Two revenue cycle leaders recently told Becker's about a change they made in the past two years that yielded better results.
Paul LePage, executive director for revenue cycle operations at Banner Health said the Phoenix-based system has shifted its denials management strategy to include denials mitigation.
"It is no secret that denials are at the forefront of administrative burden for health systems due to regulatory changes, payer guidelines and behavior, and unoptimized internal processes," Mr. LePage said.
Banner has always focused on denials managed but shifting to include denials mitigation in their overall strategy and identifying clear owners of denial categories "allowed us to align our subject matter experts with the denials that they could provide the most benefit in reducing and affecting the most change."
That shift has resulted in "drastic improvements" in Banner's write-off numbers because of more robust workflows and a decrease in denials, specifically in medical necessity, Mr. LePage said. It has also led to increases in cash collections and better relationships with payers.
Stacey Benson, director of revenue cycle operations at Houston Methodist Physician Organization, said she has historically been close-minded about outsourcing accounts. She said she is a firm believer in leveraging the internal team, system and resources.
"However, I realized that worker’s compensation accounts are more complex than our internal team could manage," she said. "Due to this change in mindset, we took the leap and outsourced our worker’s comp accounts to a vendor that specializes solely in these claims."
The change has given her team more time to work on accounts within their area of expertise while the vendor uses its experience and relationship to get the organization's worker's comp claims worked in a timely manner.
"I still believe in leveraging internal systems first, but I also realize that we can’t do it all in our complex billing world, and it’s a true win to recognize where you need help and then find it," she said.
Mr. LePage and Ms. Benson are speaking at Becker's 9th Annual Health IT + Digital Health + RCM Meeting: The Future of Business and Clinical Technologies which will take place Oct. 1-4, 2024, at the Hyatt Regency in Chicago.
If you would like to join this event as a speaker, contact Randi Haseman at rhaseman@beckershealthcare.com.
Read more responses from finance and health IT leaders here.