ACTUAL FINDINGS

HOSPITALS ACROSS THE

STATE……WHAT IS HAPPENING?

DO YOU REALLY KNOW???? UPFRONT COLLECTIONS? BILL HOLD/ERROR? SECONDARY CLAIMS? RTP REPORTS? BILLERS REAL KNOWLEDGE? CONTRACTS? HOW TO READ YOUR AR SUMMARY AND

DETAILS?

ACTUAL FINDINGS ARE YOU REALLY GETTING THE REAL

TRUTH FROM YOUR STAFF? WHAT IS LOST IN THE BLACK HOLE? WHAT DO WE DO NOW? WHY DID WE GET HERE? HOW DO WE GET OUT OF HERE?

FINDINGS:NO UPFRONT CASH COLLECTIONS $0.00 TO $1200.00 MONTHLY WE DON’T KNOW HOW TO ASK FOR

MONEY OUR BOARD WILL NOT LET US ASK FOR

MONEY OUR PATIENTS WILL GO TO ANOTHER

HOSPITAL OUR PHYSICIANS GET MAD WHEN WE

ASK OUR PATIENTS FOR MONEY

UPFRONT COLLECTIONSHOW DO WE START? EDUCATE PATIENTS/COMMUNITY EDUCATE BOARD EDUCATE PHYSICIANS EDUCATE EMPLOYEES NOT AN OPTION TO COLLECT EVEN COLLECTED ON OLD BILLS FROM $0.00 TO $64,000.00

WHAT UPFRONT COLLECTIONSCAN DO FOR YOU REDUCE BAD DEBT REDUCE AR DAYS INCREASE CASH FLOW REDUCE THE COST OF DOING

BUSINESS ON THE BACK END

FINDINGS:BILL HOLD/ERROR 60 BED HOSPITAL APPROXIAMATELY 1500 OUTPATIENTS

MONTHLY APPROXIAMATELY 450 ER VISITS APPROXIAMATELY 80 ADMISSIONS A

MONTH STAFF RUNNING REPORT FOR CFO AND

“TWEEKING” THE REPORT BEFORE SENDING IT TO THE CFO

FINDINGS:BILL HOLD/ERROR

BILL HOLD FOR DIAGNOSIS NOT COMPLETE

BILL ON HOLD FOR “COMPUTER” ISSUES

BILL HOLD FOR CLAIMS ON HOLD FOR ERRORS

NO PRECERT ON CLAIM, OR EVER OBTAINED

FINDINGS:BILL HOLD/ERROR MORE THAN $2,000,000.00 SOME CLAIMS ON LIST WERE OVER 1

YEAR OLD CLAIMS ON HOLD FOR “OTHER

DEPARTMENT” INFORMATION

HOW TO CORRECT:BILL HOLD/ERROR WEEKLY STAFF MEETINGS GOAL SETTING PHYSICAN EDUCATION BILLING EDUCATION IDENTIFY AND CORRECT “COMPUTER”

PROBLEMS TRAINING DEFINING WHO GETS AND WHEN TO

GET A PRECERT

FINDINGS:SECONDARY CLAIMS NOT FILED OVER 650 MEDICAID CROSSOVERS NOT

PAID COMPUTER ISSUES DID NOT KNOW HOW TO FILE A

SECONDARY CLAIM

HOW TO CORRECT:SECONDARY CLAIMS DESIGN A PROCESS MONITOR SECONDARY CLAIMS EDUCATION FOR STAFF CORRECTION OF COMPUTER PROBLEMS

FINDINGS:BILLERS KNOWLEDGE DID NOT KNOW THE DIFFERENCE

BETWEEN AN INPATIENT CLAIM AND AN OUTPATIENT CLAIM

DID KNOW WHAT A CONTRACT WAS OR WERE THEY WERE LOCATED

DID NOT KNOW WHAT THEY WERE SUPPOSED TO BE PAID ON A CLAIM

LIMITED KNOWLEDGE OF THE COMPUTER SYSTEM

FINDINGS:BILLERS KNOWLEDGE LIMITED ACCESS TO WHAT THEY REALLY

NEED IN THE COMPUTER SYSTEM LIMITED OR NO UNDERSTANDING OF

HCPC’S OR CPT’S LIMITED OR NO UNDERSTANDING OF

MODIFIERS DID NOT EVEN KNOW WHAT AN APPEAL

WAS

FINDINGS:BILLERS KNOWLEDGE LIMITED ACCESS TO THE INTERNET NO EDUCATION NO TRAINING

WHAT IS THE ANSWER??THE BILLERS KNOWLEDGE

WE SPEND ALL THE TIME WE CAN GENERATING REVENUE FOR OUR HOSPITAL

WE SPEND COUNTLESS $ ON COMPUTER SYSTEMS TO CAPTURE ALL THE INFORMATION WE CAN

WE SPEND COUNTLESS $ RECRUITING PHYSICIANS

WHATS THE ANSWER??THE BILLERS KNOWLEDGE WE SPEND LITTLE ON NO $ ON

EDUCATING OUR BILLERS WE HIRE AN EMPLOYEE BECAUSE THEY

CAN USE EXCEL OR WORD WE “PROMOTE” THEM BECAUSE THEY

WERE NEXT IN LINE

WHATS THE ANSWER??THE BILLERS KNOWLEDGEWHAT IS REALLY THE ANSWER?

EDUCATIONCONTINUING EDUCATION

TRAININGMORE TRAINING

YOU GET WHAT YOU PAY FOR

EDUCATION AND TRAINING

WHAT DO WE DO? EDUCATE YOUR STAFF EDUCATE YOUR “CUSTOMERS” GIVE YOUR STAFF THE TOOLS THEY

NEED MEET WITH YOUR STAFF EVALUATE YOUR STAFF LEARN TO RUN AND READ YOUR

REPORTS IF YOU CAN’T “TRUST” A MEMBER ON

YOUR “TEAM”, THEY USUALLY AREN’T A MEMBER OF YOUR “TEAM”.