Revenue cycle management case study: Managing A/R days at a specialty hospital

Pinnacle Specialty Hospital is a physician-owned specialty surgical hospital in Tulsa, Okla.

The hospital offers weight loss surgery, orthopedic and spine surgery, eye surgery, plastic surgery, pain management, sleep lab services and radiology services. Julie Kay Keele, the hospital's business office manager, offers insight into how the facility manages its days in accounts receivable.

Question: What is the average number of days in A/R at Pinnacle Specialty Hospital?

 Julie Kay Keele, Business Office Manager and A/R Manager: At present 90 to 120 days.  Now, if you asked me how much a specialty hospital such as Pinnacle Specialty Hospital should be, I would say 45 days max. Adding to this staff turnover and two incompetent A/R and billing companies, our A/R days rose until we found Yvonne Marcum and her team at SourceMedical Revenue Cycle Services.  

Q: How long has this been the average?

JKK: Only since March 2015, when RCS took over our A/R and billing. RCS literally "touched" every one of our aged accounts within 30 days, some back to 2013.

Q:  What do you think is the key to keeping the average number of A/R days low?

JKK: There are multiple keys:

1. Having a partner like Source Medical Revenue Cycle Services with their knowledgeable, mature and aggressive staff, who have multiple years of actual hospital and physician office backgrounds, top certifications in coding and billing and expeditious communication.

2. Comprehensive training and communication within the hospital departments is a large factoring key. Each department must be trained to realize they are revenue producing. When these practices are implemented the impact on a hospitals revenue cycle can be tremendous. By determining the goals in getting a claim "out the door" A/R will decrease significantly.

3. Accurate and timely initial documentation ensures that Pinnacles team at RCS can timely code and bill. Transcription, turnaround time and physicians completing their outstanding dictation is also a part in this critical process. I believe this is the most important key.

4. A specialty hospital such as Pinnacle Specialty Hospital, can't just "hand off" it's A/R goals to an outside source without a dedicated staff who daily:

•    Meet the hospitals expectation of clean claims
•    Monitor all claim rejections, track denial reasons and facilite its AR/Billing company in providing any extra required documentation in a timely manner
•    Focus to not only be on actual days in A/R but, mindful of the bottom line in all business endeavors (i.e. cash collections).

In the end when A/R is improved the administrative staff's business outlook results in enhanced work productivity and amiable surroundings knowing their goals have been competently met.  

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