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HOSPITALS ACROSS THE STATE……WHAT IS HAPPENING?.  UPFRONT COLLECTIONS?  BILL HOLD/ERROR?  SECONDARY CLAIMS?  RTP REPORTS?  BILLERS REAL KNOWLEDGE?

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Presentation on theme: "HOSPITALS ACROSS THE STATE……WHAT IS HAPPENING?.  UPFRONT COLLECTIONS?  BILL HOLD/ERROR?  SECONDARY CLAIMS?  RTP REPORTS?  BILLERS REAL KNOWLEDGE?"— Presentation transcript:

1 HOSPITALS ACROSS THE STATE……WHAT IS HAPPENING?

2  UPFRONT COLLECTIONS?  BILL HOLD/ERROR?  SECONDARY CLAIMS?  RTP REPORTS?  BILLERS REAL KNOWLEDGE?  CONTRACTS?  HOW TO READ YOUR AR SUMMARY AND DETAILS?

3  ARE YOU REALLY GETTING THE REAL TRUTH FROM YOUR STAFF?  WHAT IS LOST IN THE BLACK HOLE?  WHAT DO WE DO NOW?  WHY DID WE GET HERE?  HOW DO WE GET OUT OF HERE?

4  $0.00 TO $1200.00 MONTHLY  WE DON’T KNOW HOW TO ASK FOR MONEY  OUR BOARD WILL NOT LET US ASK FOR MONEY  OUR PATIENTS WILL GO TO ANOTHER HOSPITAL  OUR PHYSICIANS GET MAD WHEN WE ASK OUR PATIENTS FOR MONEY

5  EDUCATE PATIENTS/COMMUNITY  EDUCATE BOARD  EDUCATE PHYSICIANS  EDUCATE EMPLOYEES  NOT AN OPTION TO COLLECT  EVEN COLLECTED ON OLD BILLS  FROM $0.00 TO $64,000.00

6  REDUCE BAD DEBT  REDUCE AR DAYS  INCREASE CASH FLOW  REDUCE THE COST OF DOING BUSINESS ON THE BACK END

7  60 BED HOSPITAL  APPROXIAMATELY 1500 OUTPATIENTS MONTHLY  APPROXIAMATELY 450 ER VISITS  APPROXIAMATELY 80 ADMISSIONS A MONTH  STAFF RUNNING REPORT FOR CFO AND “TWEEKING” THE REPORT BEFORE SENDING IT TO THE CFO

8  BILL HOLD FOR DIAGNOSIS NOT COMPLETE  BILL ON HOLD FOR “COMPUTER” ISSUES  BILL HOLD FOR CLAIMS ON HOLD FOR ERRORS  NO PRECERT ON CLAIM, OR EVER OBTAINED

9  MORE THAN $2,000,000.00  SOME CLAIMS ON LIST WERE OVER 1 YEAR OLD  CLAIMS ON HOLD FOR “OTHER DEPARTMENT” INFORMATION

10  WEEKLY STAFF MEETINGS  GOAL SETTING  PHYSICAN EDUCATION  BILLING EDUCATION  IDENTIFY AND CORRECT “COMPUTER” PROBLEMS  TRAINING  DEFINING WHO GETS AND WHEN TO GET A PRECERT

11  NOT FILED  OVER 650 MEDICAID CROSSOVERS NOT PAID  COMPUTER ISSUES  DID NOT KNOW HOW TO FILE A SECONDARY CLAIM

12  DESIGN A PROCESS  MONITOR SECONDARY CLAIMS  EDUCATION FOR STAFF  CORRECTION OF COMPUTER PROBLEMS

13  DID NOT KNOW THE DIFFERENCE BETWEEN AN INPATIENT CLAIM AND AN OUTPATIENT CLAIM  DID KNOW WHAT A CONTRACT WAS OR WERE THEY WERE LOCATED  DID NOT KNOW WHAT THEY WERE SUPPOSED TO BE PAID ON A CLAIM  LIMITED KNOWLEDGE OF THE COMPUTER SYSTEM

14  LIMITED ACCESS TO WHAT THEY REALLY NEED IN THE COMPUTER SYSTEM  LIMITED OR NO UNDERSTANDING OF HCPC’S OR CPT’S  LIMITED OR NO UNDERSTANDING OF MODIFIERS  DID NOT EVEN KNOW WHAT AN APPEAL WAS

15  LIMITED ACCESS TO THE INTERNET  NO EDUCATION  NO TRAINING

16  WE SPEND ALL THE TIME WE CAN GENERATING REVENUE FOR OUR HOSPITAL  WE SPEND COUNTLESS $ ON COMPUTER SYSTEMS TO CAPTURE ALL THE INFORMATION WE CAN  WE SPEND COUNTLESS $ RECRUITING PHYSICIANS

17  WE SPEND LITTLE ON NO $ ON EDUCATING OUR BILLERS  WE HIRE AN EMPLOYEE BECAUSE THEY CAN USE EXCEL OR WORD  WE “PROMOTE” THEM BECAUSE THEY WERE NEXT IN LINE

18 WHAT IS REALLY THE ANSWER? EDUCATION CONTINUING EDUCATION TRAINING MORE TRAINING YOU GET WHAT YOU PAY FOR EDUCATION AND TRAINING

19  EDUCATE YOUR STAFF  EDUCATE YOUR “CUSTOMERS”  GIVE YOUR STAFF THE TOOLS THEY NEED  MEET WITH YOUR STAFF  EVALUATE YOUR STAFF  LEARN TO RUN AND READ YOUR REPORTS  IF YOU CAN’T “TRUST” A MEMBER ON YOUR “TEAM”, THEY USUALLY AREN’T A MEMBER OF YOUR “TEAM”.


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