[APCs] [Compliance [ Pt Access] [Pt Accounts] [ Physician/Nursing] [Clinical Data] [Med Info] [M.I.S.] [Resource Mgmt] [Managed Care] [Medical Staff] [Ambulatory Care] [Current Work] [Continuum]
	Strategies for Success:  PATIENT ACCOUNTS
	Everyone knows that efficient Patient Accounts management can do wonders for the health of your bottom line. However, while computers are an essential tool, they are no substitute for staff performance. Health care is a human endeavor and effective Patient Accounts management must be founded upon a logical organizational structure, backed by clear and comprehensive policies and implemented by a productive and thoroughly trained staff of specialists.  Accounts Receivable Solutions  Despite the advances of electronic billing, many hospitals are still experiencing accounts receivable buildup. Common symptoms accompanying this buildup are billing- cycle gridlock, inaccurate bills because of poor data quality and bills that are rejected by payors. Successful Patient Accounts management means not only a substantial reduction in accounts receivable and improved cash flow, but also improved data quality and staff productivity. It is often thought that sophisticated data processing equipment offers the ultimate solution to all billing problems. But we at Health Systems Management Network have found that while computers are indispensable, there are larger organizational and individual productivity issues that are the root causes of accounts receivable problems. Before the full potential of an electronic system can be realized, the individual and the management structure must be brought up to an equal level of sophistication. Through a detailed operational assessment, Health Systems Management Network will determine the root causes behind your accounts receivable problems and recommend specific and effective corrective actions.    Typical HSMN Patient Accounts Engagement
	Operational Assessment Phase  Interview management/staff Analyze quality of data, information flow and billing life cycles  Retrospective and concurrent review of UBs against services rendered and DRG  Review of organizational structure and effectiveness Review of staff effectiveness and skill level Staffing requirements, training and education Charge Master Review	Implementation Phase  Comprehensive management plan Work flow and work redesign organizational structure New procedures and policies Redefined billing life cycle Follow-up and collection team efforts  Defined reporting requirements  New information flow with strong linkage to front-end data sources  Curriculum and training requirements/program for all levels of staff Staffing requirements and skill levels
	Organizational Logic  As a result of rapidly changing payor requirements, the addition of new technologies and the pressures of cost containment, the billing process at many acute care hospitals has become fragmented. Just as a computer system is designed for the logical flow of data, the patient accounts organization within the institution must be designed for the logical flow of information between individuals and departments. The information needed to construct an accurate bill, according to the appropriate payor requirements, is often available at any stage of a patient's stay. All too often, however, the process of determining what information is required and then assembling that information does not begin until after discharge. This lack of timely information is a common cause of slow billing. By integrating the information gathered from admission to discharge with the information needs of the billers, the billing cycle can be shortened significantly. This integration also serves to reduce the billing staff time required to assemble bills, enhancing staff productivity. Health Systems Management Network will help your staff determine what data is required by the various payors, when and where it is available and how to expedite the assembly of data for billing.
	Patient Accounts Teams  An effective method for improving all billing and collection functions is the creation of patient accounts teams. Individual staff members are trained to become specialists in several particular payor rules and regulations, enabling them to act as "consultants" to the rest of the team. Individuals are cross-trained and serve in a variety of roles, allowing them to become sensitive to how the quality of their work affects other individuals "downstream" in the billing/collection process. Health Systems Management Network can work closely with management to develop clear performance standards for billing teams as well as supervisory support. Health Systems Management Network can provide complete training based upon the findings of our on-site operational assessment. Common training topics include: team development, interacting with payors, problem identification, quality improvement, developing and using management reports and learning to get the most out of your hardware and software
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Health Systems Management Network, Inc. is a healthcare consulting firm specializing in the following practices: healthcare consultants; consulting. managed care. subacute care, patient flow, information systems. electronic patient record management. Electronic medical records, billing,insurance, acute care, case mix, case management, ambulatory care, and resource management are areas of experience. We are familiar with UB, length of stay, DRG, in patient, out patient and TQM methods. More recently Health Systems Management Network, Inc has been pioneering work with APC, (All Patient Grouper). clinical data, clinical documentation. benchmarking. critical paths and receivables. We work with utilization review. acute care hospitals. practice groups. ICD, ICD-9, ICD-9-CM, CPT, CPT-4, HCPCS, HCFA, medicare, referrals. JCAHO, claims, RBRVS, HMO, reimbursement, Joint Commission compliance, regulations, training, reengineering, (re-engineering) total quality management for both inpatient, outpatient.