West Tennessee Healthcare improves end-to-end revenue cycle system

Jackson Madison County General Hospital, part of West Tennessee Healthcare.

Nonprofit West Tennessee Healthcare has partnered with healthcare analytics company MedeAnalytics to create a centralized, end-to-end approach to revenue cycle across the organization's hospitals and physician practices.

The health system aims to improve point-of-service cash collections, pre-registration rates and insurance verification, as well as to reduce denials and bad debt across all four of their hospitals and physician groups.

[Also: Insurers, healthcare providers find common ground in population health data, MedeAnalytics CEO says]

"Currently, we're writing off about 4.2 percent of our gross charges as uncompensated care," said Bart Teague, executive director of Revenue Cycle. "This is comprised of bad debt and charity."

To reduce the amount that is bad debt, West Tennessee is working to financially clear patients earlier and communicate with them earlier in the revenue cycle process, working with them on payment arrangements.

When a patient is scheduled, the new system financially clears that patient, verifies insurance eligibility and benefits, and estimates out-of-pocket costs.

"Patient responsibility has increased mainly through high-deductible health plans," Teague said. "Patient deductibles and copays have increased as well."

A new accounting system conversion and centralized registration system brings complex patient accounting data into a unified view to expose the lost revenue and reimbursement delays, the health system said.

"We moved to one location," Teague said. "Up until a few months ago, if a patient wanted to pay on a hospital bill in person, they would go to one place. They would pay on another physician account at another place. It's now consolidated."

The new system has resulted in staff being consolidated as well, according to Teague.

Through support from MedeAnalytics, West Tennessee is adding real-time analytics and improved documentation and coding processes.

In addition, the health system is implementing a Cerner revenue cycle system.

"Implementation is part of a larger revenue cycle project going on," Teague said. "We're in the process of replacing the revenue cycle system for our medical group as well as our hospitals. Our two core financial systems will be replaced in a little over a year. We're centralizing functions."

[Also: The top 9 revenue cycle stories from 2016: It's no longer just about the back-end]

The new integrated delivery system will have hospital and physician billing on a common system. They will not have a one-bill system, but that's a longer term goal, said Teague.

"It's something we're moving towards," he said.

West Tennessee healthcare has been working with MedeAnalytics since 2007 in other revenue cycle programs such as ICD-10 compliance. Results include over 4,000 record reviews and getting $3.7 million in refunds and $900,000 in appeals over a four-year period, according to the health system.

[Also: Insurers, healthcare providers find common ground in population health data, MedeAnalytics CEO says]

"West Tennessee Healthcare is gaining a complete picture of their financial health by taking an end-to-end approach to their revenue lifecycle," said Andrew Hurd, CEO of MedeAnalytics, in a statement. "With a single, integrated view of their financial data, they will now have the insight needed to reduce and prevent denials and improve patient service collections."
 

Twitter: @SusanJMorse