Todd Mallon, Advocare’s CFO, says the organization has a near-perfect net collection ratio.
Improving net collection rates and overall revenue cycle management processes is a focus for revenue cycle leaders, and adding new solutions and automation to streamline these operations has been essential for many organizations.
Todd Mallon, its CFO To pleadone of Pennsylvania and New Jersey’s largest physician-owned and physician-managed multispecialty medical organizations recently spoke with HealthLeaders about implementing new technology to streamline the health system’s revenue cycle management functions.
With more than 650 providers and 3,000 staff in more than 150 independent care centers facilitating about two million patient visits annually, Mallon said it was essential to simplify its revenue cycle.
Since implementing new technology from eClinicalWorks to assist with its revenue cycle management functions, Advocare now has a 99% net collection ratio. With the industry standard ratio for net collections at 95%, Advocare is now operating well above average and is experiencing the positive effects of this change across all of its care centers.
“I spend a lot less time discussing processes and denials with our accounts receivable teams. We now have the space and flexibility to focus on expanding our operations and meeting the needs of more patients in our community,” says Mallon.
HealthLeaders: What kinds of problems were you seeing in your revenue cycle that made you realize you needed to implement a change? Who was your main driver?
Todd Mallon: Our net collection ratio was the strongest indicator we needed to transform our revenue cycle management solution. The net collection ratio measures how effectively our practice collects reimbursement for services from patients and payers. This metric has always been a leading identifier of financial success in healthcare organizations.
However, the net collection ratio has been continuously falling under the previous practice management system. I felt like I spent most of my time at each financial review meeting discussing accounts receivable, denials, and current processes to get to the heart of this issue. This meant our teams were spending most of their time fixing day-to-day operations, which limited our ability to grow and provide high-quality care to more patients. So our main driver for changing our revenue cycle management was to equip our finance and accounts receivable teams with the support and resources they needed to improve our net collection rate.
HealthLeaders: What was the process of implementing the new technology and who was involved in the decision making in your organization?
Mallon: Everyone on our leadership team supported the decision-making process. Between our CEO—who provides a medical perspective, the management team and myself—who provide the financial and operational perspective, and our task force—consisting of many physician leaders across our specialties, we wanted all stakeholders to be represented in decision-making edit, process.
Leading up to implementation, we had several meetings with our supplier to define specific goals, metrics and deliverables to improve our net collection ratio. Once we were aligned with the basic workflow and back-end functions, the next step was training. The system was new to everyone—from the CEO to the providers and management staff—so we needed a lot of support to train our people. Without proper training, we were unlikely to see our net collection ratio improve.
Before the launch, a select group of our staff went to Boston for a full overview and training of the new system. Three months before launch, our vendor team trained our providers to feel confident with the system. We also provided pre-launch training courses to the rest of our staff. However, even after the training, the team was available for a quick phone call or chat to answer questions or address a potential problem with the system or workflow.
HealthLeaders: How long did it take for your organization to fully implement the technology and how did the implementation work since your practice spans so many clinics?
Mallon: Getting the system off the ground was challenging and we could not have implemented the technology smoothly without the vendor’s support. We introduced the new solution to all 150 health centers in one day. We went all the way from scratch and had to start strong.
We had eClinicalWorks trainers at each care center for approximately one to two weeks after launch to assist with the transition process and train additional Advocare staff. During the implementation, we trained the internal staff as responsible for the solution so that they could continue further implementation and staff training.
HealthLeaders: Since the implementation, what positive results have you noticed?
Mallon: The most notable positive effect is the increased net collection ratio. Many things contributed to this increase.
First, we now have a dedicated eClinicalWorks team that handles our day-to-day collections and follow-up to ensure we receive claims in a timely manner. To create an efficient workflow, our team helped create billing-ready rules to ensure care centers complete reports accurately. We can create alerts for missing information or incomplete claims. In addition to these workflow rules, our team notifies us of any issues, which gives us plenty of time to gather additional information from providers or communicate next steps with payers.
Second, our vendor team also handles denial appeals for our care centers. So if a denial comes back for a claim from a particular center that needs to be addressed or changed, they will help that center file an appeal and track the progress of the claim in our system. Once we receive payments, they handle the cash receipts and post them internally so we can track our income in real time.
HealthLeaders: What are some keys to success that you could share with another organization looking to do the same for their facilities?
Mallon: The first key to success that I will share with other organizations looking to improve their revenue cycle is to know where you are right now. Know your net collection ratio and how many days your accounts receivable are outstanding. Once you have a baseline, you can set goals and implement strategies to improve workflows and increase collections. And once you have those metrics, track them and update them regularly. We have regular meetings with our team to discuss our current metrics, compare them to our revenue and collection goals, and adjust our workflow and operations as needed. Everything needs to be measurable to be successful, especially in the revenue cycle.
Second, train your team on the new technology. Especially for multi-site healthcare operations, it is imperative to have people in each care center who can monitor the success of the solution and train new staff as needed. Now every care center is working at its best. It is also easier to open new care centers because we have a unified system.
Finally, choose a health IT vendor that listens and learns from your organization. Open communication between a health IT vendor and a practice customer can benefit both parties. For example, based on our experience with their technology and conversations between our staff and the eClinicalWorks team, they came up with a bulk lock button that would lock multiple charts at once to minimize clicks and improve billing efficiency. The most valuable part of our partnerships is open communication. We are willing to learn from them, and they are willing to learn from us. Because of this open communication, our providers and staff leverage more efficient workflows and our net collections have increased. Through them, we are also exposed to new opportunities to improve health IT solutions.
In the end, patients get a better experience and everyone wins.
Amanda Norris is the revenue cycle editor for HealthLeaders.