Together, We Navigate the Complexities in Your Revenue Cycle

On this episode of the Her Success Story podcast, Acclara's Lauralea Tanner and Ivy Slater dive into Lauralea's journey in the healthcare revenue cycle, spanning over 25 years. From leadership roles to creating better patient experiences. They discuss the core values that have shaped her career: commitment, innovation, and patient care.

In this insightful podcast episode, Acclara's Ryan O'Hara outlines his stress over the U.S. healthcare system, particularly the 22% GDP spending on healthcare despite having some of the worst outcomes. He acknowledges the need for a unique approach to address these inefficiencies, especially in the RCM space.

It's a common trap many organizations fall into – getting so caught up in the day-to-day operations that they forget to step back and see the bigger picture. Hospitals are no exception. We often get lost in the weeds of our processes, missing out on critical opportunities for improvement. This is precisely where consultants can be game-changers. They're equipped with fresh perspectives and a keen eye to spot the underlying issues that aren't being addressed in the tactical grind.

Lauralea Tanner, Chief Growth Officer at Acclara, describes the revenue cycle management critical decision points for hospitals, health systems, payers, and patients. In the hospital setting, there are lab tests, radiology, anesthesiology, surgeons, and other clinicians, all providing services that require proper coding and billing for collection.

Check in with any healthcare publication, and you’ll be met with dozens of articles about changes in leadership throughout hospitals and healthcare systems. Hundreds, if not thousands, of leadership changes have occurred in the post-pandemic era. But what makes a leader a leader in healthcare? With the healthcare workforce losing over 333,000 providers in 2021, how does a hospital find its next leader? Who should they be looking for next?

This predicament is more than just a financial drain; it exemplifies how complexity and opacity can foster injustice. Insurance companies operate in a way that hampers hospitals from receiving rightful compensation, making insurance coverage even more confusing for patients. It's time we came together and demanded change.

Few subjects gain as much fascination and promise as the convergence of artificial intelligence (AI) and blockchain. Hundreds of AI headlines capture global attention daily, from giving a woman with paralysis her voice back to discussions on how AI can be used in education. The AI-blockchain relationship might not appear immediately relevant to industries like revenue cycle management (RCM). But - the potential effects are nothing short of transformative.

Physician education in revenue cycle management (RCM) is vital in optimizing financial performance, reducing compliance risks, and improving overall operational efficiency in healthcare settings. The importance of physician relationship-building and education must be addressed. Fostering strong physician relationships, prioritizing education, and utilizing automation can foster stronger relationships.

Investing in a customized resource pool can maximize revenue cycle efficiency for healthcare organizations struggling with staffing shortages and gaps. A resource pool should offer various services, including claim editing and billing error resolution, coding and billing denial review, and registration error and denial services. The team should be an extension of the client’s team, providing personalized solutions and building trust through consistency and expertise. Acclara’s resource pool offers an agile and flexible approach to revenue cycle management, ensuring financial success for healthcare providers.

Revenue cycle leaders should be careful to not settle for merely measuring, but also managing. Select meaningful and actionable metrics, and act on them to improve the outcome, not just to improve the metric. Ensure that you are closely managing productivity while paying attention to the types of claims being worked and the outcomes. Use metrics to draw critical conclusions about outcomes and uncover root cause issues degrading those outcomes. As a revenue cycle leader, it's time to take action and start managing metrics effectively to improve the overall performance and outcomes of your organization.

In the latest View in 2 - Healthcare NOW Radio Podcast episode with Beth Friedman, Acclara's Chief Growth Officer, Lauralea Tanner, shares invaluable insights and strategies to help healthcare organizations improve their margins and achieve financial sustainability.

Patient experience is more than just providing quality care. Patients want clear communication regarding their financial obligations. By implementing a financial discharge process, you can become a trusted financial partner for your patients. By providing patients with a one-page summary of financial clearance activities, offering options for payment, providing charity care/financial assistance, reviewing patient information for errors, and creating a post-care document, you can improve patient experience and prevent denials from insurers. Start by focusing on higher dollar visits and employing current staff for bedside visits.

Improving the patient’s experience and delivering high-quality care are critical components of healthcare delivery. While healthcare organizations dedicate significant resources to improving their processes and achieving better patient outcomes, not all hospitals have the same access to proven process improvement tools.

In March 2020, the nature of how Patient Financial Services (PFS) worked changed dramatically due to the COVID-19 emergency; revenue cycle departments sent most if not all, staff home. By early April 2020, more than 90% of staff worked remotely full-time.

In a large healthcare organization, there are many moving, complex pieces and this results in competing priorities. As a CFO, revenue cycle management is key to overall business performance, but not top concern—clinical initiatives take priority. With that being said, outsourcing revenue cycle management isn’t throwing up a white flag. It’s actually the first big step toward gaining control and regaining clinical and financial focus of an organization.

Fantastic service, excellent care, and knowledgeable staff made this 80-bed acute care facility a top-rated healthcare provider in this Midwest community. KSB’s commitment to “restore, maintain and enhance health” and their vision to “be the community’s first choice for health services” were met by our own promise, to help them maneuver complex payer dynamics and provide exceptional financial services to their patients.

Regional West made a much-needed decision to move toward a single EHR and patient accounting system throughout the health system, which led to expected and unexpected challenges. Cash pressures were real. Operational processes needed to be revamped. Employees were asked to learn new, complex system. The wind-down of the legacy system proved to be a competing priority. There was talk of restructuring, which brought uncertainty, leaving many important questions without clear answers.

Unlock the potential of your Patient Access team by building trust and relationships. Patient Access is critical in the healthcare industry and impacts the revenue cycle. Gain insights and strategies to overcome the challenges faced by Patient Access leaders, including understanding the current state of work, empowering staff, and mentoring future healthcare leaders. Learn how to prioritize customer service and create a positive patient experience that drives loyalty to your organization. Read the blog post now and take your Patient Access team to the next level.

As healthcare continues evolving, healthcare providers face increasingly complex billing and claims issues. One area that poses particular challenges is newborn claims and hospital billing. Here, we’ll explore some common problems related to newborn claims and hospital billing and provide tips on navigating them effectively.

Start optimizing your revenue cycle by enhancing department collaboration and coordination. By involving executives, physicians, and nurses, you can improve processes and perspectives and take control of your revenue cycle management. Refrain from allowing simple errors in the revenue cycle process to affect your bottom line or patient experience. Start optimizing your revenue cycle today!

As one of the top health systems in the state, Penn Medicine partnered with Acclara to run its commercial insurance follow up to increase efficiency and lower the cost to collect. Acclara also manages high-touch customer service operations to ensure the patient experience matches the Penn Medicine brand.

Trust in expected reimbursement is fundamental to a strong revenue cycle. Expected reimbursement is a critical but challenging competency for healthcare organizations, requiring constant attention and expertise to manage complex agreements with payors and changes to contracts, amendments, and payer policies. Discover how a team of experts specializing in revenue cycle and underpayments can help manage complex payor agreements, identify errors, and implement proactive solutions.