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TOS Collections Initiative: Union General Hospital
Industry WebinarDecember 13, 2016
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● Webinar Recording and Presentation Slides
● Handouts
● Questions for Panelists
Housekeeping
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Handouts:
● Presentation Slides● CSH-3550-4 UGH Daily Deposit Form●
CSH-1300-3 ED Point of Service Collections● CSH-3515-3 Daily Cash
Drawer P&P● CSH-3517-3 Web Pay Reconciliation Sheet● CSH-3516-3
Web Pay Posting Job Aide● REV-1102-3 POS Scrpting● CSH-3520-4 Daily
Collection Log● CSH-3515-4 Cash Drawer Log● CSH-3516-2 Paragon
Payment Posting Job Aide
Housekeeping
http://www.azaleahealth.com/wp-content/uploads/CSH-3550-4-UGH-Daily-Deposit-Form.xlshttp://www.azaleahealth.com/wp-content/uploads/CSH-3550-4-UGH-Daily-Deposit-Form.xlshttp://www.azaleahealth.com/wp-content/uploads/CSH-1300-3-ED-Point-of-Service-Collections.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-1300-3-ED-Point-of-Service-Collections.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-3515-3-Daily-Cash-Drawer-PP.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-3515-3-Daily-Cash-Drawer-PP.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-3517-3-Web-Pay-Reconcilation-Sheet.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-3517-3-Web-Pay-Reconcilation-Sheet.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-3516-3-Web-Pay-Posting-Job-Aide.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-3516-3-Web-Pay-Posting-Job-Aide.docxhttp://www.azaleahealth.com/wp-content/uploads/REV-1102-3-POS-Scrpting.docxhttp://www.azaleahealth.com/wp-content/uploads/REV-1102-3-POS-Scrpting.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-3520-4-Daily-Collection-Log-.xlshttp://www.azaleahealth.com/wp-content/uploads/CSH-3520-4-Daily-Collection-Log-.xlshttp://www.azaleahealth.com/wp-content/uploads/CSH-3515-4-Cash-Drawer-Log.xlshttp://www.azaleahealth.com/wp-content/uploads/CSH-3515-4-Cash-Drawer-Log.xlshttp://www.azaleahealth.com/wp-content/uploads/CSH-3516-2-Paragon-Payment-Posting-Job-Aide.docxhttp://www.azaleahealth.com/wp-content/uploads/CSH-3516-2-Paragon-Payment-Posting-Job-Aide.docx
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Panelist
Jay MerryDirector of Revenue Cycle
Union General Hospital
[email protected]
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TOS Collections Initiative
Jay MerryDirector of Revenue Cycle
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▶ Collections at Union General
◦ Culture
⚫ Keep patient happy – limit refunds
◦ Limited tool set
⚫ Eligibility
⚫ KPI management
⚫ Tracking of Collections
◦ Historically retrospective
◦ Shifting payment models
Context
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▶ Emergency Department (UGH and CRH)
▶ Rationale
◦ Starting Point - Virtual zero collections
◦ Controlled Environment – Easier to evaluate changes
◦ Limited service offering- Copayments and deposits only
◦ High Patient Volume – More opportunity for engagement
◦ Registration Staff – Limited training requirements at
onset
▶ Once Perfected – adjust and implement for all levels of
care
Initiative Setting
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▶ TOS Collections as a % of net revenue (ED)
◦ UGH – .0432%
◦ CRH – .0866%
◦ Industry benchmarks*⚫ Top Quartile – 1.1%
⚫ National Average - .8%
⚫ Best – 2.4%
◦ *Based on HFMA and Revenue Cycle Academy national data▶ Avg
collection per ED registration (Based on FY volumes)
◦ UGH - $.21
◦ CRH- $.35
Historical Performance FY 2016
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Average TOS Collections in ED
• Under 200 beds• Average - $11,750 per month• Best - $20,833 or
more• UGH - $4,269.04 total FY2016
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▶ Policy and Procedure Development
▶ Cash Control
▶ EMTALA regulation compliance
▶ Clinical Staff Cooperation
▶ HIPAA (Patient Privacy)
▶ Incentives
Challenges
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Best Practice for ED Collections
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▶ Focus Group◦ Policies and Procedures – Cash Control, etc.◦
Scripting◦ Job Aides◦ Best Practice Standards◦ Incentive Plan
▶ Workflow◦ COWs – do not use currently◦ EMTALA compliance◦
Incorporated with full registration◦ Creation of “check out” area⚫
Early discharges, fast track, and semi private rooms
Development
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▶ Relay Health ◦ Web Pay - All payment methods◦ Eligibility –
Integrated Rev Runner Toolbar◦ Estimator - (pending
implementation)
▶ Polices and Procedures◦ CSH-1300-3 ED POS Collections◦
CSH-3515-3 Daily Cash Drawer P&P◦ CSH-3517-3 Web Pay
Reconciliation Sheet◦ REV-1102-3 POS Scripting
▶ Sisense◦ Collection performance – Key KPIs◦ Incentive
management
Tools
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Sisense
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Sisense
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Sisense
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Sisense
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▶ Self Pay◦ $0.01-$100.00 - .10%◦ $101-$9999.99 - .15
▶ Insurance◦ $0.01-$999.99 - .10%◦ $1000.00 - $9999.99 -
.15$
▶ 10 day window (posting date based)▶ Credited to creator of
registration event▶ Paid Monthly, in following pay period
Incentive Plan
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Incentive payout – Oct 2016
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▶ FY 2016◦ TOS Col % NR⚫ UGH - .0432%⚫ CRH - .0866%⚫ Top
Quartile – 1.1%⚫ Best – 2.4%
◦ Avg Col Per ED Reg⚫ UGH - $.21⚫ CRH - $.35
Performance Comparison▶ FY 2017 To Date◦ TOS Col % NR⚫ UGH –
.6598%⚫ CRH - .5465%⚫ Top Quartile – 1.1%⚫ Best – 2.4%⚫ GOAL –
2.4%
◦ Avg Col Per ED Reg⚫ UGH - $3.30⚫ CRH - $2.15⚫ GOAL - $5.00
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▶ FY 2016
◦ Copay collection⚫ 2.5%
◦ Self Pay collection⚫ 3.7%
Performance Comparison▶ FY 2017 To Date
◦ Copay collection⚫ 27.3%⚫ Best – 42%⚫ GOAL – 40%
◦ Self Pay collection⚫ 12.4%⚫ Best – 32%⚫ GOAL – 30%
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◦ Tools⚫ Eligibility – batch and real time⚫ Policies and
Procedures (cash control, collections, etc.)⚫ Scripting⚫ Reporting⚫
Estimator ⚫ KPI Management – Benchmarking⚫ Industry resources –
MGMA, HFMA, Revenue Cycle Academy
◦ Strategies⚫ Incentive structure – make it a competition⚫
Pre-visit estimation (where applicable)⚫ Batch AND real-time
eligibility use⚫ Combination of account AND encounter specific
balances⚫ Azalea uses “Patient Time of Service Collections
Report”
Outpatient Application
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◦ Strategies⚫ Goal setting⚫ Educate, explain, and give the
patient⚫ Options⚫ Reasons
⚫ Documentation in the record⚫ Train, Educate, Measure, Manage,
Repeat⚫ Culture
Outpatient Application
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Questions?
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