Three healthcare finance and revenue cycle leaders shared with Becker’s Hospital Review what they would change about the revenue cycle process.
Jenni Alvey, CFO of Indianapolis-based IU Health: "I would reduce the amount of steps a clinician has to take to get paid. And ensure as long as they're taking good care of the patients and documenting appropriately, we always get paid. I don't think [the process] is any value add to the patient, to the clinician, to our system and even to our payer. I would love to be able to figure out how to stop the age-old, 'These are the payer requirements in a healthcare system to get paid.' That isn't easy. You would have to get rid of those checkpoints in the process."
Aaron Eichorn, CFO of University Health System in Shreveport, La.: "One thing is to make more information and the administrative work available online. For example, with pre-authorizations, we still have phone calls to make, we still have an inordinate amount of paperwork to fill out. We're not taking advantage like the private sector does of using the internet. For example, you come in for care at a doctor's office and you have a certain amount of your deductible or coinsurance you haven't met yet. We should be able to check online and get the right answer in seconds, not guessing how much money you owe. We should be able to find out online in a second whether you're pre-approved rather than doctors doing peer-to-peer reviews that take up an inordinate amount of physician time. There's got to be a way to leverage the internet to improve the cycle. If it were up to me, if there was a way to do that, I'd do it. I just don't know the payers are motivated to build that infrastructure."
Brian Unell, vice president of revenue cycle at Piedmont Healthcare: "One thing I'd do to improve the revenue cycle process is to have insurance companies and hospitals work together to send combined statements, instead of the way it is currently done. Often, patients' dissatisfaction stems from them receiving an explanation of benefits from their insurance company that doesn't match the bill they receive from the hospital. The total amount due is different on the two statements. It is a common issue we face in revenue cycle and there has to be a better way for insurance companies and hospitals to come together on this."