The Accounts Receivables has been in the 70-80 days range for several months now and has even reached above 100 days this month. Marysville General reaches its optimum cash flow when Accounts Receivables is at 55 days. As discussed at the meeting, there are several things that can be done by the medical staff, business office and the clerical department. To start, the hospital can pull a credit line to help make payroll since Marysville only has enough cash on hand to meet payroll once. Otherwise the hospital will have to take away from the investments.
Another important step is making sure that the check-in process is improved. According to Linda, the business office manager, the night nurses are not recording the correct insurance information between the hours of 11 pm and 7 am. The best thing to do in this case is hire a night admissions clerk that can collect the correct insurance information and make sure that the information is legible. Next, we need to work with the medical staff, specifically Dr. Linscott, Dr. Patel and Dr. Nielson, on their charting.
The charting of patient medical records in a timely fashion is important for Joint Commission accreditation as well as billing (Norwiki, 2009). If there is not enough detail on the chart, the coding department cannot collect for the highest legitimate diagnosis. Dr. Nielson charts have been consistently past due estimating a total current loss of $120,000 alone. If we can work with Dr. Nielson to help him improve his charting, we may be able to recover that money. Another option is to hire someone to do his charting for him. It will save time and money for us all.
A third option is to create a slight penalty if these physicians continue to fall behind or submit incomplete charts. As for the problem with claim rejections, going with the “Clean Claims Module” option within MedXL appears to be our best bet. Being able to earn between $700,000 and $800,000 a year from what used to be rejected claims is worth every bit of the $10,000 fee and $2,000 every month thereafter. Finally, the collections problem is a large portion of Marysville’s losses are coming from. Like most healthcare organizations, the collections for self pay patients are lacking.
As of today, the collection is approximately 15 cents on the dollar. In addition to that, Maryville is paying collection agencies 40% of all collections to the collections agencies. If we allow the 25% discount to the patients that pay their bills within the 10 business days, we can save the 40% being paid to the collection agencies and earn more money upfront from the self-pay patients. Extending business office hour by an hour or two, or even moving the 7 am to 6 pm shift to possibly a 9 am to 8 pm shift, will allow more patients, truly attempting to make payment arrangements, to call in after work.
The best way to manage Account Receivables is to “provide management with information that is up to date, reliable and accurate (Nowicki, 2009). ” If that is done correctly, then the AR performance evaluation should result in a fair collection period. We should reduce the amount of bad debt write offs and make as much effort as possible to help the patients Maryville General make payments in a timely fashion.
References
Nowicki, M. (2009). The financial management of hospitals and healthcare organizations. Health Administration Pr.
