Business process re-engineering is a management approach that is based on completely rethinking how processes and workflows are configured rather than making minor adjustments to existing processes. One key tenet of re-engineering is that to make dramatic improvements in results, sometimes you need to completely rethink how work is done.
We believe that there are many new tools available to manage A/R follow up that may not have been available to radiation oncology practices as recently as several years ago. These tools can fundamentally improve A/R follow up results, but implementing them can require a complete rethinking of the business processes.
- Identify and Eliminate Bottlenecks: Often the first step in A/R follow up is a call to the health insurer to obtain information on claims status. And the start of every call is probably an integrated voice response (IVR) system that your A/R specialist must navigate to reach the correct claims representative at the insurance company. For the insurance companies, these IVR and interactive web response (IWR) systems are technologies that save them time by allowing a computer to detect voice and/or keypad inputs or gather data through a web-based system. However, from the providers perspective, the wait times and navigating multiple levels of IVR requirements can consume a tremendous amount of unproductive time. Health care providers can fight fire with fire by implementing certain unified communication solutions and automating ways to interact with insurers while facilitating a smooth transition to connect your A/R staff to the resource they need. These technologies provide automated navigation options to reduce unnecessary transfer and wait time. Similar technologies exist for navigating the insurance company websites that provide information on the status of a claim. Providers can now integrate web technology into the A/R process that retrieves this information without requiring valuable time and attention from your staff. Without such technologies you’re left with asking your A/R staff to multitask and perform other duties while they’re on-hold or navigating voice response. Multitasking can not only lead to further errors and inefficiencies, but it also creates a stressful environment for your staff if they spend a significant part of their day focused on unproductive activities.
- Redesign Work Queues to Maximize Results. Typically, health care providers A/R follow up staff are assigned to work queues, but these work queues are static and more focused on making sure that your representatives are working all accounts rather than prioritizing the accounts that are most likely to result in expedited payment. Using the technology above, providers can redesign work queues so that they’re not general queues requiring your staff to determine next steps. Rather, they’re very specific queues with a predefined tasks for which your representative is well trained. By using analytics to determine the timing and amounts of claims normally paid, you can dramatically increase productivity, reduce days in A/R, and increase cash recoveries.
The first step in any re-engineering effort is to assemble the right team. Rethinking the entire A/R process might take not only the practice manager, but also an information technology representative, A/R follow up representatives, and possibly outside vendors or consultants that can educate your practice on the latest technologies. Creating efficient radiation oncology billing services and A/R follow up processes can take a significant amount of work, but as payers continue to consolidate and cut costs, the investment become increasingly necessary. Consider applying re-engineering or management techniques like Six Sigma to remain efficient in a rapidly changing environment.