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Tip: Front-end process target areas to improve the revenue cycle, part 2

Patient Financial Services Weekly Advisor, May 20, 2005

Assessing front-end processes are integral to long-lasting change and improvement in your facility's revenue cycle, says Maria Hogarth, director of revenue cycle consulting at Integra Solutions.

Hogarth spoke during HFMA's Revenue Cycle Strategies Conference May 2 in New Orleans.

Processes relate to all aspects of the revenue cycle and help set all performance levels. You need to be sure all processes are documented, measured, and streamlined, limiting rework that causes headaches for the team.

Before drilling down into the front end, Hogarth recommends checking on the following processes, which can be used in every department:

• Reviewing existing policies and procedures
• Conducting staff interviews
• Observing work in progress
• Developing flow charts and identifying process steps
• Obtaining statistical data
• Auditing productivity, quality, and performance
• Auditing existing backlogs
• Auditing payer denials
• Auditing sampling of accounts activity for processing timeliness

When looking at front-end processes, there are several key focus points to examine:

Scheduling

• Number of same-day cancellations and no-shows
• Average number of days backlog
• Overall scheduling rate
• Percentage of registration errors
• Percentage of point-of-service collections

Preregistration/registration

• Number of same-day cancellations and no-shows
• Percentage of registration errors by type, payer, and employee
• Number of denials due to medical necessity
• Average patient wait times for all areas (inpatient, outpatient, ED)

Financial counseling

• Percentage of true self-pay bad debt write-offs
• Percentage of lost point-of-service collection opportunities per employee

Eligibility verification

• Number and amount of registration errors due to lack of eligibility verification by type, payer, and employee
• Number and amount of denials due to lack of precertification by type, payer, and employee

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