New Patient Financial Coordinator Team Saves Money, Lightens Load
By Jennifer Leone, Director of Patient Registration
Earlier this year, BHG leadership realigned the organizational structure of Patient Financial Coordinators (PFCs) to now report as one team to Jennifer Leone, Director of Patient Registration. This shift is enabling streamlined collaboration with operations and the contracting teams which is improving revenue cycle management (RCM) and lightening the load of RCM-related tasks for front desk staff.
The PFC team members are making great strides in the alignment of the new team. We had successful outcomes in March with cross-training efforts, self-pay audits, bad-debt prevention enhancements, cross-region eligibility verification, the roll-out of Smartsheet inventory management, and streamlining the authorization processes. Many efforts are in the works and we are rapidly moving toward our goals of providing more front desk support, increasing skillsets of the PFC team, and publishing results that have actionable plans.
Three key goals
The RCM team has been instrumental in making this change a reality by rolling out new processes. Before, PFCs were siloed and didn’t benefit from learning from each other. Bringing them together into one team has helped us have a better line of sight into the errors we were consistently seeing.
“The aim of this realignment is to achieve three key goals: reduce bad debt, increase patient collections at the front desk, and improve speed and throughput of clean claims filing,” said Charles Panicker, Chief Revenue Officer for BHG. “Reduction of denials helps us improve our DSO (Day Sales Outstanding). From the RCM team’s perspective, we’re always looking to take the set of actions that reduce the amount of time it takes to get paid once a claim is filed. The key thing to remember is that RCM doesn’t stand alone. Collaboration with the operations and the contracting teams is vital for us to be successful with all these endeavors.”
Training the team to do cross-region eligibilities was our first step. March was the first month they used the tool for states other than the ones they were previously supporting. An analysis of that training made us realize that almost 50% of our eligibility checks could be eliminated if the system was able to import results back into SAMMS. Today, that initiative is well underway and soon 8,000 manual checks will be eliminated, enabling teams to focus on enhanced patient care and revenue-generating initiatives.
During our authorization process analysis, we learned that the payor that requires the largest number of pre-authorizations, UnitedHealthcare Optum, can now be managed by email versus a manual read and phone call for each one. We also incorporated a tool in PowerBI that tells us when an authorization is about to expire.
Another example of where we’re seeing improvements is through self-pay audits. These audits provide insight into the causes of self-pay balances and help identify training needs and system enhancements. We review for billing errors, collection needs and preventable trends. The first audit in March resulted in adjusting a lot of inventory that shouldn’t have been on the books, and it made us aware of the steps we needed to take to appropriately collect for services rendered. We are now on our third audit and will continue to streamline the process each time.
This newly formed team of PFCs is improving the health of our company and our patients.
Accomplishments to date
- Weekly team building and group training sessions.
- Increased eligibility verifications performed by the PFC team.
- Authorizations can now be requested in bulk and electronically for the largest payer.
- Self-pay audits – In March, we audited $2.8M in Self Balances, followed by another $2.3M in April, and $2.5M in May.
- Audited 80% of all outstanding credit balances with actionable statuses.
- Financial Assessment Form Compliance Audits – Round 1 completed.
- Smartsheet Inventory Management tool implemented, allowing for trending and transparency of inventory owned between REG and RCM.
- PowerBI Enhancements and training – Double-billing prevention worklists, upcoming authorization worklists, and training on the best tools for root cause analysis of low collection rates.
- Published and trained on five chapters of SAMMS Patient Registration Manual, with two more chapters to follow soon.
What’s next?
The next time you see or interact with one of our PFCs, give them a high-five! Our Leadership Team appreciates all the hard work they’re doing and are looking forward to more financial savings, key learnings and efficiencies they’ll help us uncover through:
- Self-pay audit trends.
- Registration denial audits with published results.
- SAMMS wrap-up of eligibility results uploads from Waystar.
- System Enhancements – Elimination of false self-pay auto charges in SAMMS.
- PFC and PRC detailed live sample account reviews by site (as needed).