Healthcare Agency Revenue Cycle Management Simplified
How The Carpenter Health Network teamed up with HCHB Revenue Cycle Services to boost clean claim and collection rates.
In a recent webinar with Home Health Care News and Homecare Homebase, Patrick Rambin, revenue cycle director for The Carpenter Health Network talked about how his agency leverages HCHB Revenue Cycle Services (RCS) to streamline processes and increase cashflow. Below is a small sample of the conversation. Listen to the full webinar here.
Can you start by telling us why you decided to bring on an RCM partner?
Patrick Rambin: We were using HCHB for our hospice and home health divisions for about two years prior to asking about RCS. The biggest issue we had at the time was scalability – we were growing faster than we could keep up with – our billing team was struggling to keep up with the volume of billing.
We had lots of issues on our front end and intake processes which involved simple clerical errors like the wrong birth date for example. Although it seems really minor, things like this created a huge problem in collections. As we grew, our collections started to really suffer. At one point, our first-pass clean claim adjudication rate was in the high 80s/low 90s – which greatly impacted our cash flow.
What was it about HCHB RCS specifically that made you choose Homecare Homebase?
Patrick Rambin: First, we were already using the software, so it just made sense. Also, the HCHB team has 20+ experience in billing Medicare and commercial payors. We simply did not have the resources and experience to do what HCHB does for us. We’d probably need 3-4 times the staff, which we of course could not afford. And that’s assuming we could even find them!
Not to mention the cost savings – again it’s hard to quantify this upfront, but we found out we were leaving money on the table that we could not go back and recapture later. Knowing what the issues, denials and rejections were and working with RCS to educate our front office staff has made up the difference of what we weren’t collecting before.
Before, when we’d have a new referral or commercial payer setup or single case agreement, we’d put in the ticket and wait. Now we make a phone call to the HCHB RCS team, we get the information or codes we need and we can admit and serve that patient the same day. That’s really made the biggest impact – your team is like employees to us. It’s just an email or phone call away and we’re like: “Let’s Go!”
Can you walk us through how the partnership got started and what the implementation looked like?
Patrick Rambin: Honestly, bringing the HCHB RCS team onboard only a couple of months—which is not much time considering how much was involved. We’ve got 40 locations and serve 5 thousand patients a day, so the impact companywide has been great. There were a LOT of meetings, including daily KPI meetings that were sometimes 3-4 hours. We had to see exactly where our issues were – that included looking back up to two years to see what ARs we could still collect on.
However, within a few months those long meetings turned into daily 5-10 minute calls because we knew what we needed. We also started denial rejection meetings – every week HCHB gives us a report of everything billed the week prior including exactly what was rejected and denied and why so we can address every issue. Whether it’s a payor source setup or patient intake authorization error – we know exactly what it is to know how to attack the issue.
It’s a lot of communication and collaboration – but’s it’s really paid off!
After bringing on HCHB RCS, we were getting accurate information we could use to educate our front office and sidestep what might have been very costly denials. What I’m perhaps most proud of is the clean claim rate on those commercial payor contracts and how they’re set up on the front end.
What were some of your short- and long-term goals for this partnership?
Patrick Rambin: Short term we wanted to improve collections. Long term we needed to build a scalability model we could use for any branch we open.
We’re now running about 99% or 100%+ collections. I say PLUS because thanks to HCHB we can now review older ARs that were previously “uncollectable” that are generating additional cash flow for us. Collections has been a big, big deal for us.
We are now at 98%+ for clean claims which has significantly improved cash flow as well. A lot of what we do now is review our accounts thoroughly and use that info to train our front office and intake so we have a true model we can share for every location. It was a huge first step for us that’s allowed us to grow again.
What was the greatest challenge the HCHB RCS team has taken on?
Patrick Rambin: The clean claim rate. Because, it’s not usually a Medicare issue, like a simple clerical error that we can easily fix. It’s the amount of commercial payors we have as a percentage of our business. We now have maybe 500-600 different contracts – each one wanting specific items in a particular order. We’ve got to get them set up on the front end to be as clean as possible to keep up the cash flow. The payor setup is absolutely critical.
In fact, in our denial and rejection meetings, HCHB lets us know exactly why claims are being denied – right down to the person or branch where we might be having issues. Now, we can educate them on the front end to improve our entire revenue cycle. We’ve even requested custom videos on how to put in a billing note or do an authorization correctly. HCHB has been a great partner in this regard and has really helped us step up our game in very specific areas.
As the payer mix continues to change in our industry, it becomes more and more critical that we get the commercial payer contracts right the first time and every time. Now we can share front office best practices and training info as we grow and onboard new locations.
Where do you see the partnership going in the future?
Patrick Rambin: With a clean claim rate at 99%+ we’d be happy if everything stays status quo. What we can do now is put our foot back on the gas pedal and grow our agency using this model. We can now focus on our strategic road map for 2021 and beyond knowing that HCHB has us covered.
What would you say to others considering Homecare Homebase RCS?
Patrick Rambin: If you like collecting what you earn, HCHB is a great choice! If you want less stress fighting with commercial plans on appeals, denials and rejections HCHB is the way to go. More money in your pocket and less stress – that’s a hard one to beat.
Eager to hear more? View the full webinar for free on demand or contact our sales team to get the conversation started.