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Tip: Revenue cycle communication strategies

Patient Financial Services Weekly Advisor, May 14, 2004

The biggest challenge in overseeing an effective revenue-cycle team is getting people to communicate and to share responsibilities and processes.

People are often caught up in their own departmental issues and forget there is a bigger picture. Members of the team must look at the cycle of revenue produced by their facility if they want to continue to do business in an efficient and cost-effective manner.

There's a saying, "It takes a village to raise a child." Similarly, it takes a revenue-cycle team to get a clean claim out the door, thus increasing the fiscal well being of an organization's bottom line.

Most departments assume they are doing great, by just keeping up with their responsibilities concerning A/R issues and patient care. But in reality, they may have processes in place that are affecting another department's ability to function to its full potential.

For instance, a software vendor may approach the laboratory services department with the latest and greatest program to assist its issues concerning medical necessity, and convinces the director the program will save time and money and reduce the need for experienced front-end folks. After the sale, lab services may find that what was thought to be great software isn't compatible with the PFS claim-scrubber programs because of insufficient or incorrect program files written into the program.

It's these types of unforeseen technicalities that someone may have forgotten to ask about within the lab department. But if you involve the entire revenue-cycle team, these types of outcomes are less likely.

To stay in the loop and convey the importance of communication, here are a few ideas:

1. Be proactive with your directors and managers. Acknowledge how busy schedules are, but reinforce the necessity of meetings. Team-building exercises help get everyone involved and interested.

2. Make it a policy that you attend every departmental meeting that could affect a claim going out the door, whether it's for a software purchase or process change. Don't be afraid to pound on the desks of your CEO, CFO, and board members-it's better to be proactive than to skim help-wanted ads.

3. Be open to new ideas. As Albert Einstein said, "We can't solve problems by using the same kind of thinking we used when we created them." If you have a problem and the flow or process stays the same, you get the same problem.

4. Give people reference points. Don't go in to state a case without a hard copy of supporting documentation. Go to meetings armed with Medicare Program Memorandums, Web site addresses, or policies from a third-party payer that convey new rules or requirements. You're going to have to sell what you're trying to tell them. Know your stuff, and share the knowledge. Knowledge is power, so empower your organization to excel by assisting its fiscal stability.

Synthia Miller, CCS, has been involved in health information for more than 15 years, and is currently a corporate compliance analyst for Banner Health in Phoenix.

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