Client Profile:
A health system with seven facilities including critical access, safety net, and orthopedic hospitals throughout the South-Central U.S.
Challenge:
The health system acquired several hospitals and their shared services infrastructure did not progress at the same rate as acquisitions. McBee conducted a revenue cycle assessment which identified several strategic planning opportunities. The health system then engaged McBee to develop a work plan and implement a system that supports several hospitals in a shared services environment. The primary focus of the shared services engagement was the development of a Central Business Office (CBO) scheduling call center to better support the acquisitions, as well as improve call center responsiveness and overall performance. An average of more than 5,100 calls were presented per month and nearly 1,400 were abandoned.
Solution:
McBee provided interim management and developed a work plan for the implementation of a Central Business Office (CBO) scheduling call center. The scheduling call center managed radiology appointment booking, insurance verification, pre-registration of most outpatient services, inpatient pre-certification and established prior authorization assistance for services requiring insurance approval for reimbursement. The following steps were taken to improve call center functionality:
- Evaluated and monitored staffing productivity and work assignments for all pre-access job functions
- Developed dashboard and month end reporting for all pre-access functions
- Identified training needs for call center and patient access staff
- Returned functions that were better managed in clinical areas
- Recruited a health system Director of Patient Access
Results:
This engagement significantly improved the financial viability of the health system with a $7.8 million increased gross revenue opportunity. The call abandonment rate was decreased from 27% to 2% without increasing the number of full time employees. This drove a significant improvement in patient experience and resulted in an increase of 1,200 scheduled procedures per month.