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CohnReznick LLPCohnReznick LLPCohnReznick LLPCohnReznick LLP

COVID-19 REVENUE CYCLE RESPONSE AND STRATEGIES

Presented to: American Association of Healthcare Administrative Management

April 15, 2020

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TODAY’S SPEAKER

Caroline Znaniec is a Managing Director in Healthcare Advisory at CohnReznick LLP. Caroline has 24 years of combined industry and consulting experience within the healthcare revenue cycle. She is a recognized industry speaker and author in such areas as coding and documentation, charge description master (CDM), charge capture, pricing, governance, technology, revenue integrity, compliance and revenue cycle transformation.

Caroline can be reached at Caroline.Znaniec@CohnReznick.com

More COVID-19 Insight can be found atwww.cohnreznick.com/insights/coronavirus-resource-center

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WEBINAR OBJECTIVESThis webinar will provide an understanding of the disruptions in the healthcare revenue cycle due to

COVID-19. At the completion of this session, you will gain a better understanding of how crises, such as

the COVID-19 pandemic, can be best approached to maintain the health of the revenue cycle. Strategies

for prioritizing work efforts, managing remote capabilities and staffing, communicating opportunities,

identifying new risks and opportunities will be provided.

Learn specifics on:

• Understanding the impact of COVID-19 on the revenue cycle

• Identifying practical strategies for managing the people and business of the revenue cycle

• Implementing strategies for managing the revenue cycle during a pandemic or other potential crisis

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POLLING QUESTION 1

What type of provider organization do you represent?

A. Hospital

B. Health System

C. Physician Group

D. Post-Acute

E. Other

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UNDERSTANDING THE REVENUE CYCLE

Front

Middle

Back

• Scheduling

• Registration

• Eligibility

• Coverage

• Estimates

• Documentation and Coding

• Utilization Review

• Charge Capture

• Pricing/Contracts

• Edit Review

• Claim Processing

• Denials Review

• Cash Posting

• Collection

• Audit

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REVENUE CYCLE INTERDEPENDENCE

Defining Interdependence

• Stakeholders and stakeholder processes are mutually reliant on each other

• Trust is maintained to also provide for stakeholder independence

• Support is given to other stakeholders for the benefit of all

Interdependence Strategies

• Encourages Stakeholders

• Promotes Critical Thinking

• Provides for a Variety of Insights

• Decreases Stress and Anxiety

• Increases Productivity and Improves Results

• Improves Stakeholder and Staff Retention

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POLLING QUESTION 2

Would strongly would you agree that your organization, prior to the

pandemic, had an interdependent strategy or culture?

A. Strongly Agree – our stakeholders work seamlessly together and communicate regularly

B. Agree – our stakeholders have defined roles and meet somewhat regularly

C. Somewhat Agree – our stakeholders make it work and meet as needed

D. Disagree – we work in silos and lack communication

E. Not Applicable

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INTERDEPENDENCE IN TIMES OF CRISIS

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REVENUE CYCLE PERFORMANCE KPIS, IN CRISIS

• Medical Necessity Check Rate

• Point of Service Payment

• Eligibility/Verification Rate

Front

•CDM Maintenance Turnaround

•Coder Productivity/Backlog

•Query Statistics

• Late Charges

Middle

•Bill Hold/DNSP

•Clean Claim Rate

•Biller Productivity

•Claim Editing Corrections

•Account Aging

End

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TROUBLESHOOTING KPIS, IN CRISIS - EXAMPLE

FRO

NT

Med

ical

Nec

essi

ty C

hec

k R

ate

Pre

-Reg

istr

atio

n R

ate

Elig

ibili

ty/

Insu

ran

ce

Ve

rifi

cati

on

Rat

e

Po

int

of

Serv

ice

Pay

men

t

Req

ues

t

Po

int

of

Serv

ice

Co

llect

ion

s

Reg

istr

atio

n E

rro

r R

ate

MID

DLE

Ch

arge

Des

crip

tio

n (

CD

M)

File

Mai

nte

nan

ce

Co

der

Pro

du

ctiv

ity/

Bac

klo

g

Qu

ery

Stat

isti

cs

Tran

scri

pti

on

Tu

rnar

ou

nd

BA

CK

Bill

er P

rod

uct

ivit

y

Bill

Ho

ld/D

NSP

Late

Ch

arge

s

Cle

an C

laim

Rat

e

Cla

im E

dit

ing

Co

rrec

tio

ns

Cla

im D

enia

ls

Net

Day

s in

A/R

Cla

im R

ejec

tio

n T

urn

aro

un

d

Acc

ou

nt

Agi

ng

Ove

rall

Co

st t

o C

olle

ct

MIDDLE

Coder Productivity/Backlog Inpatient 24/day

Outpatient 40/day

Emergency 120/day

Ancillaries 240/day

X X X X X X X X

REVENUE CYCLE

STAKEHOLDER

Better Practice

KPI

INTERDEPENDENCE TO OTHER METRICS

SOURCE: CohnReznick LLP Healthcare Advisory Revenue Cycle KPI Interdependence Table

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POLLING QUESTION 3

Has your organization developed and provided clear strategies for

addressing the health of the revenue cycle?

A. Yes

B. No

C. Unknown

D. Not Applicable

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REVENUE CYCLE MANAGEMENT STRATEGIES, IN CRISIS

Prioritizing Work EffortsManaging Remote

Capabilities and StaffNew Risks and Opportunities

Communicating Change

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REVENUE CYCLE MANAGEMENT STRATEGIES, IN CRISIS

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REVENUE CYCLE MANAGEMENT STRATEGIES, IN CRISIS

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REVENUE CYCLE MANAGEMENT STRATEGIES, IN CRISIS

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REVENUE CYCLE MANAGEMENT STRATEGIES, IN CRISIS

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KEY TAKEAWAYS

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QUESTIONS

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