J.J. WATT QUOTE

I typically ignore the myriad of quotes and quips that saturate social media these days but this one caught my eye:


"SUCCESS ISN'T OWNED, IT'S LEASED. AND THE RENT IS DUE EVERY DAY"


Wouldn't it be great if everyone embraced this wisdom? It applies to our personal lives as well as our professional lives. So if you are a Revenue Cycle Leader, HIM Director, Hospital CFO or some other key role player, be sure to pay your rent :)


Hope you enjoyed reading this as much as I enjoyed sharing it. We at Nearterm practice it every day!


Jim Matthews
Principal; Nearterm Corporation
(281) 646-1330

Revenue Cycle DRP

REVENUE CYCLE DISASTER RECOVERY PLANNING (DRP) IS CRITICAL

Most hospitals have highly detailed disaster plans that are mostly focused on direct patient care issues and that is absolutely the appropriate focus. However, we as revenue cycle professionals advocate the reminder that cash flow is a critical when disaster strikes. The following wikipedia link articulates DRP issues fairly well - http://en.wikipedia.org/wiki/Disaster_recovery_plan

Here are a few questions to think about as you review your revenue cycle disaster plan:

• What is the increased volume capacity of the hospital and how would sudden increased volume caused by a disaster and perhaps sustained for several weeks impact registration, coding, billing and collections? For example, if you are accustomed to X OP/ED visits and Y census, what happens if volumes increase to hospital capacity? Is it a 25% increase, 40% or more? If your system is down and staff can't get to work, what is the plan?
• How quickly can EHR's, subsidiary AR ledgers, patient account histories and other data be accessed and what would the process be to do it?
• Is there a resource in the revenue cycle operation that is well versed in securing funds from various agencies that are involved in disaster relief?

Generally, 99% of hospital employees live in the immediate area surrounding the facility. They are therefore in the effected area and most are either dealing with personal trauma or in other cases they are patients. But the work of financial and revenue cycle professionals must continue in order to maintain patient services and to support the viability of the hospital. This includes management and technicians as well.

The contemporary and increasing practice of using remote hospital resources for certain functions is an option to consider, not only during disaster conditions but routinely. This option delivers an experienced labor pool and/or leadership team when the need arises.

Nearterm is in the business of providing interim resources to healthcare providers as part of the business model. Nearterm has clients routinely accessing this model as part of their routine non-disaster operation but it is easily applied when providers face disaster management challenges. Resources might include senior financial leaders, department heads, HIM Directors, Patient Financial Service Managers, Coding Managers, Collectors, Billers, call center personnel and more.

We are always interested in sharing solutions developed by hospitals and colleagues. Please feel free to share your experience by responding to this blog. If you would like to hear more about how we can be of assistance or simply get acquainted, let's talk.

Jim Matthews; Nearterm Corporation

(281) 646-1330

jmatthews@nearterm.com

REVENUE CYCLE EMPLOYEE DRESS CODE

HOSPITAL DRESS CODE IS CHANGING

Eric Chester has written a very interesting article on the topic of dress code.

http://ericchester.com/2014/07/16/casual-friday-or-casual-everyday/

I found this article and many others written by Mr. Chester to be very informative and practical. If you are a healthcare leader in a provider organization, you know that our industry has unique dress code protocol. Some is related to occupation at a facility, some driven by public business acumen and certainly culture and location influence dress code policy.

Because our business is revenue cycle services, we visit many hospitals every week. It is our observation that revenue cycle employee dress code policy seems to be all over the map. In any case, it is important to adapt and we hope this article provides you with food for thought as it did for us.

Jim Matthews; Principal

Nearterm Corporation

(281) 646-1330

jmatthews@nearterm.com

THE CUSTOMER IS NOT ALWAYS RIGHT

We often hear "the customer is always right" as a moniker supporting customer service training and related service management initiatives. Here is a modified version that I think makes more sense; "THE CUSTOMER IS NOT ALWAYS RIGHT BUT THE CUSTOMER IS ALWAYS THE CUSTOMER".

Our patients are not always right and we are not helping them by treating as if they are. Here are a few common examples:

"you have to take my insurance"
"you cannot deny service under any circumstance"
"you cannot come after me for payment as long as I am making payments"

There are many more examples. The point is we have an obligation to educate patients about patient financial services and that means tactfully addressing misunderstandings they may have. The best way to do that is by addressing them as the valued customers they are.

I could and may write a book on this topic but please feel free to contact me if you would like to contribute your ideas.

Patient Satisfaction Myths

We have all  struggled with customer satisfaction measurement initiatives. Patient satisfaction has become increasingly important as patients have greater influence on their care choices over recent years. I read this article recently (see link) and recommend that it is a good read if you are considering this topic.http://www.hospitalimpact.org/index.php/2012/10/17/title_70

PATIENT SATISFACTION OR LOYALTY?

For years, revenue cycle professionals have been concerned with "patient satisfaction". We conduct surveys, measure change and react to it as we design our delivery systems and work with our front line people. This has come about largely because we recognize that patients are progressively more involved in choosing their providers. But have you ever stopped to think about what it means for a customer to be "satisfied"? It means you have "fulfilled their expectations", you have been "sufficient" or perhaps "adequate". Satisfied patients are not usually the ones that are speaking favorably of your services and you are one mistake away from losing them. They are not loyal, just satisfied.

I submit that Patient Satisfaction is not enough in today's competitive market; Patient Loyalty is a more important goal. "Loyal Customers" can be described differently than "Satisfied Customers". Think of loyal customers in terms like "devoted attachment", "steadfast allegiance" and "faithful". These customers will come back to your facility, speak highly of your services and people and help you maintain and grow your share of the market you serve. I am sure you can think of a business or service you are loyal to, differentiating those that have simply met your expectations. Which would you recommend to your friends?

Nearterm can help you advance from having satisfied customers to having loyal patients. The revenue cycle has everything to do with the patient experience. The continuum starts with that first exposure to your organization and leads to patient loyalty. It includes pre-admission, patient access, patient billing, patient accounting, health information management, utilization management and others.  Let us talk with you about a practical approach that will help your hospital amass a loyal patient following.

Jim Matthews; Principal

(281) 646-1330

Hospital Access Professionals Wear A Lot Of Hats–How About “Loan Officer”?

Most hospitals understand how important admitting and registration professionals are in terms of public image and customer service. They are often the first encounter a patient has with a hospital and therefore represent the first opportunity for a patient and/or loved one to form an opinion about the facility. The intake process and even communication prior to arrival can make patients feel comfortable, confident and trusting in what can otherwise be a very intimidating provider system. That is important in today’s competitive healthcare environment where increasingly patients make choices.

Admitting representatives also have another critical role – Hospital Loan Officer. Just think, they categorically extend more unsecured credit than you see in any other industry. Every time a patient is admitted or treated as an outpatient without paying in advance 100% of the charges in cash, credit is extended. The only collateral is an insurance card, Medicare/Medicaid card, verified coverage or maybe a promissory note – no collateral. It is billions of dollars each year in unsecured credit.

Sometimes non-resource patients apply for charity care. This requires an extensive application process involving proof of income, ability to pay, proof of residency and other components. Sounds like a credit application to me. It is typically initiated and often completed with the guidance of an access representative.

Suffice to say that the role of access professionals in the healthcare delivery system is extremely important! They are the first impression and they have everything to do with getting paid. If that is the case, one might speculate about the recruiting practices, on-boarding, pay scale, training, schedule and many other items used to ensure that these functions are conducted effectively. The expectation would be that these positions would be highly trained and well compensated. If that is not the case, the organization may have a difficult time competing. Let’s face it, it is has been traditionally difficult for hospitals to maintain an access team that “wows” the public but still minds the purse strings. Those folks are hard to find and keep.

My thought here is not so much to talk about what we are doing now – you probably already know that about your organization. I offer the idea that hospitals should consider recruiting admitting personnel with banking or credit screening experience. The characteristics banks, lenders and screening companies are after include:

- Detail orientation and thoroughness

- Professional appearance

- Articulate, good interpersonal communication skills

- Computer savvy

- Comfortable asking for personal information and money

- Sensitivity in face to face encounters

- Ability to say “no” when necessary

- Knowledge about basic financial practices and ability to apply specific policy

- Commitment to confidentiality

- Tolerance to work with a diverse public

- Willingness to initiate problem escalation

I submit that hospitals might be well served to weigh these characteristics and non-hospital experience that requires these characteristics more heavily than healthcare experience when hiring entry level admitting staff. This practice expands the labor pool beyond those with healthcare background and ensures that fundamental qualities are present among the candidates. It is much easier to train a new hire in the nuances of hospital policy and procedure than to teach them the things listed above.

At Nearterm, our Patient Access Consultants have introduced and implemented this kind of thinking successfully in many provider organizations. This process typically starts with assessment of the access system and advances to a conceptual design, work plan and implementation. We also advocate other hiring practices that are “outside the box” both for our clients and internally. Related innovations we have facilitated are remote verification, pre-admission and financial counseling.

Our Healthcare Search Professionals work with clients daily as we partner to re-invent hiring guidelines designed to attract the kind of talent they need. We are always available to discuss patient access, admitting and registration issues with hospital revenue cycle managers.