications was a little aggressive. In some instances, patients thought the messages were spam. We took a second look at our messaging to soften communication, and the response has been pretty positive. We plan to take another look at our messaging to make sure it still resonates with those we serve in a high-inflation environment.
Of course, some patients still desire paper statements—and that’s OK. Today, we wait a week after a text-based notification is sent before mailing a paper statement. This gives us time to capture payments from those who prefer to pay us electronically while respecting the preferences of those who still want a paper statement. We also allow patients to opt out of mobile notifications.
HealthLeaders: What other benefits has this change created for your organization?
Smith: Text-based payment significantly decreased our cost to collect and our days in accounts receivable. We reduced the volume of paper statements mailed to patients by 11%—and this represents significant savings for our 46-facility system. We’ve also saved five hours in manual work per week for our revenue cycle team, or 260 hours a year. That’s time that can be directed to more value-added tasks, like patient financial counseling.
HealthLeaders: How has the implementation of digital patient payment options improved the patient experience for your organization?
Smith: Digital payment options give us another way of creating better patient financial experiences—and not just around payment. For instance, when patients receive a text from our mobile pay system, they can easily call us with questions right from the payment screen. Many patients who view their statement via text end up calling to make a payment over the phone or update their insurance information. This is a return on investment that may not be reflected on our performance dashboard, but it’s made our call center a better-performing channel while creating stronger connections with patients. We’ve found that the benefit of taking an omnichannel approach to payment is that it builds trust with patients by meeting them where they are. By creating a seamless, consistent financial experience, we can leave a positive impression that carries over to their next encounter with our facility.
Are you interested in sharing your expertise on this topic? Join one of our panels for the upcoming Patient Financial Experience NOW Summiton April 19. E-mail revenue cycle editor Amanda Norris at anorris@hcpro.com for more information on joining the conversation.
A new survey shows that the CDI industry has made inroads toward the higher ends of compensation. See how your revenue cycle is stacking up.
Staying competitive in the market has been top priority for revenue cycle leaders as they work to navigate an ever-changing workforce landscape—and a new survey lets revenue cycle leaders in on compensation and hiring trends for CDI staff.
Despite the continually tightening margins for healthcare organizations, no ground has been lost for clinical documentation integrity (CDI) staff compensation, according to the 2022 ACDIS CDI Salary Survey.
In fact, the survey results, which garnered responses from nearly 800 CDI professionals, show that the CDI industry has made marginal inroads toward the higher ends of compensation since it's 2021 survey.
According to ACDIS' 2022 survey, 14.84% of survey respondents reported making $90,000–$99,999 annually. Those in the highest earning brackets (earning $100,000 or more per year) rose more than 12 percentage points from 2021, making up 53.68% of all respondents in 2022. The percentage of those in the lowest salary bracket—$59,999 or less—was 2.50%, according to the survey. Mirroring last year’s results, most programs have up to five staff members at the facility level (35.51%), followed by those with six to 10 staff members (22.88%).
At the healthcare system level, the largest portion of respondents (25.52%) reported having more than 50 staff members across all sites, which is in line with the fact that many systems represented in this survey were on the larger side (3,000 or more beds), the ACDIS report said.
In 2022, 49.10% of all respondents said their program plans to hire in the next 12 months.
Of those who plan to hire in the next year, the vast majority (89.43%) said they plan to hire for CDI specialist positions, followed by 15.43% who will hire for second-level reviewer positions and 14.00% who will hire for CDI lead positions.
This is on trend with a separate survey of hospital and health system CEOs, CFOs, COOs, and other executives that found that 53% of those surveyed expect at least a 10% staffing increase for IT/coding/rev cycle experts at their organization in 2023.
For programs trying to secure funding for additional CDI staffing, Anne Robertucci, vice president of clinical revenue cycle at Prisma Health in Greenville, South Carolina, told ACDIS that she suggests investigating reports that show the program’s performance in comparison to similar local organizations.
Whether a program looks at CC/MCC capture rate or quality measure performance, if its results are lower than similar institutions, that could be leaving money on the table—which is a compelling case for organizational leaders responsible for approving new positions. Use that comparison data to paint a picture of what the program could do with additional staffing resources, Robertucci suggested in the report.
“I think it's about data. Compare yourself to other like facilities. [Vendors] love to compare you to other organizations. Go out and look at MedPAR data. If you're not at the 75th percentile, that's money lost and money to be gained. Tell a story comparing of how you look to others. Your quality data tells a story, and there are soft dollars behind that as well,” she says. “Money talks, and I think this is one area where it's so easy to build a business case to support adding staff.”
The fact sheets detail the timeline of waiver expiration dates for different providers, as well as policies and programs that have already been terminated or made permanent. Certain waivers are slated to end at the PHE conclusion, while others have been extended.
The American Hospital Association (AHA) released a special bulletin that highlights the key provisions mentioned in these waivers. Several notable policies and programs will be affected when the PHE ends, including the following:
Skilled nursing facility (SNF) bed requirements and availability
Bed limits and the 96-hour rule for average length of stay for critical access hospitals
Requirements for discharge to SNF, rehabilitation center, long-term care hospital, and home health agency
Medicare’s 20% add-on payments for patients diagnosed with COVID-19
The AHA also sent a letter to HHS with recommendations on stabilizing the healthcare delivery system, supporting healthcare workers, and removing unnecessary administrative and regulatory burdens throughout the PHE conclusion.
While some waivers have been extended for two years, other freedoms—including an important Ryan Haight Act provision—will end soon, forcing some providers to take action now. Read more about this here.
HealthLeaders' regulatory round up series highlights five essential governing updates that cover every aspect of the revenue cycle that leaders need to know. Check back in each month for more updates.
The revenue cycle is complex, detailed, and always changing, so staying on top of regulatory updates and latest best practices requires revenue cycle leaders' constant attention in this ever-changing industry.
In this revenue cycle regulatory roundup, there were an ample number of updates published by CMS and the OIG in February, including public health emergency (PHE) updates and the OIG’s Work Plan.
Guidance was released for rural emergency hospital provisions, conversion process, and conditions of participation.
CMS published a memorandum to state survey agency directors containing guidance on the new rural emergency hospital provider type.
The memo outlines requirements on delivery of care, the conversion process for eligible facilities, survey guidelines, and the conditions of participation that facilities must meet to participate in the Medicare program.
Updated fact sheets were released on COVID-19 PHE waivers.
CMS updated a series of fact sheets about COVID-19 PHE waivers in light of the recent announcement that the Biden administration plans to end the PHE on May 11.
These fact sheets are located on the “Coronavirus Waivers & Flexibilities” webpage and are not dated on the main page but have all been revised as of February 1. They detail which flexibilities will remain after the PHE and which will not. The Hospitals and CAHs, ASCs, and CMHCs fact sheet discusses the end of the Hospital Without Walls program as well as the end of several telehealth flexibilities that were permitted during the PHE.
CMS said in an email that it will continue to provide resources and guidance via its current emergencies webpage as the PHE winds down.
CMS rolls out three new drug pricing models in response to the Biden Administration’s executive order on drug prices.
CMS published a press release to announce that it has selected three new drug pricing models for testing by the CMS Innovation Center in an attempt to help lower prescription drug prices. This action is in response to the Biden Administration’s Executive Order directing HHS to consider additional actions to further drive down prescription drug costs. The three drug models include:
The Medicare $2 Drug List: Also referred to as the Medicare High-Value Drug List, this model encourages Part D plans to offer a low, fixed copayment across all cost-sharing phases of the Part D drug benefit for a standardized Medicare list of generic drugs.
The Cell & Gene Therapy Access Model: This Medicaid model would have state Medicaid agencies assign CMS to coordinate and administer multi-state outcomes-based agreements with manufacturers for certain cell and gene therapies.
The Accelerating Clinical Evidence Model: This Part B Model involves having CMS develop payment methods for drugs approved under accelerated approval to encourage timely confirmatory trial completion and improve access to post-market safety and efficacy data.
CMS published a fact sheet and FAQ on these three models. It also published a report regarding the response to the executive order.
A comparison of average sales prices and average manufacturer prices for the third quarter of 2022 was released by the OIG.
The OIG published a report regarding drugs for which the average sales prices (ASP) exceeds the average manufacturer prices (AMP) by 5% or more for two consecutive quarters or three of the previous four quarters.
When this happens, CMS substitutes 103% of the AMP for the ASP-based reimbursement. In the third quarter of 2022, 15 drug codes met this price substitution criteria. Eight additional drug codes exceeded the 5% threshold but were identified as being in short supply. Another 18 drug codes had ASPs exceeding the AMPs by at least 5% in the third quarter of 2022 but didn’t meet other price substitution criteria. The OIG will provide these results to CMS for review.
The OIG made updates to it’s work plan.
The OIG updated its Work Plan with the following new items:
The revenue cycle is making its way to the forefront of financial planning for 2023.
A recent analysis by HFMA and Guidehouse, which surveyed 182 hospital and health system CEOs, CFOs, COOs, and other executives, found that 53% of those surveyed expect at least a 10% staffing increase for IT/coding/rev cycle experts at their organization in 2023.
This doesn’t come as a surprise since workforce has been a hot-button issue for revenue cycle leaders as the revenue cycle workforce wasn't immune to the drastic changes happening in healthcare over the last several years.
Bill Arneson, director of revenue cycle process and system support, at Moffitt Cancer Center, recently told us that assessing your budget is one of the first steps you need to take when filling revenue cycle roles since it will determine if you need to develop your talent in-house or if you can hire from outside the organization.
“If you can’t afford to hire the star IT people, then you have to commit to developing them. Ask yourself, are you the New York Yankees with unlimited money? Or are you the Tampa Bay Rays who have to work the farm system and develop players?” Arneson said.
As for the areas with the greatest projected budget increases for 2023, 20% of leaders said digital engagement/virtual care is their greatest projected budget increase this year, followed closely by revenue cycle automation (18%).
With growth in labor and supply costs, many leaders are turning to AI, automation, and digital care strategies to improve engagement and efficiency, the report said.
This isn’t the first time we have heard about the push for more revenue cycle automation in 2023 either. In fact, Amanda Schutz, billing services officer at Avera Health, recently shared her plans to advocate for its revenue cycle to make greater financial investments in automation for 2023. “That could be through AI, bot technology, or any technology that allows us to be more efficient in our day-to-day work,” she says.
There is an obvious need for patient payment platforms, but revenue cycle leaders aren't letting vendors off the hook.
Revenue cycle leaders are in search of ways to better secure revenue by bolstering their technology, and if perfecting and expanding online payment options aren’t on the radar, a big opportunity could be missed. And while this is area of need for revenue cycle leaders, vendors need to better perfect their offerings.
Receiving payments at the hospital is still the predominant way consumers settle medical bills, but according to a new study that’s changing as awareness of online portals and unified digital platforms grows.
The research found that nearly 30% of the entire sample used an online portal to pay a medical bill in the past year. “In the same timeframe, 36% of consumers paid bills in-person at a provider’s office or healthcare facility. That gap of roughly 7 percentage points is closing faster as more consumers become aware of new online payment options,” the study said.
The heat is not off vendors, though, as providers have rightly high expectations for the tech.
While most providers have seen an implementation of new patient payment solutions in the past five years, the platforms still have room for improvement for both providers and patients, according to a separate survey recently analyzed by HealthLeaders.
In that study, 650 providers in the U.S. shared their experiences with patient payment solutions and what more they want out of the platforms.
Only 58% of respondents reported high satisfaction with their current patient payment systems, with 30% saying the implementations were not successful.
Revenue cycle leaders know that patients expect payment methods that are both convenient and efficient, but that doesn’t mean any and all payment platforms are worth the time and effort.
Providers also want to make their own lives easier, which includes fully integrating patient payment solutions with their EHR—something only 33% of respondents reported having. More than half (58%) said the seamlessness of their current systems could be improved.
The director of revenue cycle process and system support at Moffitt Cancer Center shares his top recruiting tips.
The revenue cycle workforce wasn't immune to the drastic changes happening in healthcare over the last several years. An entire office floor that previously housed a revenue cycle department is now silent and desolate as most staff have been working remotely for years at this point.
Working remotely has been a success for most organizations and is now a permanent work model, and since recruiting an elite revenue cycle team is still a priority, the way organizations find that talent has changed too.
Bill Arneson, director of revenue cycle process and system support, at Moffitt Cancer Center, recently chatted with HealthLeaders about his strategy for recruiting the best talent for his revenue cycle technical team.
After several years of recruiting and development, since January 2023, Arneson says his teams now oversee all revenue cycle automation systems, business rules, and all operational reporting for the hospital, the physician group, and the clinical trial revenue cycle.
Arneson says that in the month of January alone, his team of 22 automated over 360 full-time employees and 689,000 tasks, “which as we calculate out, saves us about $982,000 per month,” he says. “Based on what we accomplish, I put my team in a pretty elite tier, if not one of the best in the country,” he says.
So how did Arneson develop such an accomplished team? Read on to find out. This conversation has been edited for length, but you can listen to the entire conversation here.
HealthLeaders: Hospitals were struggling financially in 2022 as they tried to navigate inflation and labor shortages among many other challenges. Because of this, Moffitt took a unique approach to build up the revenue cycle technical staff. Can you tell us how that came about?
Bill Arneson: Moffitt has been very big in creating efficiencies and choosing process improvements or automation over hiring people for several years. The first answer is never to just hire more people. I don't think that's the first thing any healthcare system wants to do, luckily, I know how to accomplish that.
I need some smart analyst developers or software architects. But I also know we're not going to win any bidding wars with Google or Amazon or some consulting firms. So, I focus on what is in my control. I can control the culture of my team, I can control how good of a recruiter I am personally, and I can control what kind of leader I am. So, the number one thing we try to do is foster a culture that people want to join. If the people love your team, we'll help you recruit good people, and they will stay.
This enables us to get some of the stars who could go somewhere else and make more, but honestly, they would rather have a great working environment and have a great work-life balance then go somewhere else and make a little bit more. So that's one of the things we try to leverage.
We also try to, as I call it, ‘recruit the diamonds in the rough.’ I specifically search for stars in other departments that are not technical people, but who have some raw technical skills or interest.
For example, that person who is over in patient access and they are excellent in Excel. They're the one always digging into the reports. Chances are they could easily transition into a reports person with some training. Another example is the gamer. Avid gamers are great because they're usually very techie people. They might not have pursued an IT career, but they're always into the latest gadgets. Also, people that are going back to school for IT degrees are great candidates to seek out.
HealthLeaders: What criteria do these recruits have to meet before they can be hired on the revenue cycle technical team?
Arneson: It is not a hardline of requirements. We'd like to keep requirements vague because the revenue cycle is such a diverse group of tasks. You need people from across the spectrum, as far as backgrounds and talents.
The number-one thing I look for is emotional intelligence, which I admit can be very hard to identify, especially with external resources. But honestly, they have to be a good team member. They must be able to be an adult and work through problems. I'm a big advocate of peer interviews during the hiring process. I'm only going to have to work with the people one or two hours a week, while their peers must work with them eight hours a day.
Along with that, they need the technical aptitude to fit the role because there will be some very high-level technical roles that they just simply aren't qualified for. So, recruits have to be at a level that allows them to do the technical part of the role too.
We also like then to have the traditional healthcare or revenue cycle understanding, but then again, we've also chosen technical experience over revenue cycle knowledge. For example, we’ve brought over engineers from Citigroup that turned out to be wonderful and amazing, and once you're a software developer, you can apply those skills across the board.
So, as far as qualifications, it really depends, but I would say those are the top three I look for: emotional intelligence, a good team member, and enough technical skills to start the role.
HealthLeaders: Do you have any other unique recruiting techniques that you can share with other organizations?
Arneson: You have to make recruiting part of your job as a revenue cycle leader. You can't just rely on HR or talent teams. I've found a lot more people through building a network of my own than anything else. Also, you have to assess where your budget is at. If you can’t afford to hire the star IT people, then you have to commit to developing them. Ask yourself, are you the New York Yankees with unlimited money? Or are you the Tampa Bay Rays who have to work the farm system and develop players?
I've had people from both: I've brought in people from Epic, Cerner, and Siemens, as well as those home-grown people. I just find the best talent I can, you know the emotionally intelligent good team members, and then tweak it along the way until they find their groove.
I could go through the list of how I hired all of my people, but most importantly, it's never a set it and forget it. Once you hire someone, you have to constantly be thinking how you can bring them in and find new skill sets. People's interests change over time as well so be prepared to constantly be growing the team members that you already have. That will really help you retain and grow your staff so you’re not always recruiting.
HealthLeaders: What is next for Moffitt’s recruiting? Are there other areas outside of the revenue cycle that these strategies may work for?
Arneson: I think everyone's resources got completely out of whack the last few years. And just weathering that storm, we have all done a phenomenal job. But anyone who wants the top talent has to ignore all the traditional boxes and focus on what it takes to be successful on your team. If you look at your staff that have been successful, there is a certain skill set that you can attribute across the board that those people have. That's the sort of stuff you need to be looking to develop.
And keep in mind, developing staff will not always be a straight path. I don't think very many people in their careers have a straight path from college to their dream job. It honestly takes a lot of work by the leadership to build the culture teams want, and need, to be successful.
A recent report calls out the winners and losers of price transparency adherence.
The Semi-Annual Hospital Price Transparency Compliance Report, recently published by PatientRightsAdvocate.org, analyzed 2,000 of the nation's largest hospitals from December 10, 2022 through January 26, 2023 to determine price transparency compliance.
Compliance was based on the inclusion of machine-readable files for all items and services, as well as price display of the 300 most common shoppable services.
As HealthLeaders previously reported, the newest findings reveal a modest increase in compliance percentage since the previous report in August 2022, with 24.5% of hospitals (489) now compliant, compared to 16% last year.
While this shows that 75.5% of hospitals are still not complying with the price transparency rule, the report names three major hospitals that are.
According to the report, among the 489 compliant hospitals, there were three hospitals that posted “exemplary” files that were easily accessible, downloadable, machine-readable, and included all negotiated rates by payer and plan:
MetroHealth Medical Center in Cleveland, Ohio
NorthSide Hospital Atlanta in Atlanta, Georgia
NorthSide Hospital Cherokee in Canton, Georgia
In contrast, some of the largest health systems in the country continue to be some of the biggest perpetrators of the law.
None of the hospitals owned by HCA Healthcare, Tenet Healthcare, Christus Health, Providence, Bon Secours Mercy Health, UPMC, Mercy Health, UnityPoint Health, and Avera Health were found to be compliant, according to the report.
Revenue cycle leaders agree they need to unite against one common enemy: the payer.
Editor's note: This article appears in the June 2023 edition of HealthLeaders magazine.
Payer compliance was a hot topic for the revenue cycle executives attending the recent HealthLeaders Revenue Cycle Exchange in Carlsbad, CA. Regulatory burdens and never-ending denials are putting massive strains on revenue cycles, and leaders agree they need to unite against one common enemy: the payer.
When it comes to payer compliance, revenue cycle leaders agree there are two major players in the industry that cause the most headaches for them right now: United Healthcare and Blue Cross Blue Shield (BCBS).
According to a poll of the 35 leaders conducted at the event, 44% of attendees chose both United Healthcare and BCBS as the most difficult payers to work with. These results were interesting as other payers came in far behind at 5% for Aetna, 5% for Humana, and 0% for Cigna.
So why these two payers? According to the leaders, United Healthcare and BCBS generally have complicated, multi-tiered structures and rules that seem to always be changing, regardless of their contracts.
Unlike Medicare, which has standard, heavily documented rationales and processes for denials, appeals, and audits, almost anything goes when it comes to commercial payers. Each payer organization will have different rules and processes, and payers’ manuals and bulletins aren’t always easy to locate.
“For us, it's really about new policy changes that they try to impose throughout the year and in the mid-contract period,” Patrick Wall, vice president of revenue cycle at St. Joseph's Candler, said to the group.
Even when policy changes spring up out of seemly nowhere, the leaders agreed that sometimes the administrative burden alone is too much. For example, one change BCBS has made is a substantial increase in the number of medical records it requests to pay a claim.
All this back and forth means that staying compliant with payers has been a burden on their workforce and themselves. With already strained staff it can be hard to find extra hands, and money, to keep up.
“I spent so much time and money in the last four years on legal fees and going through arbitration processes, and I spend a lot of time really holding payers to our contracts. Because we don't have a lot of protections like a lot of health systems, there's a lot of competition in our market,” Wall said.
UnitedHealthcare and BCBS aside, payer relationships are hard to navigate in general, the revenue cycle executives said.
The relationship between a provider and a payer organization rests on proactive communication—like any business relationship does—but what if that relationship seems one sided?
“The house always wins, and that's what the payers are. They hold a lot of the power, and they can take the ball and go home, especially in a city like Atlanta where there's four or five other systems competing for that book of business,” Derek Dudley, AVP of revenue cycle operations at Wellstar Health System, said at the event.
“When either side has too much control, it's hard to have that 'work together' kind of relationship,” Dudley said.
“We're trying though, and we all want to reach out to our payer partners and ask, 'how can we be better partners for you?' In turn, we want them to ask, 'how can we be better partners in working towards that?' But that level of dialogue is sometimes difficult,” Dudley said.
Aside from mending the payer-provider relationship, what else can providers do to strengthen payer compliance? Revenue cycle leaders agreed that having a robust contracting team and frequent joint committee meetings can make a big difference.
“We have a very strong contracting arm within our organization,” Chris Johnson, vice president of revenue cycle management at Atrium Health, said.
Some organizations even have routine have meetings with all of their major payers, such as joint review committee meetings and operating committee meetings, to review issues and organizational impacts.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
Want to hear more about the payer-provider relationship? You are invited to a HealthLeaders Community Call, “Payers Will Be Your Partners or Owners: Get Ready,” on Tuesday, February 28 from 1:00-1:30 pm EST, with Paul Keckley, author of the Keckley Report and one of the industry’s foremost policy and strategy experts. To RSVP, please email Abby Mathis at amathis@healthleadersmedia.com.
Join us for the next HealthLeaders Revenue Cycle Exchange!To inquire about attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
Patient experience is rightfully important to leaders, so is your hospital know for high-quality billing practices, or is it falling short?
At a time when a positive patient experience is playing a heavy role in overall reimbursement, and much of the billing process is shifting to patients who do not understand healthcare billing language, revenue cycle leaders are on the line to perfect their processes.
According to the Lown Institute, there are 15 hospitals that all received “A” grades from the organization in social responsibility for their patients and that have policies disallowing egregious billing practices.
California and Pennsylvania take the lead with the number of hospitals on the list. How did your organization fair?
The hospitals with “A” grades in social responsibility and billing quality in alphabetical order are:
Eden Medical Center, Castro Valley, CA
The Johns Hopkins Hospital, Baltimore, MD
Ochsner Medical Center—Northshore, Slidell LA
OHSU Hospital and Clinics, Portland OR
Ronald Reagan UCLA Medical Center, Los Angeles CA
St. Anthony Community Hospital, Warwick NY
St. Joseph Hospital, Eureka CA
Stanford Health Care —Valleycare, Pleasanton CA
UCSF Medical Center, San Francisco CA
United Medical Center, Washington DC
University of Mississippi Medical Center, Jackson MS
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