Does your Revenue Cycle Operations have a Supplemental Resourcing Plan to Optimize Revenue?

Most revenue cycle operations need more manpower to optimize revenue.  Supplemental recovery services can help with denials management, eliminate coding backlogs and ensure billing and follow-up fidelity.  This allows current staff to focus on the most impactful activities in an ever-evolving revenue cycle environment: training, education, new technology adoption, and programs for quality improvement and patient care.  Experienced project-focused staff can help accelerate cash, reduced write-offs, and increase revenue, delivering providers a significant return on investment.

Background

Not every month is the same.  Some months are busier than others.  Unpredictable work volumes can stress staffing resources.  The inconsistent business cycle and staffing issues related to turnover, disability leave or delays in hiring approvals can result in backlogs.  Transitioning to a new hospital information system requires current staff to learn the new system while trying to maintain the day-to-day work in the old system.

Challenges

Backlogs due to processing delays, an unanticipated project, system implementation or staffing issues can negatively impact an organization’s financial health such as:

• Increase in days in accounts receivable
• Increase in aged accounts receivable requiring higher reserves
• Increase in untimely filing denials
• Delays in cash
• Decrease in revenue

Backlogs and processing delays cannot be ignored because of their direct fiscal impact.  Things to consider when work demands are greater than the permanent staffing supply:

• Hiring staff is expensive and it can distract from the daily operations
• Recruiting and hiring permanent staff is time-consuming and new candidates need to give notice
• Training and education of staff take time and resources
• Permanent staff may feel stress and tension which could result in turnover
• Asking existing staff to work overtime is expensive and can reduce staff’s overall productivity and    work quality
• Once backlogs are reduced, permanent staff may need to be laid off or re-directed

Insights

The first step to effectively using supplemental staffing is to identify project-focused work that can be

accomplished with minimum disruption to current operations or involvement by the current team.  Next step is to communicate with the current team that the supplemental team members are an extension of their team, to support their efforts, not to replace them.  Inform them that the new team consists of experienced staff that requires minimum training or support.  They are project-focused and driven to meet the required results.

Areas of project-focus that supplemental staff can help revenue cycle operations with backlogs:

Denial Support:

• Conduct root cause analysis to identify the reasons for the denials
• Write appeal letters and track for resolution
• Secure the necessary information to re-submit the claim
• Write-off accounts, as appropriate

Coding Support:

• Backfill for coding staff on leave or due to turnover
• Support inpatient coding due to census increases
• Support outpatient coding due to volume increases
• Maintain Discharge Not Final Billed (DNFB) at best practice levels
• Provide coding support for specialty needs: Home Care, Psych, Rehab

Billing and Follow-up Team:

• Supplement existing team
• Assist with specific aging categories
• Reduce unbilled AR
• Assist with the AR of a difficult payer
• Work down a legacy AR
• Support fiscal year end project efforts to maximize cash
• Assist with Medicare, or other payer, billing and follow-up

Scheduling and Registration Support:

• Overflow scheduling support
• Pre-registration assistance
• Insurance verification and financial clearance support

Summary

Bringing in project-focused supplemental staff allows operations to adjust more easily and quickly to work fluctuations, effectively reducing backlogs and improving financial performance.  Increase in cash, reductions in AR and write-offs, and increased revenue are some of the benefits that providers experience by adding supplemental staff to their team.  Does your organization have a revenue optimization plan using supplemental staffing?