Virtual Patient Account Management

The Challenge

Small and mid-sized hospitals face the same complex billing and reimbursement issues as larger facilities. Their business office and patient account managers must know how to efficiently manage and coordinate communications among the hospital's billers, clinical services, medical records department, finance department and outside vendors, third party payers and patients.

If your hospital is typical, you know the difficulty of attracting, recruiting and retaining skilled managers who can handle the challenge. This may be due to your size, geographic location or limited budget. As a result, you may be struggling without a real manager, tolerating an ineffective one, or paying more than you can afford.

Are these the only solutions?

Our Service

Through its focus on the unique challenges facing small and mid-size hospitals, RCS has developed a service that provides quality patient account management and access to additional expert resources for less than the average cost of an experienced full-time manager. Mentoring of key personnel has proven to be one of the most essential benefits of this process.

The Virtual Manager begins with an intensive on-site analysis and organization of a facility's patient accounting department and staff. RCS works with staff and management to set goals, establish policies and procedures, and develop protocols for ongoing communications between RCS and the patient accounting department.

RCS then begins remote management of the patient accounting department and routine monitoring of performance standards. Through remote and on-site communications customized to the needs of the facility, RCS maintains contact with patient accounting staff, hospital departments and management, third-party payers, and vendors.

Our Approach

Phase I: Onsite Review

  • Meet with key management to gain an understanding of primary concerns and objectives
  • Review departmental procedures and revise/supplement as necessary
  • Observe department staff
  • Identify lead staff to perform specific management tasks as directed by RCS
  • Realign existing staff as necessary to optimize department performance
  • Establish and implement short-term (3-6 months) performance standards
  • Create reference files of third-party payer contracts, policies, procedures, outside vendors, etc.
  • Establish remote access link between RCS and hospital's patient accounting system
  • Set up dedicated telephone line for automatic rollover to RCS
  • Create, review and finalize Operations Plan with help of senior management and staff

Phase II: Active Virtual Management

  • Remotely monitor patient account data and system financial reports
  • Monitor key financial reports
  • Monitor key performance reports with emphasis on cash flows
  • Communicate with third-party payers on contract and reimbursement matters through internet access and other forms of communication
  • Communicate with ancillary service departments as needed
  • Interpret regulatory updates and communicate to staff as needed
  • Conduct regular conference calls with key staff to review department performance and status of management tasks assigned
  • Provide key staff and senior management with regular updates of department's performance through telephone calls, e-mails and periodic onsite meetings

Benefits

  • Affordable alternative to skilled patient account manager
  • Continuity of management services (no backlog or limited access due to sick time or vacation)
  • Access to professionals experienced in all aspects of patient account management
  • Ongoing monitoring of performance by objective third party
  • Extra emphasis on achieving department cash goals
  • Identification of ways to improve reimbursements
  • Mentoring and education of key personnel
  • Benefits of outside consultants without loss of control