Have you been operating with an understaffed department? Are your 60-120-day buckets getting larger and larger? Do you have way too many manual processes? Were you nodding at any of these questions as you were reading them? Adding more staff and manual processes are what I characterize as "band-aid" fixes -- great for clean-up projects, but not ideal as permanent solutions to a problem that will continue to rear its ugly head.
What have we found to be the best way to address -- and solve -- these issues? Automation. Here are three revenue-generating processes we’ve built to improve our day to day efficiency and administrative effectiveness.
Resolving patient accounts requires many workflows -- for everything from billing a claim, appealing a denial, identifying a deceased person's account, and even filing probate claims. Look at your workflows. Identify the types and flow for each, and then find and record the existing bottlenecks. This is a great opportunity to redesign your process to maximize efficiency and profitability. Work with technical teams or vendors known for creating automation solutions to organize the workflows you have documented. You'll be aiming for workflows that are finite and don't overlap. Never-ending workflows tend to create problems later on. Don't forget to include performance measures -- the ability to assess and reassess workflows is crucial to success.
Automating this process has huge gains. Key components of this process include allocation, reconciliation, and exception management. Create a payment posting procedure that incorporates these components, and then work with a team to automate it. As a posting manager, you’ll need a display or some front-facing software to account for all the work. You want to make sure all payments are accounted for. This may seem like a big undertaking, but trust us -- the reduction in manual work is well worth the effort.
Post Visit Medicaid Eligibility
Your patient registration adeptly captures Medicaid eligibility at the time of the visit, but what happens after that? Medicaid’s enrollment process inherently complicates eligibility capture. Manually checking enrollment daily isn’t a feasible option for most billing departments. To properly capture Medicaid enrollment, you do need to automate the process. Batch processing your Medicaid eligibility after service will prevent your organization from missing Medicaid billing opportunities, which could have a significant cumulative impact on your bottom line.
Emerald AR Systems has spent over a decade working with consultants, billing managers, and CFO’s in building automated processes for healthcare organizations. Our time-saving services have allowed our clients to focus on higher objectives and maximize profitability and savings. To learn more, click here. It's time to work smarter.