With the implementation of the Affordable Care Act and Health Insurance Exchanges currently upon us, your health system needs to be ready to financially clear, educate, and manage the influx of newly insured patients. Are you ready?
Healthcare finance leaders are facing two major potential disruptors in the next 18 months: the changeover from ICD-9 to ICD-10 and the continued adoption of new pay-for-value models such as bundled payments. These events will have differing impacts on every healthcare provider organization, but mitigating the related financial risk will be a priority for all.
The concept of risk is not novel to healthcare. As a physician, I think about the risk of a complication or adverse event every time I prescribe a drug or order a procedure for an individual patient. These concepts were drilled into me during medical school and residency. The concept of risk in managing a population of patients, however, is a novel concept to most physicians and health systems. Providers in a fee-for-service world could simply focus on each individual patient as he or she walked through the door.
Don’t confuse "rural" with "behind-the-times." Andrew Molatore may be able to teach you a thing or two about the healthcare revenue cycle. Andrew is the director of patient financial services at Sky Lakes Medical Center in Klamath Falls, Oregon. His 176-bed hospital is a well-oiled machine when it comes to financials. They even have patients saying how great they are and "upping the ante" with other nearby facilities when it comes to their billing processes.
Even in today's 24x7, hyper-connected world, consumers (and patients) really only have four main ways to interact with an organization: by phone, in person, by mail or online.
Sure, there are a lot of subcategories (like tweeting, using a mobile app, sending a FedEx, and using a carrier pigeon) but when you really break it down, that’s it.
When you hear someone is “on the defensive,” it usually has a negative connotation. It could be an overreaction to an innocent comment. Or simply being on the wrong side of things – the side where you’re explaining yourself, and not having much fun in the process.
But creating accurate, defensible estimates is a great thing in the hospital revenue cycle world.
Good Samaritan Health System in Lebanon County, Pennsylvania, is all about speed. Speed of payment, that is. The path to payment can sometimes be riddled with obstacles both big and small. However, no matter the size, obstacles can cause payment delays.
According to Murphy’s Law, if something can go wrong, it will. (Actually, I think it was Murphy’s lawyer who said it, but I can’t prove it beyond a reasonable doubt.) In the pharmacy, there are many steps involved with processing a prescription order, and each step is an opportunity for something to go wrong.
Several years ago, I was unexpectedly in the hospital for about a week. A mysterious illness landed me in the critical care unit, and when I was nearly back to normal, I received my statement in the mail.
Hospitals today are faced with rapid industry changes and greater financial pressure. The ability to quickly and efficiently process claims for reimbursement is not only important, it’s critical to their financial success. Issues impacting a hospital’s payment velocity greatly influence their outstanding accounts receivable. At HFMA ANI 2013 this year, we introduced Pulse Perspective – The RevCycle Report to provide an industry view into the speed of payer reimbursement.