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Managing A/R from Afar: How Well Are Your Remote Agents Performing?

Managing A/R from Afar: How Well Are Your Remote Agents Performing?

The healthcare industry’s remote A/R workforce is growing fast, as more providers and RCM service providers discover the benefits of this arrangement and build the infrastructure to make it work. According to a 2019 Deloitte survey, 56% of executives surveyed plan to have at least some contact center employees working at home in the next two years.

While this is a positive trend, A/R leaders are struggling to manage their remote agents’ performance. Many are forced to rely on agents’ self-reporting, which can be unreliable and doesn’t lend itself to effective performance management.

If your remote A/R team isn’t firing on all cylinders, you’re still miles away from optimizing your revenue cycle.

What’s the secret to helping remote A/R agents become more effective and engaged in their jobs? How can you make informed decisions about how best to use the talent you have? How can you do all this with ease while scaling your operation?

The answer to all of the above is real-time performance data put to good use.

 

Remote A/R Agent Performance: The Crucial Data You’re Missing

If you have remote A/R agents, you need real-time visibility into a variety of qualitative and quantitative performance measures including:

  • How collectors are using their time (how much time spent on the phone, how much time they spend on hold, number of claims worked per hour, etc.)
  • How appropriately and effectively they interact with payers and patients
  • Any procedural errors they might be making
  • Opportunities they may be missing to follow up on claims or serve patients better

With these data, you can take significant steps to improve productivity, ensure compliance with employer and payer standards, and keep engagement and morale high through timely encouragement and feedback. You can also compare productivity levels to reallocate your resources for the best possible results.

These are the keys to not only cutting days in A/R, but also improving efficiency and creating a more motivated, loyal workforce.

 

Continuous Performance Management (CPM): What Remote Agents Need to Succeed

A/R performance management

Source: HR Technologist

“Traditionally, performance management has been a forward-looking solution based entirely on hindsight. But organizational culture is evolving to one of continuous feedback powered by technology, where managers can foresee problems based on current employee performance and initiate any form of course correction to bring the employee back on track.” – HR Technologist

 

4 Ways to Use Real-Time Data to Manage Remote A/R Agents

You require certain things of your remote agents to keep the revenue cycle humming. They need certain things from their managers to understand the importance of their role and increase their value to the organization.

If you’re looking to take charge of performance management, energize your team, and improve their results over time, these four capabilities are mission critical.

Voice and data monitoring

Without detailed, timely information related to every call made and every account worked, it’s tough to assess (let alone improve) remote agents’ performance. Managers should be able to listen in on agents’ calls, whether in progress or recorded, and monitor all account-related activities and updates as they occur.

Dashboard displays

Every agent and manager should have a dashboard display that streams real-time data including accounts worked per payer call, hold times, call volumes, time spent on the phone, etc. This shared view allows managers to deliver valuable coaching as needed and gives agents the means to self-correct.

Performance alerts

Setting daily and monthly performance goals is critical. So is monitoring agents’ progress and knowing when they aren’t making the most of their time or advancing toward their goals. Any signs of declining performance should trigger timely notifications so managers can intervene early and effectively.

Collector rankings

Friendly competition is a powerful motivator. It boosts engagement, builds team cohesion, and drives progress. Agents should always know, at a glance, how they rank against the team’s top performers so they can use the data at their disposal to try to improve their standing.

 

Next Up: Automating QA to Drive Efficiency and Progress

Manual quality assurance (QA) processes have plenty of downsides for A/R leaders and teams. Among the biggest are the time managers must spend mining data and scoring agents (leaving less time for coaching and training) and agents’ perceptions of bias and unfairness.

For providers with remote teams, automation can turn QA into a less burdensome, more valuable performance management tool. In a future post, we’ll explain how automated QA works and why it’s a must have for the A/R front line.

Want more insights and tips you can use to improve your financial health? Subscribe to the OS blog, and we’ll deliver them straight to your inbox.

GetixHealth Increases Claim Follow-up Efficiency by 60%

Learn how this leading RCM provider transformed their collection team's performance with the addition of a simple EHR complement.

Disclaimer: Ontario Systems is a technology company and provides this blog article solely for general informational and marketing purposes. You should not rely on the content of this material for any other purpose or as specific guidance for your company. Ontario Systems’ advice, services, tools and products described herein do not guarantee compliance with any law or industry standard. You are ultimately responsible for your own company’s actions and compliance efforts. Because everyone’s situation is different, you must consult your own attorneys, accountants, and/or other advisors to obtain specific advice on your company’s compliance, legal, tax, regulatory and/or other business needs. Despite Ontario Systems’ efforts to provide current and up-to-date information, you need to recognize that the information contained herein may become outdated quickly and may contain errors and/or other inaccuracies.

© 2020 Ontario Systems, LLC. All rights reserved. Information contained in this document is subject to change. Reproduction of this publication is not permitted without the express permission of Ontario Systems, LLC.

Automation in RCM: How to Remove Friction from Your Revenue Cycle Processes

Automation in RCM: How to Remove Friction from Your Revenue Cycle Processes

In the healthcare industry today, there’s a lot of buzz and hype surrounding automation. Large healthcare networks, medical facilities, and RCM service providers looking to achieve a more efficient, robust revenue cycle are eager to invest in automation technologies.

All this excitement is understandable. Any technology that can free employees to focus on more complex, high-value tasks—and make revenue cycle operations easy to scale—holds great promise for improving providers’ financial health.

Given the financial and market pressures providers now face, and the potential top- and bottom-line benefits automation technology can provide, there’s no question that automation is the future of revenue cycle management (RCM). The question healthcare executives should now be asking is, “Are the practical benefits and ROI available, here and now?”

They are, as long as you take a practical approach to investing.

 

In this post, I’ll share my recommendations for how you can maximize your tech investment. But first, let’s delve into the three main types of automation technology and how they can improve RCM.

 

3 Automation Technologies that Are Revolutionizing RCM

“There is no doubt that technology has transformed the world of revenue cycle. [ . . . ] The automation of processes not only saves time, it reduces the chances of errors to allow for a steady stream of revenue and cash collections.”

 

Megan Zannetti, VP of Revenue Cycle, Graham Healthcare Group

Automation has the power to streamline and improve revenue cycle performance and lower operational costs by taking unnecessary manual touches out of the process and redirecting valuable knowledge workers to even higher-yield tasks. Here’s how current automation technologies work—often in interrelated fashion—and how they impact RCM.

Robotic Process Automation (RPA)

RPA can be easily programmed and deployed to interact with software applications just as human workers do. Designed to handle repetitive rule-based tasks, RPA can help reduce errors in the revenue cycle and ensure more uniform revenue cycle processes.

Example use cases: RPA can be used to automate status inquiries or reduce payer hold times for A/R agents when calls are still warranted.

“I do think [RPA] has tremendous potential to expand within healthcare . . . and the primary use case that I see is in [the] revenue cycle.

 

I worked for a third-party claims organization for about 15 years. [I]t could be easier to train a fleet of robots who are doing repetitive activities and similar activities than it may be [to train] a large human staff. And so I see there being tremendous potential not just for the ability to accommodate change, but because there are a lot of rules-based activities within the revenue cycle process as well.”

 

A.J. Hanna, Executive Director, Ascension Ministry Service Center

Artificial Intelligence (AI)

AI is a field of study within computer science that strives to create intelligent machines that work and react like humans and become smarter over time. Speech recognition, visual perception, language translation, and decision-making are among the most common applications.

Example use case: AI can be used to model and predict availability of important resources such as access to a payer representative when gaining prior authorization or following up on a claim. While the various forms of automation technology can lessen our need to call payer IVRs, when a call is warranted, we want to undertake that task in the most efficient manner possible.

“The capabilities of AI and other technology-based tools to improve data accuracy and process efficiency and support overall financial improvement for the revenue cycle present compelling cases for organizational investment.”

 

ECG Management Consultants

Data Analytics (“Big Data”)

Big Data Analytics is the complex process of examining large and varied data sets, or “big data,” to uncover information such as hidden patterns, previously unknown correlations, market trends, and customer preferences. This data science helps providers make informed business decisions.

Example use case: Big Data can be used to better understand your patients’ behaviors and preferences with regard to your ongoing engagement with them through calls, portals, email, text, and social media. Armed with this information, you can ensure your patient engagement strategy is responsive to the preferences of each patient while improving overall patient satisfaction.

“[D]ata analytics has and will continue to play a significant role in efficient and profitable management of health systems. [ . . . ] Operational efficiencies and cost reduction through analysis of performance metrics can be achieved from the front-end contact center to back-end offices, and everywhere in between. [C]ountless organizations have increased profitability through revenue cycle optimization.”

 

Deloitte report, “The future of artificial intelligence in health care” (2019)

4 Tips for Maximizing Your Investment in Automation Technology

While automating RCM processes can help address major operational and financial challenges, automation must be applied intentionally to ensure you realize its benefits. The following practices can help ensure your tech investment delivers the greatest possible return.

1. Identify high-value opportunities.

What are the real business problems you’re facing? Where are your operational needs, inefficiencies, and gaps? Any new automation solution should align closely with them.

To identify process improvement candidates, focus on tasks that are high volume, rule-based, and repetitive—i.e., work that shouldn’t require manual touches.

As current candidates are monitored for success and new candidates are identified in an ongoing closed-loop process, you can continue to ease friction in the revenue cycle, create a virtuous cycle of improvement, and accelerate your revenue gains.

2. Look for ways to “reskill” your most important asset—your people.

Don’t think of automation as a way to generate ROI by simply reducing head count. Instead, look to unlock the talent you have and improve employee satisfaction and engagement at the same time.

With the support of automation technology that frees them from routine tasks, your employees can focus on more high-yield, productive work. They’ll also have the insights and tools they need to make better-informed business decisions. As your existing workforce becomes more informed, effective, and impactful, they’ll deliver more value to your organization.

3. Aim for higher-than-linear yields.

The application of automation technology shouldn’t be determined simply by the task at hand. It should also be applied in the context of current business conditions: time, talent, expected yield, and budget.

The relationship of technology to yield is NOT linear. More technology may not be better. Your organization’s progression across the technology axis (see below) will be determined by yield targets you’ve deemed acceptable.

Your business challenge is to achieve yields in the green bubble above—in other words, well beyond a simple linear investment. To do so, you should follow the tips I’ve previously outlined: 1) attack and automate the right problems; and 2) free up resources to move to higher, more productive endeavors.

4. Be forthright about asking for practical solutions.

Many technology providers offering automation solutions tout exciting new capabilities and features such as RPA, neural networks, machine learning, data analytics, and AI. Your challenge will be to navigate these many options to apply the right technology to the business challenges you’re currently targeting.

Be wary of optimism and hype. These technologies are amazing, but according to experts, they are still in their infancy. You deserve practical solutions that are a precise match for your requirements and goals.

Ask your technology provider to help you align automation with practical, proven results. By creating this practical momentum, you can then launch into new use cases as your ROI unfolds and the technology continues to mature.

Success Story: Automation on the A/R Front Line

For GetixHealth, long payer hold times and a lack of visibility into agent performance were two major barriers to revenue cycle optimization. But a simple EHR complement, within the first hour of its use, changed everything. Download the success story below to learn how GetixHealth slashed hold times and increased claim follow-up efficiency by 60%.

GetixHealth Increases Claim Follow-up Efficiency by 60%

Learn how this leading RCM provider transformed their collection team's performance with the addition of a simple EHR complement.

Disclaimer: Ontario Systems is a technology company and provides this blog article solely for general informational and marketing purposes. You should not rely on the content of this material for any other purpose or as specific guidance for your company. Ontario Systems’ advice, services, tools and products described herein do not guarantee compliance with any law or industry standard. You are ultimately responsible for your own company’s actions and compliance efforts. Because everyone’s situation is different, you must consult your own attorneys, accountants, and/or other advisors to obtain specific advice on your company’s compliance, legal, tax, regulatory and/or other business needs. Despite Ontario Systems’ efforts to provide current and up-to-date information, you need to recognize that the information contained herein may become outdated quickly and may contain errors and/or other inaccuracies.

© 2020 Ontario Systems, LLC. All rights reserved. Information contained in this document is subject to change. Reproduction of this publication is not permitted without the express permission of Ontario Systems, LLC.

A 5-Step Dive into HIPAA Compliance for Email and Text

A 5-Step Dive into HIPAA Compliance for Email and Text

 Last week, I wrote about email and text guidelines the American Medical Association (AMA) set forth to help healthcare providers ensure their electronic communications comply with the Health Insurance Portability and Accountability Act (HIPAA). Thanks to this...

RCM Reality Check: How Healthy Is Your A/R Operation?

RCM Reality Check: How Healthy Is Your A/R Operation?

This is an introduction to our OS blog 2.0 series highlighting costly RCM issues and what providers need to address them.

 

Across the healthcare finance industry, shrinking operating margins (which fell from 1.8% in 2017 to 1.7% in 2018) are making providers increasingly uncomfortable. Most are now focused on finding ways to increase efficiencies and revenue across the enterprise, starting with the front end of the revenue cycle.

But what about the back end?

Is your A/R operation in peak condition?

If you haven’t assessed your collection efforts lately, you might be missing a major opportunity to strengthen your top and bottom lines.

Consider this: all day long (presumably), your A/R team is following up on patient balances, claims, and denials. How much time are your collectors spending on hold? Are they asking the right questions? How productive are your work-at-home collectors? How high is your A/R employee turnover rate, and how much is it costing you?

The only way to optimize your A/R operation, and your entire revenue cycle, is to track these data and work to improve them.

Unfortunately, your EHR platform isn’t designed to give you a good read on front-line performance. Nor can it arm you with the tools you need to help collectors improve their productivity and results. We call this the “EHR platform gap”—the missing piece that’s hampering your revenue cycle along with your ability to compete and grow.

 

The Secret to Optimizing RCM: Accountable Collectors

Why do collectors tend to underperform and then abandon their jobs at high rates? Because they’re not accountable. After a burst of initial training, collectors are set loose without the benefits of intentional coaching, routine refresher training, and meaningful QA—i.e., a strategic management approach that drives engagement and ongoing improvement.

Making collections work even more difficult and less productive are the crucial capabilities and resources these employees are forced to do without. Between long payer IVR hold times, uncertainty about how to prioritize calls, and missed opportunities on the phone, collectors simply aren’t accomplishing enough. And management is handcuffed without the tools to identify problem areas and trigger process improvement.

Now, imagine a collections team that has it all: solid managerial support, automation that allows them to sprint from call to call, and all the information they need at their fingertips. Collectors recover more, feel a greater sense of confidence and control, and become more seasoned and more effective over the long term.

Soon, a virtuous cycle is set in motion—one that naturally lowers labor costs, improves collections results, and frees the provider to pursue bigger, bolder business and market strategies.

 

Bridging the EHR Platform Gap 

 

 

A Stronger, More Streamlined A/R Operation . . . Without the Side Effects

Having spent the last 30+ years helping providers optimize RCM without upending their operations, we understand how painful change can be. We also know it doesn’t have to be. There’s an easy way to unleash your A/R team and boost revenues without making a single change to your existing EHR setup.

Want to learn more? Check out The Accountable Collector: Transforming Healthcare A/R with One Simple Fix. This complimentary eBook explains how you can slash payer hold times by up to 90% and increase collector productivity by as much as 25–40%.

 

Don’t miss the other posts in this series:

 

Want more insights and tips you can use to improve your financial health? Subscribe to the OS blog, and we’ll deliver them straight to your inbox.

 

Boost Your A/R Results—and Your Business Results—with Ease

In this brief guide, “The Accountable Collector: Transforming Healthcare A/R with One Simple Fix,” learn about the two big revenue drains every provider must address and how to fill your “EHR platform gap” so you can build an accountable collections team.

Disclaimer: Ontario Systems is a technology company and provides this blog article solely for general informational and marketing purposes. You should not rely on the content of this material for any other purpose or as specific guidance for your company. Ontario Systems’ advice, services, tools and products described herein do not guarantee compliance with any law or industry standard. You are ultimately responsible for your own company’s actions and compliance efforts. Because everyone’s situation is different, you must consult your own attorneys, accountants, and/or other advisors to obtain specific advice on your company’s compliance, legal, tax, regulatory and/or other business needs. Despite Ontario Systems’ efforts to provide current and up-to-date information, you need to recognize that the information contained herein may become outdated quickly and may contain errors and/or other inaccuracies.

© 2020 Ontario Systems, LLC. All rights reserved. Information contained in this document is subject to change. Reproduction of this publication is not permitted without the express permission of Ontario Systems, LLC.

3 Reasons Why Omni-Channel Communication Buzzed At HIMSS This Year

3 Reasons Why Omni-Channel Communication Buzzed At HIMSS This Year

 

If you’ve been before, you already know: The annual HIMSS conference is the conference to learn about healthcare’s information technology evolution. Myself and a few of my OS colleagues were fortunate enough to attend once again last week, and the event remained a vibrant, chaotic, and important place to evaluate and preview the industry’s next big things, network with new friends, and learn about the challenges facing providers coming out of the first quarter of the year.

But perhaps more importantly, our key takeaway from the conference this year was how revenue cycle management has continued its trajectory as a topic of growing importance to hospitals, doctors, and their business offices. The patient’s financial experience, especially, has become an obvious point of focus on the HIMSS main exhibit floor. That’s not surprising, given how continued downward pressure on margins has challenged providers to deal with patients as “consumers” with high expectations not only for their care, but service once they leave the hospital or clinic.

HIMSS even went so far as to organize the Revenue Cycle Solutions Summit, held Monday during the first day of the conference. Featuring superb presentations by providers, consultants, and vendors, the meeting shone a bright light on technology used today by leading healthcare organizations to improve the revenue cycle from start to finish. It was clear in networking with others in attendance at this event that more work needs to be done.

In what respects do providers have to catch up? Three big factors were apparent:

  1. Transform patient engagement during the billing process
    Large EHR providers provide invaluable advantages to healthcare networks. But today’s revenue cycle challenges require strategic solutions that provide automation, analytics, and productivity controls to effectively serve and satisfy patients while also attaining a reduction of days in A/R. Healthcare leaders continue to invest in targeted RCM solutions as they are proven to improve results, reduce costs and provide a strategy to connect with patients more effectively.
  2. Find ways to repeat excellent patient experiences, consistently
    Many discussions at HIMSS this year focused on how important it has become to provide an excellent “consumer” experience, achieved by repeatable – and profitable – processes outside the surgical suite. Bringing operations to that level requires advanced technology, plain and simple. Providers need to focus less on the art, and more on the science, looking deep into applications that help measure and improve their performance.
  3. Use data in more sophisticated ways for better, and more actionable insight
    Big Data offers fascinating benefits to healthcare finance. We all rely on retrospective reports, but today’s technology allows us to uncover important data trends and craft a business process response. This insight can be used to predict and adjust business office outcomes and empowers us to lead rather than follow.

How do these three factors boil down? Omni-channel patient engagement.

It’s important to offer the patient communication pathways that provide convenience – compliant phone calls, online options, SMS, smartphone apps, etc. – but that tactic only goes so far. The service you provide as a reaction is what really matters. If there’s one lesson HIMSS attempted to teach this year, it’s that transforming the patient experience relies on managing communications in a manner that recognizes patient preferences, while also controlling how associates respond, and identifying ways to improve productivity at the same time.

For an omni-channel patient experience to be realized, the underlying platform should aggregate data to raise awareness of all patient communication, while also directing account representatives appropriately and efficiently. Our patients, as consumers, expect a more contemporary relationship with us and a well-deployed omni-channel strategy will meet that need. The conversations we heard at HIMSS this year have us on the right path.

 

 

Disclaimer: Ontario Systems is a technology company and provides this blog article solely for general informational and marketing purposes. You should not rely on the content of this material for any other purpose or as specific guidance for your company. Ontario Systems’ advice, services, tools and products described herein do not guarantee compliance with any law or industry standard. You are ultimately responsible for your own company’s actions and compliance efforts. Because everyone’s situation is different, you must consult your own attorneys, accountants, and/or other advisors to obtain specific advice on your company’s compliance, legal, tax, regulatory and/or other business needs. Despite Ontario Systems’ efforts to provide current and up-to-date information, you need to recognize that the information contained herein may become outdated quickly and may contain errors and/or other inaccuracies.

© 2018 Ontario Systems, LLC. All rights reserved. Information contained in this document is subject to change. Reproduction of this publication is not permitted without the express permission of Ontario Systems, LLC.