Evaluate Personnel | Streamline CBO
Case Study 3 - 400-Bed Hospital
Problem
A 400-Bed hospital wanted to work with Select Health Management to evaluate
key personnel and processes with the goal of reorganizing the Client’s Central Business Office (CBO) to be more streamlined
and profitable. The Client expressed concern over the lack of leadership in key areas, and needed teambuilding in the midst
of a “culture change.” It was vital to approach the assessment with sensitivity and to then provide organizational
structure and guidance, including creating job descriptions and hiring key leaders where needed.
Solution
Within the initial evaluation period, Select Health identified the need to replace
inefficient staff and provided three full-time interim managers for the duration of the project. We helped the managers revise
and clarify team member roles and delivered training programs to improve efficiency and to give those managers a better focus
on their own strengths to lead their staff better. The next stage was to propose a new structure, including job descriptions,
that would ensure a team mentality and to get the entire staff “on the same page.” We ran hospital-wide AR steering
committee meetings in cooperation with the hospital CFO, and wrote policies and procedures for across-the-board compliance.
Select Health supported the development and key improvements in the Charge Description Master department to improve
the charge capture process at the department level.
Our Revenue Cycle Improvement Teams (RCIT) implemented RCIT
development and implantation teams for billing, collection, patient access, information systems, and charge capture. These
teams met weekly and identified issues and solutions which were reported to the system RCIT. In the Patient Access arena,
we implemented a cash collection training program and hired financial counselors. We created and implemented a public communication
plan on improved collection of insurance, and implanted more than ten web-based insurance verification programs for various
payers.
Select Health’s Business Operational Improvement plan reorganized the department and realigned management
responsibilities. Other business office and Patient Access roles were reorganized, as well, to affect Financial Assistance
processes, cash collections, electronic billing, and home health services. We also developed monitoring tools for Medicare
RTP, the 72-hour rule, E Premis claims, CCI edits and held claims, in addition to providing third-party vendor management
and negotiations.
Results
Our managers facilitated a one-time AR outsource of $22 M, and reduced denial management from 5% to less than 1%. We also
increased front-end cash collections by more than 300% and reduced late payment charges by more than 80%.
In addition, Select Health delivered to our Client a complete roadmap of
how the hospital should operate to make best use of its most valuable resource: people. Our detailed implementation plans,
combined with our interim management team approach, ensured the hospital would not only make improvements in the short term,
but for years to come.
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