healthcaretechoutlook

Finding the Right Revenue Cycle System for Your Organization

By David Chou, CIO & CDO and Ashlee Teater, Sr. Director, Business Systems, Children's Mercy Hospital

David Chou, CIO & CDO and Ashlee Teater, Sr. Director, Business Systems, Children's Mercy Hospital

In the healthcare industry, the complexity of billing has grown substantially over recent years. Revenue Cycle system vendors have invested heavily to keep their technology relevant, continuing to focus on pushing clean claims (no touches) out the door to allow for quicker reimbursements and striving to make systems easy to use. Are you looking to make a change with your current system? Are there gaps that your current vendor cannot address? If you are considering moving to an integrated clinical and revenue cycle system, the advantages may seem obvious-one strategic vendor to manage for your core workflows, one overall application to manage and control hiring practices, and users are able to work out of one system. An integrated Revenue Cycle can offer many opportunities to work towards more efficient workflows across clinical and business teams. At the same time, there are also many challenges. Here are some considerations as you think through this organizational decision.

1. Understand and find key individuals that know your clinical workflows today in order to identify broad impacts and minimize surprises during implementation. An example of this is to look at where charges are dropped today and how those are triggered. As interfaces and such are removed, it is imperative to make sure these charges continue to drop.

2. Be prepared to do some Charge Description Master (CDM) clean up and analysis. Likely if you are moving from a disparate system now you will need to analyze and rebuild portions of the CDM.

"An integrated Revenue Cycle can offer many opportunities to work towards more efficient workflows across clinical and business teams"

3. Prepare your system transition plan early in the project. Understanding your cutover and legacy AR work down path is an integral planning component. Working back from that plan to make sure your interfaces are connected to the right places to continue billing out of legacy for a time will help mitigate risk for any attributable negative revenue events.

4. Make sure your clinical leaders are on board to support this implementation and are open to change. This support helps you in a community where you likely don’t have a large, regular presence. Work to be consistent in communicating early and often to begin educating and setting expectations.

5. Leverage the vendor’s partner relationships for bolt-on, specific solutions that surround your system. The vendor is likely developing their product with these in mind.

6. Last but not least, consider how strong your relationships are inside the Revenue Cycle department. Establishing a strong relationship with the business is critical as it allows for open communication throughout the vendor selection and implementation. Information systems works best when considered part of the department, not a department that simply supports systems.

To close, I will leave you with a thought, consider your relationship with all the business areas you support and think about if it is where it needs to be to manage change. I find with all current and former jobs, this is the key to quick success and a lasting partnership. Being connected to those departments who are undergoing transformations, particularly on the business side and demonstrating the ability to serve them as a reliable partner is one of the greatest accomplishments of all!