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The Opportunity = 3 Ps
Process = Cut denial rates by half(was 10% now 5.7% soon to be 3.0%)
Patient = Better understanding
Payment = Boost cash flow $100k/month
Highlights• Defining the bottom line• Centralization of scheduling: the
key to success• Defining where you are and where
you will go• Develop and deploying a process• Training• Tracking, measuring, and
evaluating the success
The $6 Million QuestionTM
On a scale of 0 to 10, how well do you communicate your patients’ payment responsibility?
John CookWhy should you listen to me?• Served as Revenue Cycle Director for 22 years •Pro Recovery, Inc. = Worked with more than 100+
hospitals on improving their revenue cycle•Reducing AR days from over 100 to 55 days•Advising and mentoring hospital managers•National HFMA Yerger Award for Outstanding
Performance in Education
Lesson #1: Define your bottom line.
•Define why you are implementing a pre-encounter process.•What efficiencies do you want to realize?
Here is what your colleagues said• Consistency• To create efficiencies to promote patient satisfaction and financial accuracy by education patients prior to
service• To educate the patient, financially and clinically• Customer service• Reduce errors / streamline and improve the patient experience• Pre-financial screening• Patient Friendly!!• Financial clearance and education• Get it right the first time• Scheduling• Customer service and collection of money• Obtain authorization• Implement a new program
Source: Answers given by attendees of NCHFMA Roundtable Discussion on Pre-Admission Procedures and Best Practices, July, 2012
Bottom Line: 5 Key Elements1.Cleaner claims2.Patient payment issues3.Communication of
payment expectations4.Asking for payment upfront5.Service excellence
Lesson #2: Centralize Scheduling
• The foundation of a successful pre-encounter process• Scheduling is a patient access
function•One calendar•One location• Everyone on the same page
Lesson #3: Define where you are and where you need to goRate your responses on a scale of 0 to 10, 0 = extremely poor; 10 = extremely well.
• ____ Overall, how would you rate your pre-encounter program?• ____ How would you rate the information you get from patients?• ____ How would you rate your clean claims?• ____ How would you rate your scheduling software?• ____ How would you rate your scheduling process?• ____ How would you rate your insurance eligibility capabilities?• ____ How would you rate your ability to estimate charges?• ____ How would you rate your ability to refer uninsured patients to their
payment options?• ____How would you rate your current collection policies and procedures?
Lesson #4: Develop and Deploy a Process
•Act•Centralize scheduling•Secure technology•Establish a plan and timelines•Complete buy-in
Lesson #5: Train, Inspire, Create
•Create passion•Ask for money•Create service excellence•Communicate expectations
Lesson #6: Track, Measure, and Celebrate the Success
•Reduction in AR days• Increase in clean claims• Increase in point of
service collection• Increase in patient
satisfaction scores
Results: Cone Health
•Reduction of denials to 5.8% from 10%•Pre-Service collections at $400,000 average of $133,000 per month
Summary Questions
•Where are you in this process?•What is your biggest obstacle?•What are your failures?•What are your successes?
Now ask yourself the $6 Million QuestionTM
If you put in place just a few of these ideas…
How well could you communicate your patients’ payment responsibility?
Quick Start Consultations
Available from John Cook at no cost Contact [email protected] (Cell)866-907-8023
E Book: The Six Million Dollar Question
How to reduce denial rates, improve patient satisfaction and increase cash flow.
Sign up TODAY to get your copy sent to you via email…www.6milliondollarquestion.com