Ask a Revenue Cycle Leader is a series featuring insights from health system and hospital revenue cycle executives nationwide. Becker’s poses questions on the most pressing issues in healthcare finance — from payer relations and automation to workforce and patient experience. We welcome responses from all revenue cycle, finance and reimbursement leaders.
Question: What is one thing your revenue cycle team stopped doing in the past year, and what changed as a result?
Editor’s note: Responses have been lightly edited for clarity and length.
Renee Coleman. Patient Financial Services Director at Hospital Authority of Miller County (Colquitt, Ga.): Relying on the team to follow up on their denials. Instead we have a documented report on the status that is reviewed to ensure issues and processes are updated timely to reduce ongoing denials.
Adam Gobin. Vice President of Revenue Cycle at Access Medical Clinic (Valley, Ala.): What we stopped doing: blaming the payers. It’s easy for a revenue cycle team to treat every denial, delay or underpayment as a payer problem and escalate it one claim at a time. That approach burns energy, strains relationships and rarely fixes anything at scale. So we changed how we show up. Instead of reacting claim by claim, we started organizing our issues by trend: grouping them by root cause, payer, volume and dollar impact. That gave us a clear picture of where the real friction was, and which problems were ours to fix versus true payer-side issues. From there, we built a data-backed story for each payer and brought it to them as a partner, not an adversary. What changed: Our payer conversations became focused and productive. Rather than debating individual claims, we’re working jointly on the handful of issues that matter most, resolving them more efficiently and building stronger relationships in the process. The result has been meaningful cash acceleration, and a team that spends its time solving problems instead of assigning blame.
James Hartman. Director of Revenue Cycle at Thorek Memorial Hospital (Chicago): Staff used to check claim status one account at a time, by phone or through payer portals like Availity. It was slow, inconsistent and a poor use of PFS staff’s time. We moved to enhanced X12 claim status transactions (276/277) through our clearinghouse and host system, so status comes back automatically instead of being pulled by hand. That changed how we work the A/R. We built work queues around each payer’s actual claim response times, so follow-up happens when it should instead of on a fixed set of days. Staff spend their time on claims that need action, not on finding out where claims stand. Claim status checks are now automated, and follow-up now starts just days from payer claim status updates. Our workflow has shifted from status checking to denial resolution, driving down A/R through account resolution and increasing cash flow. The lesson: Manual status checking isn’t follow-up. It’s the work you do before follow-up can begin. Automating it let us put people on the work that actually collects cash.
Johanna Weller. System Vice President of Patient Access and Revenue Cycle at Main Line Health (Radnor Township, Pa.): On Oct. 4, Main Line Health stopped accepting cash and checks. This included our cafeterias, coffee shops, gift shops and all points of care. In high-traffic areas, we installed “reverse ATMs” to translate cash into a debit card. We have saved the cost of the courier pickup and experienced no decline in weekly self-pay collections. My team worked with many other areas within the health system to ensure a successful transition.
Next question: What is one payer behavior that has changed the most in the past year, and how has your team adapted? If you are interested in responding, please send responses to Andrew Cass at acass@beckershealthcare.com.
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