This project took place at a newly merged CBO for 3 large medical centers. All the Patient Financial Services staff had recently moved into a new location. They were using 3 different AR/ADT systems, and the largest medical center was still fine-tuning their system after a recent computer conversion. The three groups of staff each followed a unique set of procedures and were adjusting to becoming a new team. Receivables were climbing, and compounding the issue, the Patient Accounts Director position was vacant.
Masters Associates Main Objectives:
- Audit accounts for each payer group to determine efficacy of current follow-up procedures.
- Review data flow throughout the accounts receivable system
- Develop parameters for the automated follow-up worklists
Masters Associates was asked to look at several processes, however, the initial task was to perform an analysis of the current account follow-up practices. Working with staff and management as a team, Masters Associates' consultants were to help them redefine the follow-up process. The audits revealed that accounts were sitting for months with no follow-up activity. In addition, a backlog in unbilled Medicare accounts was discovered. Masters Associates found a system glitch that prevented statements from being produced on 16,000 accounts in the amount of $6,000,000. In addition, the automated transfer of balances was not working for all payers. To resolve these issues, Masters Associates established a ‘team' of Billing and Follow-up staff, as well as Cash Posting, Systems Analysts, and IT personnel.
The team defined processes were used as a springboard to re-write system logic. Each collector now had an automated work-list that displayed only the accounts that needed to be worked that day. No more wasted time looking at accounts that didn't require attention. The Medicare backlog of 2,368 accounts for $1,005,627 was billed. Using a workplan with defined timelines, corrections were made to allow a ‘phased' production of statements. Working with the team, Masters Associates developed new policies and procedures addressing account follow-up and quality assurance