Here are four revenue cycle management tips from industry experts, published by Becker's Hospital Review on or after April 24.
1. "Too often I see revenue cycle consultants that move every few years or who specialize in independent consulting. While this is a good way to grow your career and skill set, hiring organizations for top executives like to see stability as well. There's something to be said about being ambitious and moving up, but not to the long-term detriment of your career." - Andrew Trechsel, senior associate in executive search firm Witt/Kieffer's healthcare practice
2. Ryan O'Hara, chief revenue officer of Flagstaff-based Northern Arizona Healthcare, recommended focusing more on yield with respect to clinical documentation integrity.
To elaborate on this thought, Mr. O'Hara shared an analogy in which net revenue is a dollar and cash is 98 cents.
"It's much easier to move net revenue and just let cash lag behind it," he said. "They're not binary. You still have to do both. But, I think sometimes we forget about moving the dollar, and we're focusing on that two-cent gap. I think we get kind of deduction-focused sometimes."
3. "In January 2011, the RAC program was initiated to identify improper Medicare Part D payments that could be costing the government several millions of dollars. According to the fiscal year 2015 report, the RACs identified and corrected $440.69 million in improper payments. There were $359.73 million collected in overpayments and $80.96 million in identified underpayments paid back to providers.
"CMS will continue to audit payments to reclaim overpayments and restore underpayments in a ratio that seemingly benefits CMS far greater than the providers. The next opportunity for identifying revenue streams may reside in an audit process for all insurance payers." - Julie Vigue, strategic business development executive at eVOLUTIONcr
4. Gerard Brogan Jr., MD, executive director of Huntington (N.Y.) Hospital and medical director of revenue operations at New Hyde Park, N.Y.-based Northwell Health, recommended emphasizing quality when engaging with physicians on clinical documentation improvement.
Mr. Brogan said this involves educating physicians on how quality data is used. "There's a little bit of wind at our backs if we explain to physicians how risk adjusting occurs and how they are tiered by insurance companies," he said. Mr. Brogan also noted hospitals should provide physicians with concrete ways to improve their documentation that are specific to their practice area.
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