Let Us Share Some Insights

We gain new insights every day as we work with customers to improve their revenue cycle performance.  Below you will find our blog, resources, and links to other information that we think is important. Feel free to peruse our library and learn with us!

Resources

Issue Brief: Training for Sustainable Results

Empower Your Team to Improve Your Revenue Cycle

Presentation: Leveraging EHR

Leveraging Electronic Health Record Capabilities to Drive Sustainable Improvements in Your Revenue Cycle

Recent Blogs

Top 5 Missed Epic Revenue Cycle Optimization Opportunities

October 24, 2018

Epic is a platform within the healthcare industry which generates a strong love/hate relationship.  On one hand, it centralizes information and opens communication across the provider spectrum. On the other hand, many supposed efficiency gains are bogged down in tedious workflows while promised reporting transparency remains unavailable or hidden in a mountain of reporting options which may all yield different results.  Five examples of underutilized Epic functionality that revenue cycle leadership should evaluate include account prioritization (also known as workqueue scoring), activity code enhancement, simple visit coding (SVC), watch list development, and comprehensive workqueue re-design. Some of these concepts can … Read more

Pinnacle Welcomes Kevin Blanchard to the Team

October 22, 2018

We are pleased to announce Kevin Blanchard has joined the Pinnacle Healthcare Advisors team.  Kevin has extensive experience leading revenue cycle transformation engagements with large multi-system hospitals, pediatric hospitals and single-facility hospitals.  Kevin’s areas of expertise include Epic Resolute Hospital Billing optimization, workflow and work driver management, DNFB/CFB management, denials management, system automation, customer service/scripting and pre/point of service cash collections. Kevin is actively involved in the ongoing development of our Epic enhancement solutions. Click here to read Kevin’s blog post, ‘Top 5 Missed Epic Revenue Cycle Optimization Opportunities”. If you are interested in more information about reporting transparency, workqueue re-design … Read more

Accounts Receivable Outsourcing – 3 Keys to Making a Decision

June 18, 2018

In our last newsletter, we introduced the blog series: Why AR Outsourcing Fails and How to Avoid Common Pitfalls. We introduced two primary dangers with outsourcing arrangements: Hospitals that outsource frequently relinquish full control to the vendor and end up in an “out of sight out of mind” situation Vendors many times interpret “silence” from the hospital as positive reinforcement for the program they have implemented There are lots of opportunities to avoid these common pitfalls, most of which occur in the stages before a vendor has been selected and during the implementation. In this article we will focus on the first … Read more

Why Accounts Receivable Outsourcing Fails & How to Avoid Common Pitfalls

January 18, 2018

Your internal self-pay team can’t handle the increasing volume of calls.  You’re aged insurance accounts receivable (AR) continues to increase.  Or maybe your internal resources just don’t have the necessary expertise (or time) to work a specialty population like out-of-state Medicaid or third-party liability. Any of these scenarios can cause you to start down the path of outsourcing a revenue cycle function or segment of your AR.  This is a process that can deliver increased net revenue, but it can also be fraught with unmet expectations. This blog series will address common challenges seen throughout the outsourcing process and provide … Read more

Getting in Front of the Self-Pay Trend in 2018

January 8, 2018
Improve Your 2018 Revenue by Focusing on the Self Pay Category

There’s no denying that self-pay (SP) is on the rise. It’s a clearly established trend. If you are looking to improve your facility’s financial performance, then the SP category must be a significant part of your revenue cycle focus. Here is a quick snapshot of the trends, some levers you can pull to drive improved performance, and some questions you should ask to determine the size of your SP collections improvement opportunity. The Self-pay Outlook – 2018 and Beyond In the future, healthcare providers can expect to see a continued increase in both uninsured (UI) and self-pay-after-insurance (SPAI) populations (collectively … Read more

Managing the Shift from Traditional Medicare to Managed Medicare Plans – Here’s How to Get It Right

September 6, 2017
Managing the Shift from Traditional Medicare to Managed Medicare Plans

As the mix within Medicare continues to shift from traditional to managed plans, hospitals that don’t take steps to address the differences in administrative expectations and claims processing between plan types run the risk of increased denials and mounting accounts receivable (AR). The Kaiser Family Foundation, in its 2017 Medicare Advantage Spotlight Report, states that: “Both the Congressional Budget Office and the Health and Human Services (HHS) Office of the Actuary (OACT) project that Medicare Advantage enrollment and penetration rate will continue to grow over the next decade, with CBO projecting that about 41 percent of Medicare beneficiaries will be … Read more

The Anatomy of A Revenue Cycle Scorecard

July 10, 2017

Using metrics to drive actions that improve financial results Managing your revenue cycle in a world of shifting populations, increasing patient financial responsibility, and competitive pressure on volumes can be challenging, to say the least!  There are so many variables and changes in core processes that it can seem like an impossible task to keep track of it all.  The concept of using a scorecard is not new.  But when environmental factors begin to shift (and they will), we have found that managing to specific metrics, interpreted using a defined methodology, will enable hospitals to more quickly act and correct … Read more

How to Determine if Your Current EHR Platform Can Solve Your Revenue Cycle Challenges

June 29, 2017

Don’t Buy More Software! – Four questions to help determine if your current EHR platform can solve your revenue cycle challenges   When hospitals determine that they have a challenge to be solved within their revenue cycle, it is extremely common for them to buy “bolt-on” software to fill perceived gaps in their electronic health record (EHR) capabilities.  But what we have found is that this is often unnecessary and can add cost and complexity to a problem that can often be solved by leveraging existing EHR functionality. There are many vendors on the market with excellent bolt-on technologies, and we … Read more