How Nebraska Medicine improved revenue cycle performance through analytics

Hospitals and health systems are consistently seeking to improve their revenue cycle processes, especially as patient financial experience becomes an increasingly important priority for organizations.

At Omaha-based Nebraska Medicine — which consists of two hospitals, more than 1,000 physicians, and 40 specialty and primary care clinics — part of revenue cycle improvement has included teaming up with The SSI Group, a healthcare software vendor. The health system also has focused on physician documentation education.

Here, Jana Danielson, Nebraska Medicine's executive director of revenue cycle, discusses the SSI initiative and provides her takeaways for other hospital revenue cycle leaders.

Note: Responses were lightly edited for length and clarity.

Question: What is one proactive approach Nebraska Medicine adopted that has improved revenue cycle performance?

Jana Danielson: As it relates to SSI, we use their analytical tool to identify areas of opportunity for our claim edit team and to identify potential payer issues up front and proactively. The information you get back really groups things in a way that you can see where you can identify things that are causing rework [of claims] to help us get those types of items resolved and to reduce the time frame it takes to get paid.

We've identified through some of the data an opportunity to change the way we work our Medicare claims. We're anticipating getting those paid probably within a couple weeks sooner for things that come back that require additional information.

We've also implemented with SSI an enrollment process where they help us make sure we're getting enrolled with payers, which is seamless and has helped us be able to focus resources toward things that are more valuable, [such as addressing] items that could potentially result in rework.

Q: What lessons have you learned from this initiative that you would pass on to other hospital revenue cycle leaders?

JD: Technology continues to change. It's bringing significant opportunity for us to evaluate how we do our work, to automate things as much as possible where we can, so we can focus on things that are most important to our patients and bring the most value to the organization as a whole.

Q: What is one revenue cycle goal you have for 2020?

JD: Increase our use of automation within our workflows.  

Q: What qualities do you look for in an ideal revenue cycle team member when hiring? 

JD: In general, we're looking for someone who can demonstrate our values and [is] a good fit for our culture. So, someone who's a team player, analytical, a problem-solver, and someone who is excellent from a customer service perspective. And that's going to span patient access, health information management, patient financial services. There are many folks who are patient-facing and others who aren't. [Nebraska Medicine also looks for] the ability to grow and change and adapt as things continue to shift and move.  

 

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