Mr. Vigus wanted to take a new look at Newberry’s revenue cycle because “it is one of the most important features in the hospital in terms of its viability,” he says. “We needed a second set of eyes.” So Newberry County Memorial brought in Quorum Health Resources to provide an extensive analysis and identify key inefficiencies in its revenue cycle.
“We are in the process of implementing several changes based on the review,” Mr. Vigus says. Here, he explains some of the key findings of QHR’s analysis.
1. Scheduling process. Previously, each hospital department had its own scheduler. This meant that when a physicians’ office called, they might have to communicate with several departments depending on what services were needed. “The process was inefficient for the physician’s office and for the hospital,” Mr. Vigus says.
Today, the hospital has begun the process of centralizing scheduling. Newberry County Memorial started the process a month ago by bringing the scheduler for radiology to the central office. “It made sense to start with radiology because it has significant volume,” Mr. Vigus says.
2. Point of service collection. Newberry County Memorial is strengthening its efforts to collect money owed by patients when they are at the hospital. “As more patients move toward high-deductible policies, it becomes more important to collect money owed by the patient at the point of service,” Mr. Vigus says. The hospital reports self-pay volume is at $3 million this year, up 10 percent from the year before. “This is the biggest reason we try to do upfront collections,” he says. The hospital offers payment plans for patients who can’t afford to pay the full amount.
3. Case management. “We were doing okay on case management, but our average length of stay is a little higher than what we would like,” Mr. Vigus says. According to QHR, improved case management processes and procedures could help the hospital reduce its length of stay. The hospital is beginning to delineate the duties of case managers who are nurses and social workers. Social workers will now focus on discharge planning while nurses focus on the clinical aspects of case management.
4. Documentation of services. “In coding we were in very good shape,” Mr. Vigus says. “We were very pleased with the results.” However, he says physicians still need to improve documentation in the charts. To this end, the hospital plans to introduce education sessions for physicians and other staff. “Physicians have a key role here,” Mr. Vigus adds. “I think they will understand the need for good documentation because they are very supportive of the hospital.”
5. Receivables management. “This represented our greatest opportunity for improvement,” Mr. Vigus says. “We were recording the collections manually.” Newberry County Memorial has been changing the computer system that can make the work go much faster. In addition, “there is less human error,” he says. “Now we can get a clean bill sent out the first time.”
With this change, the hospital has seen a drop in days in accounts receivables and an improvement in cash flow. “When we reduce accounts receivables, more cash comes in,” Mr. Vigus says. “The cycle is shorter so that cash flow is improved. The older an account is the harder it is to collect.” The hospital started the last fiscal year, which ended June 30, with accounts receivables at 75 days and ended it at 54 days. “It’s a work in progress,” Mr. Vigus says. “We continue to improve the computer system and continue to educate employees. It takes a lot of hard work to achieve these results.”
6. Customer service. Customer service involves handling customer inquiries and resolving issues quickly. “We want to respond to our customers’ needs better and with greater speed,” Mr. Vigus says. “To accomplish this, we know we need more staff training. We need to teach our team how to reslove the many issues that could arise.”
Mr. Vigus is pleased to be continually working toward revenue cycle optimization at Newberry County Memorial, especially today, when a strong bottom line is more important than ever. “Quorum brings a great deal of expertise,” he says. Even though Newberry County Memorial has a good financial position, “it’s important to be proactive and improve what we do here.”
Learn more about Newberry County Memorial Hospital.
