Todd Mallon, Advocare’s CFO, says the organization has a nearly perfect net collection ratio.
Improving net collection rates and overall revenue cycle management processes is top of mind for revenue cycle leaders, and adding new solutions and automation to improve those operations has been a must for many organizations.
Todd Mallon, CFO of To callone of Pennsylvania and New Jersey’s largest independently owned and physician-governed multi-specialty medical organizations recently spoke with HealthLeaders about implementing new technology to improve the system’s revenue cycle management operations health.
With over 650 providers and 3,000 staff in over 150 independent care centers facilitating approximately two million patient visits annually, Mallon said it was critical to streamline the revenue cycle.
Since implementing new technology from eClinicalWorks to assist with revenue cycle management operations, Advocare now has a 99% net collection ratio. Since the industry standard ratio for net collections is 95%, Advocare is now performing well above the average and is experiencing the positive effects of this change in all of its care centers.
“I spend far less time discussing processes and denials with our accounts receivable teams. We now have the space and flexibility to focus on expanding our operations and meeting the needs of more patients in our community,” says Mallon .
HealthLeaders: What kind of problems were you seeing in your revenue cycle that made you realize you needed to implement a change? What was your main driver?
Todd Mallon: Our net collection ratio was the strongest indicator we needed to change our revenue cycle management solution. The net collection ratio measures how effectively our practice collects reimbursement for services from patients and payers. This metric has always been a key identifier of financial success in healthcare organizations.
However, our net collection ratio was constantly falling with our previous practice management system. I felt like I spent most of my time in every financial review meeting discussing accounts receivable, denials, and actual processes to get to the bottom of this issue. This meant our teams were spending most of their time managing day-to-day operations, which limited our ability to grow and deliver high-quality care to more patients. So our main driver for changing our revenue cycle management was to equip our finance and accounts receivable teams with the support and resources they needed to improve our net collections ratio.
HealthLeaders: What was the process of implementing the new technology and who was involved in the decision making in your organization?
I miss you: Everyone in our management team supported the decision-making process. Between our CEO – who provides a medical perspective, the admin team and myself – who provide the financial and operational perspective, and our task force – comprised of multiple physician leaders across our specialties, we wanted everyone to interested parties to be represented in the decision-making process.
Prior to implementation, we had several meetings with our vendor to define specific goals, metrics, and outcomes to improve our net collection ratio. After we lined up the basic workflow and final operations, the next step was training. The system was new to everyone – from our CEO to providers to management staff – so we needed a lot of support to train our people. Without proper training, we were unlikely to see our net collection ratio improve.
Prior to launch, a select group of our staff went to Boston for a thorough overview and training of the new system. Three months before the launch, our vendor team trained our providers so they felt confident with the system. We also provided pre-departure training courses for the rest of our staff. However, even after the training, the team was available for a phone call or quick chat to answer questions or resolve a potential problem with the system or workflow.
HealthLeaders: How long did it take for your organization to fully implement the technology and how did the implementation work since your practice includes so many clinics?
Mallon: Launching the system was challenging and we could not have implemented the technology smoothly without vendor support. We rolled out the new solution to all 150 health centers within one day. We were all in from the start and had to start strong.
We had eClinicalWorks trainers in each care center for about a week to two weeks after launch to help with the transition process and train additional Advocare staff. During implementation, we trained internal staff as point people for the solution so that they could continue with further implementation and staff training.
HealthLeaders: Since implementation, what positive results have you noticed?
I miss you: The most obvious positive result is the increase in our net collection ratio. Several things contributed to this increase.
First, we now have a dedicated eClinicalWorks team that handles our day-to-day collections and follow-ups to ensure we receive claims on time. To create an efficient workflow, the team helped us set up billing-ready rules to ensure care centers complete reports accurately. We may create alerts for missing information or incomplete claims. In addition to these workflow rules, the team notifies us of any issues, which gives us plenty of time to gather additional information from providers or communicate next steps with payers.
Second, our vendor team also handles denial complaints for our care centers. So if a denial comes back for a request from a specific center that needs to be addressed or changed, they will help that center file an appeal and track the progress of the request within our system. Once we receive the payments, they process the cash receipts and post them internally so we can keep track of our income in real time.
HealthLeaders: What are some keys to success that you can share with another organization looking to do the same for their facility?
I miss you: The first key to success I’ll share with other organizations looking to improve their revenue cycle is to know where you currently are. Know your net collection ratio and how many days your accounts receivable are outstanding. Once you have a baseline, you can set goals and implement strategies to improve workflow and grow collections. And once you have these metrics, keep track of them and update them regularly. We have regular meetings with our team to discuss our current metrics, compare them to our revenue and collection goals, and adjust our workflow and operations as needed. Everything must be measurable to succeed, especially in the revenue cycle.
Second, train your team on the new technology. Especially for multi-site healthcare operations, it is imperative to have people in each care center who can monitor the success of the solution and train new staff as needed. Now every care center works in the best way. It is also easier to open new care centers because we have a unified system.
Finally, choose a health IT vendor that listens and learns from your organization. Open communication between a health IT vendor and a practice customer can benefit both parties. For example, based on our experience with their technology and conversations between our staff and the eClinicalWorks team, they came up with a mass block button that would block multiple charts at once to minimize clicks and improve billing efficiency. The most valuable part of our partnerships is open communication. We are willing to learn from them, and they are willing to learn from us. Because of this open communication, our providers and staff use more efficient workflows and our net collections increased. Through them, we are also exposed to new opportunities to improve health IT solutions.
In the end, patients get a better experience and everyone wins.
Amanda Norris is the Revenue Cycle Editor for HealthLeaders.