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Reimbursement
Accounts Receivable Assistance - Case History
Situation:
As a large regional health system continued to grow its home medical equipment and home infusion product lines through managed care agreements in multiple markets, it found that while revenue was increasing, cash flow was not. As the accounts receivable balance grew, highly trained accounts receivable personnel became increasingly difficult to recruit and retain. In the short-term, the health system required a solution that would enable them to recover the cash in their aging receivables while training new hires to handle the increasing volume of transactions and payer sources. In addition, the solution required a long-term plan that would ensure that it effectively utilized the billing software to automate and track time limited processes and prevent claims re-work.
Strategies:
The Corridor Group was retained to assist the health system with the development of an accounts receivable management plan that would:
- Enable the operation to maximize their short-term cash flow.
- Implement a retention and training program to develop the highly skilled collection staff.
- Maximize the potential of their information system investment.
To address the current cash flow situation and ensure long-term success, TCG recommended a four phase approach that combined collections, training program development, software utilization review and compliance planning. This approach enabled the client to remain effective long after the consultation had concluded and could be modified as changes in third party payer obligations occurred.
Tactics:
The on-site team of TCG collection experts reviewed the accounts receivables assigned for collections activity, completed trend analysis of payment issues and evaluated contract compliance. Billing software utilization, customer file organization and content were also analyzed. The TCG team conducted work process interviews with intake, delivery and billing staff. Job descriptions, position requirements, staffing levels, and back office policies and procedures were reviewed. The Corridor Group then designed a plan and a process for implementation that integrated the following strategies:
- Timely filing risks were identified and prioritized for collection.
- Targeted collections by TCG to promote short-term cash flow.
- Trend analysis utilized to determine highest training priorities.
- Automated processes supported by a billing system identified for training and implementation.
- Compliance issues identified for ongoing training program.
- Training programs designed to eliminate claims re-work, automate processes, support compliance and retain staff through job satisfaction and adequate resource allocation.
Results:
Through The Corridor Group's accounts receivable management expertise, the client organization has reduced days outstanding, automated tracking and compliance monitoring processes, reduced claims re-work and improved job satisfaction among accounts receivable staff. The new strength of their cash flow strategically positioned the organization to drive the home care market in which they operate. In addition, The Corridor Group's solution enabled the organization to:
- Increase productivity by 30%.
- Minimize its Accounts Receivable over 360 days (less than 2% of A/R balance).
- Increase monthly cash flow by more than 30% (based solely on collection productivity).
Meet all performance requirements of managed care contracts (billing compliance).