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This article concludes our “RCM Reality Check” series highlighting costly RCM issues and what providers need to address them.

 

Throughout this series, we’ve explained the importance of closing the EHR platform gap. This simple step could help streamline your A/R operation, introduce accountability on the front line, and make your collectors (even those working at home) more productive and more effective at recovering revenue. We’ve also explained how you can accomplish all this without disrupting operations or nullifying your EHR investment.

The last step to A/R optimization is an automated quality assurance (QA) program—one that’s efficient, data rich, and precise.

If you rely on a manual QA process now, you might feel like you’re running in circles. Between manual spreadsheet entries, paper shuffling, and combing through account records for a handful of calls to audit, QA can be a constant mad dash that drains resources and leads nowhere.

What if you could simultaneously reduce the QA burden, make QA a more powerful performance management tool, and start moving the needle (and never stop)? Imagine the value for your operation and your enterprise.

Here are three reasons an automated QA program—one that complements existing EHR functionality—is essential for improving collector performance and results over the long term.

 

1. Allows for More Frequent, More Valuable Feedback

Manual QA tasks are tedious and time consuming. They not only leave managers with fewer opportunities to help collectors perform better, but also slow the QA review process. An audited call might be weeks old, and the collector might not recall the circumstance or context—thus diminishing the QA review’s relevance and value.

Automation drastically reduces administrative burdens and streamlines the QA process. Every step of the process feeds into the next, making performance management easier and more effective.

For example, when a call ends, the collector is prompted to select specific tasks performed. All performance data is automatically fed into the QA scorecard, which is customized for the collector or his or her unique role. The collector’s QA score is updated in real time.

A complete scorecard is routed to the collector electronically. It shows the criteria the collector was scored on and specific accounts he or she worked. Once the collector signs off on the score, the scorecard is stored in the system.

With real-time at-a-glance views on their dashboards, managers can mine scorecard data to identify individual and team performance trends. They can also respond to automatic alerts informing them of urgent training needs. Thanks to automated QA, team leaders have the time, tools, and visibility they need to address performance issues in the moment.

 

2. Offers a Comprehensive View of Performance

In an automated QA process, all conversations are automatically recorded and matched with the account record. When an account is pulled up to be scored, the corresponding voice recording immediately plays. As the team leaders goes through the scorecard, he or she can see and hear what collectors have done.

These recordings have several important uses. They can be compared with collectors’ notes about the call to ensure proper steps were actually followed, they allow team leaders to score on behavioral measures of quality, and they reveal how much effort the collector put into working the account.

If a collector’s account volume soars near the end of the day—possibly in an attempt to inflate the number of accounts worked during his or her shift—team leaders are automatically notified so they can access accounts in question, hear the recordings, and ensure collectors are working all accounts to the fullest extent.

Team leaders can also discern how well collectors perform on site and at home. Comparing these results can help improve resource allocation. If some collectors perform better at home than in the call center, granting them more work-at-home privileges is an easy decision.

 

3. Ensures QA Is a Reliable Indicator

How accounts are selected for review can be a big point of contention among collectors. If the selection isn’t truly random, it could present a distorted view of the collector’s overall performance. Collectors could also claim favoritism if other collectors are scored based on less demanding accounts. If a collector feels a QA review is unfair, the QA score becomes meaningless.

This scenario (all too common with traditional QA) can negatively impact motivation, loyalty, and retention—an industry problem made worse by rising labor costs.

With automated QA, accounts are chosen randomly across the board. Collectors don’t feel singled out or misrepresented, so they’re more receptive to their scores. They’re also more invested in improving them.

If your goal is to help collectors follow proper procedures and develop their soft skills—for the sake of your company’s image and your recovery rates—it’s important to build a scorecard that reflects your priorities for both. Fortunately, automated QA makes this easy; performance data can help you build and refine the scorecard. With a comprehensive measure of quality as their guide, your collectors will know exactly what to aim for during every call.

 

With Automated QA, Keeping Collectors Accountable Is Easy

A quality assurance program that can’t fulfill its purpose drains resources and revenue. For providers, it’s an obstacle to progress. Performance issues that hamper revenue recovery can’t be detected, addressed, or corrected. Attempts to drive improvement, ill informed as they are, can adversely affect team morale and performance.

Automated QA changes everything. It eliminates mundane tasks, speeds the review process, and frees and empowers team leaders to drive meaningful improvements on the front line. In an automated environment, QA offers tremendous value for collection teams and the providers they serve.

If you’re looking to supercharge the back end of your revenue cycle, our latest eBook is for you. “The Accountable Collector: Transforming Healthcare A/R with One Simple Fix” explores the EHR platform gap and what it may be costing you. You’ll also learn about the EHR-friendly solution that can turn your once costly A/R operation into a profit-driving machine. Be sure to download your free copy today.

 

 

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.

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Posted by Mike Mullins

As a Senior Director of Enterprise Sales, Mike Mullins leads the Ontario Systems team that is responsible for driving the company’s healthcare market growth and revenue. Mike is a 19-year veteran of Ontario Systems and during that time he focused largely on the healthcare and outsourcing markets. Throughout this previous tenure at OS, he gained an extensive knowledge of the revenue cycle from both a provider and outsourcer perspective.
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