Revenue Cycle Management

Revenue Cycle Management Feature Story

Scripps Tackles RAC Challenges

Among the lessons learned in pilot project is the need for comprehensive revenue-cycle management systems and processes.

San Diego County’s Scripps Health (Scripps) was one of many health systems across three states taking part in a three-year recovery audit contractor (RAC) pilot project. "Scripps had a number of challenges at the start of the process," says David Cohn, vice president, revenue cycle, for Scripps.

 

Charge Capture: Case Study

While the Kentucky Medical Services Foundation was successful in converting users to the new platform, there were surprises along the way.

Two systems, six years and almost 300 users ago, the Kentucky Medical Services Foundation (KMSF) investigated whether or not automated charge-capture technology was a viable solution for its physicians. KMSF, a provider of billing and other administrative services for the more than 700 providers who deliver care across more than 80 sub-specialty areas, had little familiarity with the technology. Interested in its potential, KMSF initiated a pilot study, engaging a small group of physicians to determine if this type of mobile computing would add value to the charge-capture process.

 

Software Verifies Reimbursement Accuracy

Contract-management system helps centralized billing office recover $2.7 million in contractual underpayments.

When the UCLA Faculty Practice Group (FPG), Los Angeles, began centralizing its billing and collections operations several years ago, it identified a range of measures to pursue in order to take advantage of the restructuring. The physician billing office of UCLA FPG, responsible for billing for 1,300 providers at four hospitals and 65 clinics, first decided to centralize billing for most of its departments.

"We wanted to enhance our efficiency and also improve our financial position," says Anton Loman, director of quality development at UCLA FPG. "One of the initiatives that resulted from the centralization was to transition to a system for validating reimbursement and managing our payers’ performance against contract terms."

   

Revving Up Revenue

Investment in process redesign and claims management technology leads to financial success for a growing physician practice.

Olive Branch Family Medical Center was a paperless practice almost as soon as it opened in August 2003. A spin-off from a larger medical group, its practice management (PM) system was in place from day one, followed by an integrated electronic medical record (EMR) several months later.

 

The Road to Effective RCM

Drawing on the expertise from multiple departments, this regional healthcare provider develops a top-notch revenue cycle team.

Pittsburgh’s St. Clair Hospital (SCH), a 329-bed general and acute care facility, serves 300,000 residents across 21 communities in western Pennsylvania. Despite being a recognized health information technology leader for more than a decade, like most hospitals, SCH continues to face a never-ending challenge to streamline workflows, reduce A/R days and maximize collections while still providing the best care and customer service to our patients.

   

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