Hayes Management Consulting recently performed a revenue cycle assessment for a large physician practice consisting of a medical center and several specialty clinics. Consultants analyzed the current performance of operations and information technology in addition to assessing staffing and accounts receivable.

Over the course of three days, using Hayes’ MDapproach™ assessment methodology, the team reviewed the workflow, processes, and policies of the central business office (CBO), and interviewed CBO management team, staff and front desk staff at each of the clinics.

The staffing analysis showed that the CBO was not adequately staffed, and managers were performing multiple roles. To improve revenue cycle, the CBO would need more managerial, operational and analytical support. The IT assessment revealed capabilities within the CBO’s practice management system that if implemented, would help organize and manage workflow. The accounts receivable assessment determined that there were significant revenue opportunities.

The client requested that Hayes serve as Interim Director of the CBO to implement recommendations and assist in the recruitment of a new Director. During the ten-month engagement, Hayes:

• Created new roles and either hired new staff or trained existing staff to fill these roles
• Reviewed and managed denials, uncovering more than $100K per month
• Negotiated with 3rd party payers to collect underpayments
• Worked directly with clinics to help them meet their customer service and cash collection goals
• Developed feedback reports on denials for individual clinic locations
• Screened, interviewed and hired a new CBO Director

With minimal turnover, Hayes was able to thoroughly restructure the CBO. Staff satisfaction increased. Collections were dramatically improved through a combination of reduced bad debt write offs, reduced denials, successfully appealed underpayment claims, better collection of deductibles at clinics, and the implementation of a self-pay collection unit. By the time Hayes turned the operations over to the new CBO Director:

• Revenue cycle improvements had increased gross collections by three percentage points resulting in $3M annually.
• A new denial management strategy raised gross collections three percentage points over four months.
• New department and company policies and procedures were developed with strict rules regarding who was authorized to make adjustments. The document was created with buy-in from all involved, and used as a reference in daily operations.
• Senior staff had greater confidence in the CBO.

In the transition of leadership to the new CBO Director, Hayes ensured the role was positioned for authority and success. The revenue cycle improvements formed a foundation from which improved collections would only increase over time, directly affecting the revenue and viability of the client’s business.

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