Hospitals and provider practices across the country are struggling with unprecedented staffing shortages. While the spotlight is on clinical and other frontline staff, revenue cycle staff is also in high demand. According to an article by Becker’s Hospital Review, “Front-end revenue cycle staff, back-office specialists, coders, accounts receivable, and denial management experts are all in short supply.”
In times when business offices are seeing higher turnover and staffing shortages, it can be challenging to maintain highly skilled resources to effectively manage A/R follow up. We’ve put together four tips for mitigating these challenges in order to achieve optimal reimbursement with fewer resources.
Shore up your SOPs
Some organizations are fortunate enough to have the ability to assign a single team member to manage each payer. But if one of those experts leaves, they take their knowledge with them. It can take months to bring a new business office employee up to speed. Just trying to understand each state’s unique regulations and keep up with a payer’s continually changing requirements can be a daunting task.
The best way to mitigate these challenges is to create a specific SOP (standard operating procedure) for each payer, as well as for more complex claims like worker’s compensation and motor vehicle accident, or secondary and tertiary claims. Having detailed procedures as a resource can help streamline A/R management and facilitate faster reimbursement.
Leverage A/R technology
Managing the daily inflow of claims, especially complex accounts, can be challenging during times of worker shortages when existing staff are already overwhelmed. Backlogs can quickly grow to become a cog in the entire A/R follow-up process.
The good news is that the right technology can help streamline and simplify claims management by classifying each account by type or payer using roles-based workflows. Configurable tools within the A/R technology support things like workflow pattern flexibility and task allocation. This eliminates the time-consuming process of manually assigning accounts or routing information. Account access can be controlled more easily, thereby enhancing efficiencies and increasing security.
The use of bots for automation is also extremely helpful. Bots can be deployed for rules-based tasks that are highly repetitive. For example, bots can be used to automate process steps in A/R follow-up work as well as eligibility verification, which can be both highly repetitive and time-consuming processes. Bots can also validate ERAs and post them in payer portals and can automate the appeals process to improve revenue reconciliation. Besides reducing errors, the use of bots gives staff more time to spend on more complex activities that require human judgement. Another benefit of bots when used by a service provider such as Omega Healthcare is that bots can be customized to meet the unique policies and guidelines of a client, helping streamline service delivery and ensuring adherence to each client’s specific processes.
When combined with artificial intelligence (AI), A/R technology can provide powerful insights that can help reduce revenue leakage, more effectively manage operations, and optimize revenue. Analytics tools like executive reports and dashboards help you monitor productivity in real time and provide actionable information around aging accounts, statuses, progress, and problematic trends. These analyses can then be used to identify and address upstream processes that lead to rejections and denials so they can be proactively addressed. This helps increase clean claim ratios and reduce denials and associated follow-ups and appeals, giving staff more time to focus on more strategic initiatives.
The best technology will also provide notifications and alerts for a variety of issues that could impact cashflow, giving you the ability to proactively address the issues before they hit your bottom line.
Rethink claims status processes
The way you manage claims status workflows has a direct impact on your ability to effectively manage A/R and collections. When staff is in short supply, it can be challenging to thoroughly work each claim. The end result can be unnecessary underpayments, delayed reimbursement or write-offs.
A more effective approach is one that includes multiple status avenues, including electronic, telephone, and paper. Admittedly, this can be time-consuming for staff, but failure to uncover all necessary information can result in delayed revenue and increased A/R days (DSO).
Most billing platforms don’t fully address the needs of A/R management, which is why so many teams who “do it themselves” must rely on multiple Excel files to track and manage their data. Compiling this data and analyzing it is a time-consuming, manual process that is prone to errors and doesn’t allow for real-time tracking. This, along with the fact that staffing shortages are likely to continue for some time to come, makes outsourcing a more attractive option.
Omega Healthcare is a great choice to consider as an A/R management partner. Our A/R management services team of specialists leverage our automation, bots, and analytics-driven technology to help providers lower DSO and bad-debt, automate cash posting, speed-up collections and dispute resolution, and improve staff productivity.
We work with each client to create specific SOP guidelines for each payer. Our team has vast expertise in secondary and tertiary claims, giving us the ability to quickly resolving older, more complex accounts, including worker’s compensation and motor vehicle accident claims.
Our team of more than 6,500 A/R representatives have a track record of proven success:
- 30% average reduction in total A/R days
- 25% average increase in collections
- We manage more than 341M claims and $10B in collections each year
The journey forward
The road to post-pandemic financial recovery is likely to be a long one. Hospitals and provider organizations cannot afford to settle for inefficient, manual A/R management processes. By partnering with revenue cycle management experts like Omega Healthcare, you’ll be able to spend less time and money recruiting and training new staff while reducing overhead, improving cashflow, and achieving more timely, accurate reimbursement.
 “To keep cash flowing in today’s tight labor market, revenue cycle leaders are using technology — 3 experts answer 3 Qs,” Becker’s Hospital Review, November 16th, 2021.