Hayes' Healthcare Blog

Sou Chon Young

Sou Chon Young is a Senior Consultant with Hayes Management Consulting.

Recent Posts

Building a Denial Management System? Here’s Where to Start

Posted by Sou Chon Young on August 30, 2017 at 9:00 AM

As healthcare costs grow, reimbursement continues to decrease, and margins for providers get smaller, we see the room for error getting smaller as well.  To combat this there has been an increase in mergers and acquisitions (M&A)[1].  As the number of mergers and acquisitions increases, one result is system conversion.  Instead of disparate systems, the newly formed organizations either move to one new system or they consolidate their systems to make their processes more efficient. As more organizations implement new revenue cycle systems, they are faced with many challenges but also many opportunities – one of which is the opportunity to implement a denial management system.

A strong denial management system will help you not only identify issues with your revenue cycle and help you avoid leaving money on the table, but it will also give you the information you need to optimize it.  Below is a quick summary on how to set up a denial management system.

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Topics: A/R management, denial management

Payment Posting: A Crucial Link to Efficient Revenue Cycle Management

Posted by Sou Chon Young on October 19, 2016 at 9:00 AM

“For the want of a nail the shoe was lost,
For the want of a shoe the horse was lost,
For the want of a horse the rider was lost,
For the want of a rider the battle was lost,
For the want of a battle the kingdom was lost,
And all for the want of a horseshoe-nail.”

- Benjamin Franklin

What’s a horseshoe-nail story got to do with healthcare revenue cycle management? It illustrates that the smallest detail can ultimately make the difference between success and failure. In revenue cycle management, that detail is payment posting. Posting errors can lead to all the major revenue cycle issues: understated accounts receivable, mounting denials, false credits and inaccurate patient statements.

Payment posting has never been a glamourous position – considered a simple “heads-down” data entry job with little impact on the revenue cycle. If that was ever true, it certainly isn’t today.

The massive changes in the healthcare landscape have dramatically affected the professionals responsible for posting payments. Sophisticated new technologies, multiple new payment models and organizations transitioning from one billing system to another means today’s payment posters must handle a much wider range of scenarios.

The bottom line: take your payment posting operation for granted at your own peril. Here are some of the major new competencies you should be looking for in your payment-posting professionals.

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Topics: revenue cycle management, Payment Posters

Why you need a Data Analytics Plan and How to Get Started

Posted by Sou Chon Young on May 11, 2016 at 9:00 AM

 

Rapidly changing payment methods. Shift from fee-for-service to value-based care. Declining insurance reimbursements. Increased government regulations.

Sound familiar? The litany of changes impacting the healthcare industry appears to grow longer every day. Taken together, they add up to one thing: more stress on your revenue cycle. Organizations need to adapt to this new reality to survive the upheaval.

There is a way for you to not only address these issues, but also to thrive in the turbulent times ahead. The key to solving the dilemma is close at hand: the data that resides in your EHR and other IT systems and applications. Harnessing this treasure trove of information and converting it into actionable data can help you meet the growing demands you face. But to access this big data, you need to develop a comprehensive data analytics program.

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Topics: Data analytics, Fee-for-service, value-based care, big data

Four Keys for Effective Communication in the Workplace

Posted by Sou Chon Young on May 4, 2016 at 9:00 AM

Chances are you have encountered a situation or two where things may have been blown out of proportion. You may find yourself spending time and energy explaining situations to colleagues that were perceived as problems but were situations actually taken out of context.

We all remember the telephone game - how funny it was to hear the difference of the original message versus what it had become when passed along through several people. Unfortunately, this exists in the workplace as well.  But it doesn’t have to.  When you strategize and implement an effective communication process, these games – and the waste of time and resources – can be eliminated.

Here are four keys for effective communication in the workplace.

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Topics: healthcare change management, effective communication

Post Epic Implementation: Now What? Watching your Watch List

Posted by Sou Chon Young on September 30, 2015 at 9:00 AM

Post implementation of any system can cause concern for your Patient Accounting department. As we know with all implementations, the design and builds of any system are not perfect and frankly some implementations go better than others. There is often a delay in submitting claims immediately after go-live, which can be caused by a number of issues ranging from charges to edits to simply misplaced or lost claims.

As you assess your claims post implementation, there are a couple of key questions to ask yourself. Are you monitoring and addressing all of your accounts to ensure you are not missing or misplacing claims? Are there accounts that are falling through the cracks and at risk for timely filing?

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Topics: healthcare IT, healthcare project management, EHR implementation, revenue cycle optimization, Epic Implementation

Testing 1, 2, 3. How to Be Ready for ICD-10 by Leveraging Your 835’s

Posted by Sou Chon Young on May 27, 2015 at 9:00 AM

So, it looks like ICD-10 is finally going to happen. The U.S. Dept. of Health and Human Services (HHS) has finalized the previously tentative October 1, 2015 go-live date for ICD-10. Are you ready? Have you done your due diligence and remediated your systems and performed testing? Ideally, you have tested with some of your major payers. If not, here’s a quick punch list to help with your testing. For ease of use, I’ve grouped the list into an internal versus external focus.

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Topics: testing, ICD-10, preparation, 835s

The Importance of Documentation: Why It’s All About the Details

Posted by Sou Chon Young on October 1, 2014 at 9:00 AM

Don't you hate it when you go to the store and you can't seem to remember the item that you went out for because you didn't write it down?

With a healthcare IT project the importance of documentation is magnified a hundred fold. This is particularly true if you are involved in creating processes and procedures, are responsible for managing a project or part of a team that is designing or implementing a new system. Let’s face it, most healthcare projects are fast moving and evolve significantly from beginning to end. To keep track of changes there are a few best practices we suggest. Get into the habit of documenting changes, notes and to do lists. Share your documents with other team members and ask for feedback. Utilize a sharing system like a shared file or software (e.g. SharePoint, LiveLink, etc.) so that it can be easily accessed and referenced. For example, when working on a system enhancement it’s best to have a test plan where a team can work collaboratively to create test scripts and document results and findings. When working on an implementation, a project plan will help you and the rest of the team members coordinate work efforts and help head off any potential surprises.

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Revenue Cycle Fixes: Show Me the Money

Posted by Sou Chon Young on July 31, 2014 at 4:11 PM

When evaluating the health of your revenue cycle, there are a handful of key questions worth asking. For example, are you getting your money from payors as quickly as possible? Is your cash posting team iStock_000023845602Smallleveraging the benefits from the Patient Protection and Affordable Act (ACA)? Are you holding up posting payments because you are waiting for that check? Are you having issues reconciling your revenue with finance? asking. For

If your answers to any of these questions are not what you’d like them to be, consider implementing the following revenue cycle optimization measures.

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Topics: revenue cycle

The Importance of Testing: Why Testing Today Will Save You Headaches Tomorrow

Posted by Sou Chon Young on June 18, 2014 at 8:50 AM

When implementing a new system, healthcare organizations may vary on the terms or stages of testing – functional, unit, system and integrated, and user acceptance. But in order to ensure a smooth transition, I recommend the following sequential process:

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Topics: training, testing, integration, 80/20, implementation

How to build an ICD-10 implementation safety net with 835s

Posted by Sou Chon Young on June 10, 2014 at 2:55 PM

ICD-10 is a game changer 

There is no doubt that ICD-10 is going to change the healthcare system
substantially and will impact your revenue cycle and cash flow. The amount of work to convert to ICD-10 is considerable. While tempting to approach this transformation as another in a long list of “to do’s”, I suggest looking at it as an opportunity to improve your revenue cycle. ICD-10 will not only provide more detail for clinical coding, but healthcare organizations should use this opportunity to review business processes and optimize operations. By building a “safety net” you can minimize your risk to cash flow and reimbursement by using your electronic remittance advice (aka 835) files.

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Topics: 835, meaningful information, cash flow, CARCs, RARCs, ICD-10, revenue cycle

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