Maximizing Affinity for Superior AR

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Maximizing Affinity for Superior A/R

• Re-engineering for Better Cash Flow
• Charles E. Christian, FCHIME, FHIMSS
• Director IS and CIOGood Samaritan
  HospitalVincennes, Indiana

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Good Samaritan Facts

• 267-bed acute care regional hospital
• Good Samaritan is a values-driven regional
  hospital that provides quality care in a
  patient-centered atmosphere to communities of
  Knox and surrounding counties.

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Challenge

• Restore A/R Levels to HARA Superior Hospital
  Performance
• Metrics
• Reduce Gross Days Receivables Outstanding (GDRO)
  from over 70 to under 60 days
• Cut A/R over 90 days from more than 35 to 20

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Plan

• Replace inefficient manual reporting systems with
  state-of-the-art IT solutions and Best Practice
  processes

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Plan Objectives

• Maximize use of existing Affinity revenue cycle
  solutions
• Implement other enabling technologies
• Develop staff expertise, buy-in and enhanced
  interdepartmental communication

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System Review

• Good Samaritan and QuadraMed staff discovered
  that the P/A staff were continuing the use of
  their old tried and true manual processes.
• There were no Collection Flows. Accounts sat on
  the worklist until paid or written off, making
  the worklist huge and unmanagable.
• Multiple forms of the tried and true manual
  processes were in place . No best practices.
• Paper shuffling / filing / re-filing required too
  many FTEs

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Maximizing the Affinity System

• Created Best Practice processes everyone
  doing the same job, the same way.
• Developed over 15 Collection Flows
• Redesigned worklist so accounts are sent to
  collectors worklist at strategic flow points
• Eliminated manual bad debt referral process

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Staff Development

• Reviewed leadership in the following departments
• Patient Accounts
• Information Systems
• HIM
• Registration
• All P/A staff was trained on all aspects of the
  application, providing knowledge depth and
  cross-training opportunities

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Staff Development

• IT Department trained a dedicated Patient Account
  Analyst who assisted the Patient Accounts
  Department to produce reports on demand and
  assist in process re-design and staff education.
• Reports can now be created by fields including

• Primary and Current Finance Class
• Original Billing Date
• Insurance Type
• Payments and Adjustments

• Age
• Alpha
• Patient Service
• Balance
• Last Note Date

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Immediate Focus for positive Impact

• Primary focus Current receivables
• Secondary focus A/R over 90 days

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Implementing Enabling IT

• Optical Imaging
• Medical Necessity
• Charge Master Maintenance

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HARA Benchmarks for Superior Hospitals

• Gross Receivables Days Outstanding (GDRO)
  below 60 days
• A/R over 90 days not-to-exceed 25

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Good Samaritan Results

• In less than one year
• GDRO dropped from 70 to 53 days, and holds
  steady in the mid-50s
• A/R over 90 days fell from 35.8 to a low of
  13.7, and remains below 20

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Other Benefits

• By replacing redundant, manual processes, Good
  Samaritan was able to
• Transfer one position to the Medical Records
  coding staff
• Reallocate positions to optical imaging
• Create a new float position

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For More information Contact

• Kathy Hartsell
• email khartsell_at_gshvin.org
• Phone [phone]

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Thank You