Health Systems Management Network, Inc. Announces Formation of Financial Structural Assessment Team for Revenue Cycle Management Teams

Wellington, FL — (SBWIRE) — 03/21/2013 — HSMN announces the formation of a “Financial Structural Assessment Team” under its Organizational Structure division. The purpose of this Team is to assess the financial structure within the revenue cycle management and determine how roles should be defined, work processes refined, system efficacy, staff allocation by function and finally the leadership.

HSMN has learned after doing “reorganization” for 27 years, financial goals must be set and confirmed in real time. Once goals are stated, and the financial mission defined, then begins the difficult task of shaping the financial structure to be able to produce the desired outcomes within the timelines stated.

Very important in all of this is the assignment of metrics to monitor progress to completing goals, and putting into place a management team that knows in exquisite detail how each function within the structure is working.

The HSMN process has been established after 27 years of restructuring: it is termed “zero based restructuring”. The process starts with a comprehensive analysis of every data point related to revenue and looks carefully for variants that might have caused up or down changes.

For example, in one organization (a large Academic Medical Center) the revenue was down by 3% but that also coincided with two important factors: the loss of some surgical specialists which meant that medicine was producing more than procedures and at much lower rates.

The second factor was the lack of real time interaction between the coding staff and the house staff who provided the source documentation. In this engagement it was found that house officers (Residents) would keep the bulk of their documentation on their own media to allow for efficient “hand offs” to the next resident. The problem was that critical document elements were not finding their way onto the official hospital record.

HSMN began a program of restructuring that included a new kind of interaction between house officers, attending staff and the coders/billers.

Professional fee billing had one staff and the Hospital another staff. In reviewing cases it was quite clear that often diagnoses did not match. HSMN has had a program in place called “Financial Structural Assessment”.

It is comprehensive and goes through all sources and all functions that affect financial outcomes. The assessments are shared with staff who are asked to challenge the findings and come up with their thoughts about restructuring. At this point in the engagement HSMN asks staff and managers to step back mentally from the current structure and look at a new way to meet goals with appropriate changes.

HSMN’s methodology has worked in many organizations and our client list reflects their success. When ICD-10-PCS and CM becomes reality and when MEDPAC reduces payment in hospital outpatient procedures, it will be too late. Now is the time to think about a “Financial Structural Assessment”.

About Health Systems Management
Health Systems Management Network is a leading hospital, physician practice and health services management consulting firm. They have completed complex medical billing and coding engagements and are experts in the ICD-10 coding arena. Their expertise in revenue cycle management, ambulatory care billing and healthcare financial management comes from over 25 years of experience in the field.

They can be contacted at 866-908-4226 or email for a consultation and discussion.