quickly improving rev cycle health
a growing, comprehensive healthcare provider in the SE United States
How are we able to quickly see a $6.35M improvement in AR?
You’re one of the nation’s top Epic revenue cycle performers with hospital AR days consistently in the mid to high 30s. You’re noticing a trend in the wrong direction, though, and you can’t find the root cause.
You slowly start to realize that letting this slip on your list of priorities could hurt your organization in more ways than one. But you’re not sure your staff has the expertise or bandwidth to identify root causes and quickly mitigate the issues.
A swing in AR days is finally starting to take its toll. To fix this quickly, we’ll need some true Epic experts who can focus exclusively on this while our staff is busy maintaining our normal day-to-day operations.
A long-time Bluetree partner and growing healthcare provider serving central Georgia needed a quick but thorough deep dive with real, actionable outcomes. Recognizing their successful past collaborations, our partner turned to a trusted team of Bluetree revenue cycle application and reporting experts in late 2016.
Bluetree quickly identified several areas that could collectively strengthen our valued partner’s revenue cycle health. In a three-month span, we helped optimize their Watch List, conducted an overhaul of Resolute Professional Billing curriculum, implemented a task force for the notoriously difficult Accelerated NRP functionality, and optimized statement hold data and automated write-off build.
We agreed with our partner to prioritize the reduction of the Outstanding Insurance Balance Not on Workqueue metric of the Hospital Billing Watch List. We created custom queries to slice and dice the population of HARs, which allowed our partner’s billing leadership to segment, prioritize, and distribute hospital accounts.
We then worked closely with Operations and IT to optimize their workqueue build and provide staff with reeducation of key Epic functionality and processes. Those collaborative efforts led to a reduction of the Watchlist by nearly 6,900 accounts and a general AR reduction of $6.35M in just three months.
Professional Billing Training
Prior to Bluetree’s arrival, our partner’s Patient Financial Services team took on both the hospital and professional billing of a newly created service area. The PFS staff, however, had never been formally trained in the Resolute Professional Billing (PB) application. Several changes to the Epic version 2015 of PB added to their difficulties.
To help, Bluetree customized more than 130 pages of in-depth PB curriculum and spent multiple days on-site training the PFS operational trainer. This curriculum gave their staff an in-depth overview of PB, resulting in greater workflow unity, increased system efficiency, and reduced human error.
Accelerated NRP Roadmapping
Epic’s Accelerated NRP functionality, which allows organizations to move balances to next responsible parties without having to first finish pursuing a balance from a primary payor, offers tremendous long-term AR and cash collection benefits to organizations. Our partner previously attempted an Accelerated NRP go-live but ultimately turned it off due to various challenges with their adoption of the functionality.
We also partnered to establish a task force in hopes of creating a roadmap for a new, successful NRP implementation. The task force involved team members from PFS, IT, Finance, Coding, Patient Access, and Internal Audit. Bluetree facilitated discussion surrounding design, build, testing, training, reporting, and maintenance, and subsequently created a 250+ line project plan that was transitioned to our partner’s PFS and IT owners.
Statement Hold Optimization
Bluetree sought to accomplish three goals in this area:
- Determine why Epic was flagging accounts without Self-pay Balances for Statement Hold
- Review legitimate statement hold reasons with PFS and verify correct functionality
- Provide ongoing monitoring of statement hold reasons
Bluetree’s HB analytics specialists created custom Cache queries to verify statement holds were functioning appropriately and circulating normally. Bluetree then conducted a line-by-line analysis of all system actions related to bad debt self-pay follow-up. We identified numerous pieces of system automation that were functioning too exclusively, preventing perfectly legitimate accounts from going to collections.
Automated Write-Off Optimization
Bluetree conducted a line-by-line analysis of every automated write-off in the system. We identified over a dozen separate system actions requiring modification including the addition of new plans that were eligible for write-offs, the combining of duplicative system actions, and the creation of new write-off system actions.
Bluetree delivered an easy-to-understand catalog of all system action queues capable of performing a write-off as a reference tool for our partner to use in the future. By the end of this engagement, they had a far greater understanding of current write-off build, closed numerous automated write-off gaps, and possessed a non-technical catalog for easy future reference.
Our collaboration provided the immediate results our partner needed, along with a foundation for their continued revenue cycle success. Our partner has also retained us in an advisory capacity and is currently considering additional initiatives that could benefit from our partnership and jointly produce the real and sustainabile outcomes they need.