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2014 WPHCA Fall Learning Session

2014 WPHCA Fall Learning Session

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2014 WPHCA Fall Learning Session

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  1. REVENUE CYCLE LEARNING PLAN: Bringing it full circle Zoe Wolf Director of Revenue Cycle Sixteenth Street Community Health Centers Milwaukee, WI 2014 WPHCA Fall Learning Session

  2. None Conflict of Interest and Commercial Interest

  3. Sponsored by WPHCA Facilitated by WPHCA STAR Program Manager Provided opportunity for organization leaders to gain an understanding of all aspects of the revenue cycle Used outcomes of SVA Consulting STAR Deep Dive as initial discussion points Revenue Cycle Learning Series

  4. To provide leadership who are not involved in revenue cycle operations with knowledge of the revenue cycle and revenue cycle processes using operational modules PURPOSE OF REVENUE CYCLE LEARNING SESSIONS

  5. EXECUTIVE TEAM (E-TEAM) CEO Executive Vice President CFO, Vice President of Finance Vice President of Communications & Public Relations Vice President of Human Resources Vice President of Information Systems SENIOR MANAGEMENT TEAM (SMT) Directors and Managers reporting to E-TEAM members Behavioral Health Communication Environmental Health Programs Funds Development Grants Development Health Education & Community Programs Information Systems Medical Services Nursing Quality Improvement Revenue Cycle REVENUE LEARNING CYCLE PARTICIPANTS

  6. CFO, VP of Finance Director of Revenue Cycle Managers and Leads of: Billing Cash Posting Coding Collections Financial Counseling Registration THOSE INVOLVED WITH REVENUE CYCLE ON A DAILY BASIS

  7. REVENUE CYCLE – PRESENTATION MODULES Customer Service Contract Management Kay Brewer, WHPCA

  8. One or two modules presented per session Each module is presented by billing office staff subject matter experts Each presentation allows for open discussion Q & A at the end of each session Presentation format

  9. SAMPLE PRESENTATION FORMAT Typical Front End Process Appointment Scheduled Pre-registration (if applicable) Registration Insurance Eligibility Check-in • Front Office • Collect paperwork and copay • Check that insurance is verified • Indicate patient arrival • Reschedule late patients and follow up with no-shows • Scheduler/Front office • Answer phone • Schedules appointments • Cancels appointments • Reschedules appointments • Blocks schedule • Appointment reminder calls • Registrar/Front Office • Collect demographics and insurance information • Mails or calls patient to complete paperwork • Registrar/Front Office • Verify Demographics • Enter and/or verify insurance information (phone or web) • If in advance: • Arrange for interpretation or special needs • Schedule other appointments (ex. Financial Counseling) • Registrar/Front Office • Log into insurance site and enter patient information • OR call insurance company • Update in EHR Depending on staffing, multiple steps could be combined across one role. Kay Brewer, WHPCA


  11. Cast votes to prioritize opportunity identified in learning sessions Determined top four priorities based upon votes Assigned work teams with both E-Team and SMT members on each team Each work team develops a project plan Implementation needs identified Timeline identified How did we use the information?

  12. To be determined OUTCOME OF PROJECT PLANS