Revenue Cycle Management Source: The Academy of Healthcare Revenue
Properly Documenting Policies to Ensure Revenue
Cycle-Wide Comprehension, Consistency
Revenue cycle leaders can often become
burdened with identifying appropriate policies
and having them approved and implemented,
and as a result, ensuring those
policies are written down and universally
understood may get lost among these other
demands. However, revenue cycle leaders
must develop policies that are understood
by their staff, so processes are appropriately
and consistently executed from the
front end to the back end of the revenue
cycle. As one healthcare provider discovered,
creating this comprehension will help
enhance patients’ hospital visits and make
revenue cycle processes more efficient.
The University of North Carolina at Chapel
Hill Health Care System (UNC Health
Care) is an integrated academic healthcare
center with 4 hospitals and a total of
760 licensed beds. UNC Health Care, while
re-examining its debt collection practices,
found that it lacked a detailed, consistent
policy regarding point of service collections.
Chief Revenue Cycle Officer Keith
Gran explained the health system’s findings
during a recent coversation with The
Academy.
“We’ve never really had a written policy
on point of service collections,” Gran
said. “We had been doing it hit-and-miss
throughout our system, but it wasn’t consistent,
it wasn’t uniform, and there was
really no source for staff to go to as a guide
in order to help patients find out what their
responsibility would be.”
To address this issue, UNC Health Care’s
leaders decided to draft a POS collections
policy that would ensure clarity of upfront
collection guidelines and consistency with
execution of processes.
"The policy makes it consistent in all our
entry points, including admissions, our
emergency department, and our outpatient
clinics,” Gran said. “[Staff] will ask for copays,
co-insurance, deductibles, past-due
balances, and, in some cases, a future prepayment.”
UNC Health Care had other incentives
to ensure this consistency as well. Over
the span of 18 months, the organization’s
self-pay payer mix grew from 5% to 9%. Additionally, its self-pay collections had
decreased, leading to a rise in bad debt.
In order to document and communicate
the POS collections policy, UNC Health
Care leaders identified 3 key steps, ensuring
consistency and staff comprehension:
Drafting the Policy. When creating
the actual policy, Gran said that there
are 2 key groups that leaders must
keep top of mind: patients and staff
members. The policy must assist
patients in understanding their financial
responsibilities, while at the same
time effectively helping them to fulfill
those responsibilities. For staff, the
policy must be both easy to understand
and easy to effectively communicate.
Training and education will help
to prepare staff, but if the policy is
intrinsically difficult to understand,
processes may not achieve full efficiency.
Identifying Organization-Wide
Education and Training Needs. At UNC
Health Care, leaders identified tasks
that staff members in each department
must complete in order to effectively
carry out the new policy. Front-end staff
would request items such as co-pays and past-due balances, which required
training in how to determine these costs
and communicate the options that
patients had for resolving their balances.
Financial counselors were educated
in how to financially assist patients
unable to pay upfront, such as specific
documents to request from patients to
complete financial aid applications and
steps to determine patients’ income
levels.
Providing Staff with Policy Reference
Materials. Although training and
education provide a solid foundation
for staff to rely on, leaders must also
provide materials for staff to consult
when they are in doubt about a
particular aspect or process in following
the policy. Financial counselors at
UNC Health Care, for example, are
given scripting so they are able to
effectively communicate patients’
financial responsibilities and options
in compliance with the POS collections
policy.
UNC Health Care’s recent documentation
of its POS collections policy is projected to
help increase cash collections and reduce
days in A/R and bad debt. Gran said that if
the health system does not effectively collect
at the front end, it has a 60% less likelihood
of collecting it at the back end, making
the consistent execution of this policy a
key contributor to UNC Health Care’s financial
success.
“Having the policy has made [the process]
uniform, and we’re much more consistent
in how we’re applying point of service
collections,” Gran said. “I think, by not
having the policy, patients would have different
experiences at the different areas of
our institution, and we are trying to not
have that happen. It’s going to enhance
our ability to collect what’s owed, and it’s
also going to enhance the patient’s ability
to understand what his or her responsibility
is.”
As UNC Health Care has recognized,
improving revenue cycle efficiency requires
the documentation and communication of
consistent policies. Doing so can ensure
staff members are effective in completing
their job responsibilities and enhancing the
overall patient experience.
The Academy of Healthcare Revenue
The Academy of Healthcare Revenue is a membership-based community that provides healthcare leaders with objective research focused specifically on the healthcare revenue cycle. Members receive an unlimited supply of all research--including benchmarking and best practice reports, implementation tools, monthly journals, attendance to virtual conferences, and more--designed to enable them to improve their revenue cycle processes and financial health from within. Furthermore, The Academy's membership offering is tailored to team members throughout the revenue cycle, from executive leadership to patient access, coding, billing and collections, and clinical staff, helping to drive process improvement efforts revenue cycle-wide. Collecting in Healthcare is one of four journals written by The Academy of Healthcare Revenue monthly.
To learn more about the benefits of membership with The Academy of Healthcare Revenue, contact us today.
Media Contact Andrea Morrill
Research Director
262-782-7919
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