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 lets current staff 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, reduce 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. Consider these when work demands exceed the permanent staffing supply:
- Hiring staff is expensive and can distract from daily operations
- Recruiting and hiring permanent staff takes time and new candidates need to give notice
- Training and educating staff takes time and resources
- Permanent staff may feel stress and tension which could lead to turnover
- Asking existing staff to work overtime is expensive and can reduce staff’s overall productivity andwork quality
- Once backlogs reduce, you may need to lay off permanent staff or redirect them
Insights
The first step to effectively using supplemental staffing is identifying project-focused work that you can accomplish with minimum disruption to current operations or involvement by the current team. The next step is communicating 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 reasons for the denials
- Write appeal letters and track resolution
- Secure 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:
- Provide overflow scheduling support
- Offer pre-registration assistance
- Conduct insurance verification and financial clearance support
Summary
Bringing in project-focused supplemental staff lets operations adjust more easily and quickly to work fluctuations, effectively reducing backlogs and improving financial performance. Increases 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?
