This is the third in a series of five articles highlighting costly RCM issues and what providers need to address them.
If your A/R operation isn’t as streamlined and effective as you’d like, and turnover is typically high, you’re in good company. Many healthcare providers struggle to manage and retain the people who power the back end of the revenue cycle.
Perhaps you’re resigned to these realities. You’d love to help your collectors improve their performance, but there’s no way to track their daily activity. How your work-at-home collectors spend their time is a complete mystery. A manual, labor intensive and data-lacking quality assurance (QA) process offers little value.
Without effective management and support, many collectors tend to disengage. They’re not motivated to excel, or even to stay.
You could continue hiring and onboarding new collectors, setting them loose, and watching a large percentage of them leave. Or you could unleash and strengthen your team by bringing accountability to the collections process—and drive productivity and recovery rates higher and higher, even as account volumes grow.
If you’re determined to optimize your revenue cycle, accountability is the way to go. Below, we’ll walk you through the three things you’ll need to achieve it.
What If You Take the Wait Out of the Equation?
By simply enhancing their EHR host architecture, providers can do a lot to boost their collectors’ productivity and results. Insurance Hold Manager (IHM), a key feature of the Artiva Magnify™ solution, is an easy fix designed to address the long IVR navigation and hold times that plague so many A/R operations.
The Artiva Magnify solution determines which payer to call next and uses IHM to automatically navigate payer IVRs and consume the time collectors historically spend waiting on hold. With IHM, the collector completes follow up on claims with the current payer and is then connected to the next payer call that is already in progress with IHM, thereby dramatically reducing time spent navigating IVRs and listening to hold music. All day long, collectors move seamlessly from one call to the next without having to navigate payer IVRs or endure painfully long and unproductive hold times.
This simple EHR complement translates into a significant increase in productivity and can have a dramatic impact on A/R operations.
1. Visibility Into Collector Performance
IHM is one of many EHR enhancements that can supercharge your collectors’ productivity. But the health and success of your A/R operation also depend on how well your collectors—including the growing number who work from home—perform in their roles.
“Often, a leadership team believes something is being done a certain way, but an analysis of day-to-day operations reveals it’s actually being done another way—and important things are slipping through the cracks.”
Katy Dettman, Plante & Moran, PLLC
“Healthcare accounts receivable valuation: Four pitfalls to avoid”
This is where your A/R transformation begins: knowing precisely how your collectors are using their time, the quality of their interactions with payers/patients, and any procedural errors or missed opportunities that need to be addressed. The process of measuring individual and collective performance has never been easier or more reliable.
Voice and data monitoring
Managers can listen in on calls, listen to recorded calls, and monitor account-related activities to evaluate performance from every angle.
Through their individual dashboards, collectors and managers can see the same steady stream of performance data on a variety of metrics (accounts worked per payer call, time talking vs. holding, calls made, etc.). Managers have what they need to deliver valuable one-on-one coaching, and collectors can independently self-correct.
When collectors aren’t maximizing their time or progressing toward daily or monthly goals, managers receive timely notifications so they can intervene early.
Who are the top performers on the team? Knowing where they rank motivates collectors to challenge themselves and improve their standing. Friendly competition among team members builds cohesion, increases engagement, and naturally drives progress on the front line.
2. A Performance Management Program That Drives Results
“If we expect performance improvement, then we must constantly measure and then actively move. Effective revenue cycle reporting should be developed not only to monitor our current success, but to manage it to the next level.”
Luanne Yeley, Halley Consulting Group
Regular, intentional coaching and training is essential for driving performance gains and keeping collectors engaged. With a steady stream of data, a more efficient and relevant QA process, and the benefit of timely alerts, managers can provide specific, actionable feedback that helps collectors make meaningful improvements and reaffirms their value to the organization.
Automated QA tasks
Call recordings are automatically matched with account records, and performance data is fed directly into collectors’ QA scorecards. Free from having to manually pull and evaluate random payer calls—which may not be representative of a collector’s overall performance—managers can use their time to coach and train as needed.
More relevant scorecards
Arbitrary or subjective definitions of “quality” might not reflect what collectors should focus on to get the best possible results. A QA scorecard that’s shaped by performance data is a more relevant and useful measure.
Better team management
As they watch performance data and QA scores change in real time, managers can identify widespread problems and provide refresher training. They can also share information with other internal teams to improve RCM overall.
Bigger performance gains
With more meaningful QA scoring and timelier intervention by managers, collectors can set goals, understand how they’re progressing, and continue to improve their scores, rankings, and recovery rates.
3. Tools That Boost Agent Productivity
Ample performance data and timely, valuable feedback help keep collectors sharp and motivated. But collectors also need help juggling high account volumes and making the most of every call. The right tools and resources can eliminate a lot of wasted time on the phone and ensure nothing gets missed.
Work queue scheduling
Collectors always know in advance which accounts they should prioritize. Collectors can be scheduled to move between queues based on time of day or duration so they can work accounts more evenly.
Insurance Hold Manager
We discussed Insurance Hold Manager (IHM) in our previous RCM Reality Check post. By drastically reducing IVR navigation and hold times—which can consume a third of the average collector’s workday—IHM alone can significantly increase productivity.
Process guide helps new collectors perform on a par with their more seasoned counterparts. Each time a payer picks up, collectors can refer to dynamic content on their dashboards related to SOP, relevant training, and state regulations governing payer responsibilities.
No more missed opportunities on the phone: from one call to the next, dashboard displays show collectors which high-priority claims they need to discuss.
Building an Accountable A/R Team Is Easier Than You Think
Filling the “EHR platform gap” with these missing capabilities might seem complicated and costly. In fact, the opposite is true. You can have it all, without disruptive change—and, in the process, get far more out of your EHR investment.
In our final post in the RCM Reality Check series, we’ll reveal how you can transform your A/R operation—and greatly enhance your EHR’s value—while preserving existing functionality and workflows. Subscribe to the OS blog and check out our latest eBook, “The Accountable Collector: Transforming Healthcare A/R with One Simple Fix.”
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.
© 2019 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.
Boost Your A/R Results - and Your Results - with Ease
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