Despite revenue cycle challenges, including an estimated $12 million billing backlog, Yvonne Robinett has been able to step forward and help lead Gillette, Wyo.-based Campbell County Health toward improvement.
Most recently, the revenue cycle director was involved in hiring revenue cycle solutions provider Xtend Healthcare to help address the system's billing backlog, which came after CCH combined and relocated its clinic and hospital business offices. Already, the system has been able to reduce accounts receivable days by four and revenues have increased by $3 million. Ms. Robinett expects the backlog to be reduced by at least 50 percent by Jan. 1.
Ms. Robinett joined CCH in January from Syringa Hospital and Clinics in Grangeville, Idaho, where she was the revenue cycle director and privacy officer for a critical access hospital and two clinics. She also worked with Coding Continuum, a consulting firm based in Tucson, Ariz.
Here, Ms. Robinett discusses the biggest challenge she faces and her goals for the near future.
Note: The following responses were lightly edited for length and clarity.
Question: What's your favorite part about being a revenue cycle leader of a healthcare system?
Yvonne Robinett: I see a huge opportunity to help an organization to potentially do better by improving the revenue cycle. Many hospitals are dealing with a fragmented revenue cycle, and — even though I may lose sleep over it sometimes — I like the intellectual challenge of pulling the revenue cycle processes together and improving the workflows. I also like the prospect of improving the revenue cycle functions for the community, whether that's ensuring our communications are more patient friendly, ensuring their billing statements are easier to understand, or to provide community education so that patients and their families are better equipped to understand their insurance benefits and options they may have for payment. I think I enjoy it because I have the opportunity to make the revenue cycle better for both the community as well as my organization.
Q: What is the biggest challenge you're facing as revenue cycle leader?
YR: Reimbursement is a challenge. Things are changing so quickly. You never know from month to month what Medicare may decide to do, or Medicaid. I think that's probably the biggest challenge is to keep an organization viable with all the changes in reimbursement that we're faced with. Every year we're faced with new regulations and new proposals and being able to navigate that efficiently is a huge thing.
Q: What are your goals for next year?
YR: My specific goals for the next year are to look at our payer contracts and then look at our reimbursement to ensure we're being paid according to contract. Our denials are also increasing, so [another goal is] to really understand those denials and why we're getting them. [I want] to see if they're a payer contract issue or if there are things upstream within the revenue cycle or outside of the revenue cycle with the clinical departments I can work on to decrease those.
Q: What is one thing you'd do to improve the revenue cycle process?
YR: Timely documentation from our providers is a huge factor for us. Whether [it's from] nurses, providers [or] mid-level providers, getting that documentation in a timely fashion is probably one of our big pain points right now.
Q: CMS aims to increase price transparency for patients with its annual Inpatient Prospective Payment System rule released Aug. 2. Under the rule, hospitals are required to publish a list of their standard charges on the internet. What is CCH doing to prepare for CMS' price transparency change?
YR: We're going to put the aspects of our chargemaseter online hopefully in a fashion that makes sense to an average community member. The other thing we're looking at is a specific vendor that provides a price estimator tool that we can put on our website that will help patients. The thing I like about this particular one is it will link to their insurance, so if they have deductibles they can put in their information and the system will check how much they have left on their deductibles so they can get a really pretty good idea of how much the service will cost them.
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