We recently talked to Emma about how revenue cycle management has evolved since she started her career and the challenges she sees facing her clients today. Here’s what she had to say:
Can you tell us your story? How did you get into revenue cycle management?
My healthcare career started in the 1990s. Starting in registration, I gained 14 years directing Patient Access and Patient Financial Service functions in various sized healthcare systems and physician practice networks.
Additionally, as a consultant, I managed numerous successful projects overseeing assorted aspects of revenue cycle assessments and process improvement implementations. I also served as featured speaker on various revenue cycle topics for AAHAM.
Tell us about HFS. What services do you offer? What sets you apart from other RCM providers?
Since 1998, HFS has been providing quality revenue cycle management services to large, prestigious medical groups, hospitals and healthcare systems. The foundation of HFS’ success is our ability to understand the needs of clients and adapt to the ever changing environment.
Our focus is and always will be in revenue cycle management. However, the definition of RCM is ever-changing and we have committed the resources to change with it. Our investment in a significant technology infrastructure enables us to understand the difference between traditional fee for service revenue cycle management and what is now becoming an alternate reimbursement model.
HFS’ goal is to become the “go to” resource not just for technology, but also in the consulting and outsourcing market. Enhancing our clients’ ability to manage cash flow effectively by way of our strategic methodology in combination with our technology and elite class of industry experts.
We are set apart from our competitors because we are adaptable to each client’s needs, our RCM solutions and methodologies have been proven and market tested to produce results. Our expertise and commitment to understanding the marketplace and the organization is major driving force producing maximum results for our clients.
How has the definition of revenue cycle management changed since HFS was founded?
It used to be that the focus for revenue and improvements were always on the back-end. In time coding/HIM and Patient Access became an important aspect of the process.
Today, operational expenses and expertise are limited in most organizations. They do not have the financial means to hire top level experts in their field because of the costs, and when they do, the employees ultimately lose their knowledge base or stop engaging in education because the organizations lose site of the bigger picture, which is that continued education is vital to the success of any organization.
What are some of the most common challenges facing your clients today in managing their revenue cycles?
Staffing is a huge component of the limitations, which is where HFS comes in to support the organizations. Talent pools are low in rural areas costing organizations an enormous amount of lost revenue.
What are the most common mistakes or oversight you see practices making with revenue cycle management?
Mismanagement of pended/rejected or no-response claims due to staffing limitations and/or knowledge base of the internal staff.
How has the Affordable Care Act affected your business?
Higher out-of-pockets for patients result in more patient responsibility. This in turn has affected the payer reimbursement of claims, which in turn has had some revenue impact for HFS.
How do you stay ahead of regulatory compliance, technology and CMS rules?
We ensure that we participate in all the forums and educational conferences and newsletters. We continuously send our employees to enhance their skills through classes, seminars, newsletter articles, etc. Whatever is available we make sure we are part of it.
What’s your competitive position against mega players like eClinicalWorks, AthenaHealth and McKesson?
We are a boutique firm that strategically analyzes each client individually. Clients are not just a number to us and we do not just work high dollar claims and/or easily reimbursable claims. We focus on the client’s needs and ensure performance of all outsourced projects. The larger firms offer lower rates, but do not focus on the client as an individual and therefore performance is generally impacted.
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