Allegiance Group provides turn-key solutions to automate the collection of outstanding balances for healthcare providers. In this article, HME Business mentions Allegiance Group as a provider that can help optimize your revenue cycle management. (The following excerpts are from the article printed by HME Business in June 2019.)
How should RCM work in the world of HME and how can providers use IT to optimize their entire revenue performance?
This acronym-heavy HME industry, you might have come across yet another three-letter abbreviation, RCM. It stands for revenue cycle management, and it could change your business.
Don’t confuse RCM with billing. Billing is the process of filing claims with reimbursement sources such as Medicare or private payer plans. Then it follows up with those funding sources to ensure the claims get reimbursed. RCM is broader than that. RCM encompasses billing and claims management, but it also optimizes how claims denial is handled, how patient co-pays are collected, and how much staff time is expended on claims. Revenue Cycle Management tracks the revenues and costs related to a patient’s interaction with a healthcare provider from the beginning and end of the process. RCM is the umbrella under which all revenues are managed and maximized.
And now, RCM has come to the HME industry. In fact, in some ways, it has been here, thanks to the software systems and services that have proliferated in the HME industry. However, HME software makers have started working with providers in earnest to start defining how RCM should work in the HME industry to help providers overhaul their entire revenue performance — not just refine their billing.
Outsourcing (to optimize your revenue cycle management)
In addition to implementing new software solutions, another option is to outsource parts of the RCM process to third parties. Various third-party companies serving the HME industry specialize in particular elements of billing and claims processing. For instance, one outsourcer, Allegiance Group, specializes in patient pay and another, Prochant, focuses on insurance.
To learn more about how to optimize your revenue cycle management, read the full article in HME Business.
We were pleased to host the COLLECTPlus Advisory Board meeting for the mutual clients of our partner Allegiance Group (AG) in December, 2018.
The AG team created an environment of open and honest feedback that made for some amazing troubleshooting and enhancement ideas. Seasoned users from Hart Medical, Carelinc and Sobaks Home Medical took the time to step through questions at each level of the collections process. In addition, clients like SuperCare, connecting from the west coast, offered up powerful integration design ideas.
Of the 52 meetings I attended in December, this was by far the most collaborative and actionable! Be sure to attend the next one at the 2019 Users Conference in September!
Lisa Anderson, Universal Software Solutions
Today, there is an urgency to improve patient collections. You have thoughtfully created your collection policy and procedures to meet your goals. Now what? The two keys to success that cannot be found in a written policy are your staff and your company culture. Learn how your culture impacts collection results.
Assume you have the best employees. Culture can be the X-Factor that accelerates collections. Culture is the beliefs, assumptions and attitudes that guide what’s acceptable behavior and what’s not. When you hear, “That’s how we we’ve always done it,” that’s your culture talking. When you create a culture that supports your policy and procedures, you will optimize staff efficiency and recovery results.
Here are five best practices to help introduce your new culture:
- Continuously communicate your collection policy and procedures. Your employees must understand what you are trying to accomplish. This understanding will help establish accountability at every level.
- Realize that culture has a huge impact on results. It impacts your employee’s attitude, effort and engagement at work.
- Include your staff in the planning. If you do, it will be easier for them to help implement the changes in your culture and support your goals. Culture change is time-consuming, but well worth the effort. What actions should stop, what actions should start and what actions should be continued to reach your goals? Also, focus on attitude and personal-interaction protocols, which can make a huge difference in fostering a cohesive team and positive company representatives.
- List and prioritize the changes and train your staff on how to implement them.
- Monitor, measure and encourage. Offer positive reinforcement, such as “Caught in the Act” recognition. Create short-term wins. Review each employee’s adherence and contribution to the culture during your regular one-on-one meetings.
When completed, employees should be able to explain, “My job is to do X and here’s how I do it.” This helps demonstrate how individual daily actions help achieve the company’s bottom line.
By Anne Orrick, COO, Allegiance Group
As seen in HME News, December 21, 2018
Do I need a Collection Policy if I have Collection Procedures?
Absolutely, and here’s why you need a collection policy even if you have collection procedures. Your collection policy defines the mission and rules you want employees to follow to reach company goals. It guides employees on how to handle patient accounts and outlines your approach to balancing getting paid with customer satisfaction.
Policies will differ for each provider. For example, direct HME/DME providers may demand more credit cards captured upfront versus HME/DME providers receiving referrals or infusion providers, who are supporting end-of-life scenarios.
Collection procedures detail the patient invoice workflow starting with the referral and ending with the balance being paid in full or written off as a bad debt. When creating or reviewing your workflow, you and your team can have a healthy discussion on how to handle a patient’s balance throughout the process. Here are some questions to consider as you are outlining the workflow.
- What information should we collect with each new order?
- Will credit card info be kept on file?
- What payment terms will we offer?
- When and how will we contact patients with balances?
- If an account has an outstanding balance, will we process new order?
When responding to these questions, make certain your answers are clear, concise and easy to understand.
Before finalizing your policy and procedures, we recommend you ask your accountant to identify topics that may be unique to your business so they can be addressed.
Follow these 4 steps to keep your policy and procedures relevant:
- Train your staff. If you are making several changes to your procedures, you might consider formal training or team meeting.
- Make the documents easy to access. Have your policy and procedures hosted on your intranet or shared document server. If they are hard to find, they will not be used.
- Hold employees accountable by measuring their adherence to the procedures. Monitor their activities and provide feedback on how they are doing, both praise and coach.
- Review the documents on a regular basis, especially if your results are not meeting your goals. Remember to update the documents and retrain your staff as you make changes.
Remember, these proactive steps will help improve your cash recovery. The time you spend on these documents will reap benefits for your organization.
Anne Orrick, COO, Allegiance Group
As seen in HME News, November 2018
By Anne Orrick, COO, Allegiance Group
A collection policy is the set of procedures your company will follow to ensure payment of patient accounts. To cover the basics in your policy, answer these five essential questions:
- What are your collection goals?
Always start with the end in mind, so establish your collection goals. Industry goals to consider include days sales outstanding, clean claim ratio, open order days, hold days, cash recovery rate, denial rate, write-off rate.
- How will those goals be measured?
Use the SMART criteria when setting your goals: specific, measurable, attainable, relevant and time-based. Track your workflow ratios on a daily, weekly, monthly, quarterly and annual basis. By watching your trends, you can determine if you need to adjust your collection policy to meet your goals.
- What is the collection process?
Begin by flowcharting your workflow. Identify the information to capture upfront and the payment options you will offer. Answer the following questions: Will you be flexible on your payment plans? Define how you’ll contact the patient. What steps will you take to collect a past-due balance? Remember to focus on how you can automate your process. Look for systematic ways to communicate to patients, process payments, track responses and age accounts with as little of your staff’s involvement as possible.
- Who will resolve disputes?
Consider identifying a few employees as resolution specialists. Their responsibilities should include handling questions, researching accounts, determining how much should be written off and approving the write-off.
- When will you write off an account?
Set guidelines to determine when to label a balance as uncollectable. Then outline the next steps. Will you send the account to an outside agency? Will you report the debt to a credit bureau?
The answers to these five essential questions will serve as the foundation for your collection policy. Once you train your staff on the procedures you will create clarity and consistency within your organization.
As seen in HME News, October 30, 2018