Marysville General Hospital

As the CFO of Marysville General Hospital, I realize we have a serious accounts receivable problem here. It has gotten out of control, and we are going to get it back in control. All it takes is a little effort from everyone to get us back on here. With the process improvement plan I am proposing, I will need the assistance and cooperation of the medical staff, the clinical departments, the business office, health information management, and all other departments.
To propose my plan of improving the current situation of the hospital, I will need to get a current report on all past, current and future collection data from the finance department to determine how much we are actually losing at this point. I need to collect the admissions and registration information from the business office. I also need electronic medical records information from health information management. I need a current report on charge captures from the nursing staff.
I need a current report on the status of claims processing, payment posting, and secondary billing/patient follow-up. For this plan to be a success we will need complete cooperation from everyone. We need to get some experienced personnel or train our current personnel to do the admissions more accurately. The nursing staff should not have to check vitals and register patients also. Patient registration should be done before the patient even sees the nurse unless it’s a life or death situation.

Clear instructions will be given to these staff members to ensure that we have all the current contact and billing information and legible copies of all documents and claims are processed appropriately. With verification of all information, we should see a more smooth billing process and the correct plan codes being applied to the various accounts. The implementation of the electronic medical records has been very helpful to all departments because all patient information is in the system and accessible if needed.
However, we have to ensure that our physicians are charting their patient’s information in a timely manner and giving detailed information about diagnosis and plan of care. If the physicians are not completing their charts on time, we will have to put them on some type of suspension until they are up to date on their charts. We cannot let them continuously see patients and not complete their charts because they would have too many to try to catch with. Therefore, we should have time period deadline for all patients’ charts. If the physicians are not being compliant, they will go into suspension.
We understand they have a busy schedule, but if we have to constantly remind them that there are charts that need to be completed, we will do that. We will designate a couple of staff members to stay on top of the physicians if we deem it necessary. To help with charge captures, we will invest in the “Clean Claims Module” from MedXL to ensure that all the claims requirements for the various insurance companies are current and up-to-date. It will also ensure that we are notified of any changes that may occur.
I would much prefer if we invest in this program to ensure clean claims processing to ensure we receive payments for services provided in a timely manner. Every little bit helps. As far as self—pay patients, we should look into some type of discount plan that may assist these patients with the cost of their services. If we can offer some kind of discount or financial assistance to our patients, it may prevent us from having to send so many of their accounts to the collection agencies where we are losing monies because of the fee the collection agencies charge to collect on our behalf.
We can also remind patients about their bills when they come in. There should be a notification that pops up when we go into a patients account that lets us know they have an outstanding balance. With the cooperation of all departments and staff members, we can bring Marysville General Hospital back to previous accounts receivables standings. Teamwork is required and not optional. Let’s keep our community happy.