HOSPITAL CORNER

By Cheryl Skiffington

Health Systems have basically three options for patient billing: outsourcing, insourcing or a hybrid of the two. After eight years with four different billing companies, CCHS decided to bring the billing back in-house in June 2018. It was August 1, 2018 when we were up and running with two remote billers and a cash poster. One local biller was already with us. Two years later, we have a total of 10 staff including the manager and seven are remote workers.

The split of the accounts receivable into manageable portions between each biller, has evolved over the two years. We started with one Medicare biller and two billers who covered the rest of the facility receivables. Now, we have two Medicare billers, three commercial billers, a nursing home biller, two self-pay billers, a cash poster and a manager. The billers all have goals that align with industry standards. Assigning billing codes is all outsourced. In other words, the department has become more efficient in its work.

When the hospital previously used a billing company, there were many complaints by patients who received services here. We used that information as learning material to better the billing service to the community. The first things we changed was to make sure one-hundred percent of patient statements were manually approved prior to mailing. Currently, that is about 1,500 statements being reviewed each month by our self-pay billers!

As a group, we are focused on process improvement and are continually becoming more efficient through our efforts. By looking closely at the cause of insurance company denials, we have reduced them to 1.4%. Since we send out an average of 2600 claims to insurance companies (down from an average of 3,000 per month pre-COVID 19), that 1.4% is a great measure of our success.

Since inception, we have been having mandatory weekly Zoom meetings. We have developed important partnerships since we can't do everything on our own. Engage, the company that provides software support, has helped us maximize efficiency with our software system. As mentioned earlier, we work closely with two coding companies who have helped streamline many processes.

Last, but certainly not least, Dr. Kyle Terry, Chief of Staff, has helped us tremendously by appealing insurance company denials.

They say it takes a village, well, in this case it takes a community and we appreciate all of the support you have given us!

-Skiffington is DGH's Revenue Cycle Coordinator.