In this episode, Randi Deckard, Director of Client Relations at BESLER, shares perspectives from a recent HFMA roundtable that examined how hospitals optimize their revenue integrity efforts.
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Mike Passanante: Hi, this is Mike Passanante. And welcome back to the Hospital Finance Podcast.
Today, I’m joined by Randi Deckard who is the Director of Client Relations here at BESLER. And if you’re an HFMA (Healthcare Financial Management Association) member, and you get the magazine each month, you’ll notice that in the September issue, BESLER participated in a roundtable discussion entitled Optimizing the Revenue Integrity Function. And Randi has joined us on the program today just to talk a little bit about some of the reactions of the other participants and the perspectives that they had.
Randi, welcome to the program.
Randi Deckard: Thank you, Mike.
Mike: So Randi, the roundtable included participants who are working in hospital financial functions at various institutions across the country. And we were proud to be part of that roundtable. And we really got to see how different institutions approach revenue integrity.
So, why don’t we jump right in and talk about some of the questions that were posed to the roundtable participants. And the first one was: “What components make your organization’s revenue integrity program? What are the top two or three areas that are the highest priority for your team?” And as you can imagine, the answers were kind of diverse. What did you find there?
Randi: So, when I read this, I thought it was very interesting that it seems like the size of the organization and the amount of resources that they were able to utilize in their system impacted what they have for revenue integrity services. It could be chargemaster-focused, charge capture, auditing, and the ones that had more resources included training, quality reviews, and audits. And those are the ones had, like I said, more resources to throw at revenue integrity.
Mike: And that’s kind of what you see in the revenue integrity environment right now. It’s sort of a mixed bag. It dovetails nicely with the next question that the group was asked and that’s: “Do you have a dedicated revenue integrity department or staff position?” And of course, the answer to that question is probably even more diverse than the answer to the first question.
Randi: This is one of the things I found very interesting about the results. There were some organizations that had a centralized program. Another responder, they actually use analysts that worked with the different service lines. Another hospital is focused on certain projects. And the reason they focus on projects is that if one project is maybe stuck, they can use those analysts in another project, which I thought was a very interesting approach. And then, some even use outside vendors to partner with and review as part of audit, quality, and training, looking for opportunities.
Mike: And it goes without saying, the challenges are different at each institution depending upon how they’re structured, how their teams are structured, maybe even their geographic region, and the challenges that are in that specific area.
And so, the roundtable was asked: “What are some of the challenges you face?” Could you tell us a little bit about that?
Randi: It seems like staffing is a very common challenge. It doesn’t matter what size of your organization. They brought up training, making sure that you invest in an analyst or someone to really understand the function and how it’s performed and the process. But there seems to be some turnover in having this unique skill set. It poses a problem for a lot of facilities.
And then, it’s just the knowledge base, keeping up with state and federal regulations, knowing your commercial contract terms. There are just a lot of rules for compliance, and then processes that need to be kept up. So it’s a challenge.
Mike: And of course, no roundtable would be complete without a lessons learned question. And we heard from the group on that as well. What did you find unique about some of the responses to that question?
Randi: I think the methodical approach is important. You have to show that you’re adding value. I thought it was interesting that some of the responses indicated making sure you have a trackable metric and actually tying a dollar amount so you can show the department is adding value, I think that in some of the hospitals, because a lot of this is very process-orientated, a lot of data, people really want to know how is this impacting the bottom line.
Mike: Indeed! And if you’re interested in reading through all of the responses for this roundtable, just visit our website at besler.com and go to the blog section. You’ll find this particular post there along with all of the show notes and resources associated with it. And we’ll link directly to the roundtable of course.
If you’re an HFMA member, and you get HFMA Magazine each month, you’ll find the supplement in there right within the September issue for 2017.
Finally, I’ll also mention that you may have deduced that BESLER has a service around revenue integrity that can boost what you’re doing, whether you have an existing revenue integrity team or not. And if you want to find out more about that service, please visit besler.com/RI. We have a video there you can watch. That will give you an overview of what we do.
Or if you’d like to contact us directly, feel free to drop Randi a line at firstname.lastname@example.org. And she’ll be happy to connect you with the right individual here at Besler.
Randi, thanks so much for joining us on the program today.
Randi: Thank you for having me, Mike.