As director of patient financial services at Billings (Mont.) Clinic, Clay Fosjord directs patient registration and revenue cycle operation, as well as manages accounts receivable.
Prior to joining Billings Clinic, Mr. Fosjord served as director of operations for the Rocky Mountain Health Network, a Billings-based physician hospital organization. In that role, he directed operational functions of three RMHN offices.
Mr. Fosjord recently answered questions from Becker's Hospital Review about his greatest challenge as a revenue cycle leader and how he would improve the revenue cycle process.
Note: Responses have been lightly edited for length and clarity.
Question: What's your favorite part about being a revenue cycle leader of a health system?
Clay Fosjord: For me, being part of a team that works with all areas within the healthcare system to gain efficiencies and process improvements to bring benchmarks into industry best standards and to actually see days in accounts receivable decrease … it's so satisfying to see the end result of measurable outcomes. And gaining those efficiencies, it brings more value to the patient as well.
Q: What is the biggest challenge you're facing as a revenue cycle leader?
CF: In medical billing generally speaking there are two standardized billing formats that you bill on, and it would seem in utilizing standardized billing formats the billing cycle would be fairly straightforward, very clean, very efficient. But the reality is … yes the fields are in a standardized format, but payers have different needs from the different data fields within the standardized billing formats. So managing all these different payer requirements or needs for their claim systems to pay them first time through, and doing that without adding internal costs within our revenue cycle, is extremely challenging. We're always looking at ways for streamlining processes without adding costs to our revenue cycle because we're trying to bring more value to our patients and have our costs for generating revenue cycle at a minimum.
Q: What is one of your goals this year?
CF: My goal this year is to heighten our patient engagement specifically for the revenue cycle process. What I mean by that is we're going to be implementing technology that allows more transparency on the finance side for our patients and brings more value to them. And what I mean by that is they'll be able to go online and look at the services they received, what were the charges, did the insurance pay, did Billings Clinic receive any response back from the payer — they'll be able to see all of this online without having to interact with a person. They'll have more control. They'll be able to work on paying their bills, setting up payment options, have interactive communication with our patient financial services representative, again all online. We're going to give them more control over the finance side of their visit.
Q: What is one thing you'd do to improve the revenue cycle process?
CF: There are industry standardized transaction formats between us and the payers and the payers back to us. The goal is to reduce manual intervention and cost … but the reality is when we receive information back from a variety of payers, the standardized format is not always completed the way it was intended to be used, and the result is manual intervention. So if it were up to me, enforcement of standardized transactions and formats would consistently be used across all payers so we can gain that efficiency and reduce costs and give more value to our patients.