Ah, yes, it’s that time of year – time to make those New Year’s resolutions. Exercise, diet, vacations, revisit the old “bucket list”, maybe even finances. Finances? Now a financially-focused resolution or two should resonate with any AR Manager. Maybe we can help you kick off 2016 right with some helpful resolution hints. They may not be earth-shaking taken independently, but together, they can certainly have a positive impact for you and your team.
Resolution #1 - Make sure that pre-admissions screening covers all the financial bases before the admission. This may sound overly simplified, but it is so essential with numerous moving parts. It is a time not only to be informed, but to inform not just once, but regularly after the admission.
- To be informed – All members of the admissions team must know who the payer is and the proper billing procedure - how much, how long, and for what services. Not only immediately after admission, but should the length of stay outlast such coverage as Medicare or private insurance, the team, the family, and resident must know who will pay. You might say that you want to make sure all your “bucks” are in a row.
- To inform – This is something that some providers forget to proactively pay attention to and communicate. Communicate to whom? The rest of the team, the party (private or third party) who will be paying the bill, and the family. Providers need to keep in mind that placing a loved one in a facility is traumatic and unavoidably new. Prior to and on admission, family members/responsible parties encounter so much information. Your team needs to compassionately and frequently remind them of expectations and their loved one’s status. Changing from one payer to another should never be a surprise. Fostering a positive relationship with responsible parties throughout each resident’s stay will pay big dividends in the long run.
Resolution #2 - Make sure the census is correct, up to date, and entered correctly in the billing software. Whether your facility or facilities are still laboring under a manual census tracking and recording process or you are enjoying the benefits of electronic charting, knowing who is in what bed each midnight is critical. Even electronic charting still requires the personal touch, that is, someone has to make the rounds to confirm the beds are occupied, on hold, or vacant.
Resolution #3 - Make sure to conduct a triple check before submitting any bills or claims. We are not going to elaborate on the triple check process at this time, but stay tuned for helpful tips in future blogs.
Resolution #4 – Stay informed by attending seminars and webinars. Medicare, Medicaid, Bundled Payments, ACOs, VA, etc. are changing and unless you and your team are informed about what has changed or is about to change, you may be a day late and a dollar short. State and Federal agencies, your state and national trade associations, industry media publishers, and others conduct education sessions throughout the year to help you effectively manage the revenue cycle. Plan on attending as many of these as possible.
Resolution #5 - ICD10 training and updates. Although you and your team are usually not the initial coders, you still have to be ICD10 savvy. The key here is specificity – the highest level of specificity. You have our permission to review those codes and if you are uncertain about the codes specificity, push back on admission and during the triple check. At primeCLAIMS, we have seen many claims rejections since the ICD10 implementation due to a lack of specificity.
Resolution #6 – Stay on top of your Days Sales Outstanding (DSO). Discuss DSO with your team and set goals to reduce it to an acceptable level – ideally around 30 days. However, realistically identify what is in your control. For example, Medicaid in some states pay much later than others. Consider that carefully, set goals thoughtfully, and collect aggressively.
Making and successfully achieving resolutions specific to your department’s and business’s needs can make 2016 truly a Happy New Year at least financially.
It just make cents.