This article is part one of a three-part blog series with Scott Mendenhall.
Scott Mendenhall is an experienced revenue cycle professional with twenty-five years of healthcare experience. He has worked in both hospital and physician settings reviewing revenue cycle performance and providing recommendations for improvement. He has also provided project management expertise for the implementation of recommendations across Patient Access, HIM, and Patient Financial Services.
What does the end-to-end process of a revenue cycle review look like?
To begin the revenue cycle review, I send out a request for basic financial data. We want to understand, before we go in and interview directors and managers of the major revenue cycle departments, where they stand in relation to some HFMA benchmarks. We want to see where they are so we have some idea of where we might need to start looking deeper. We send a data request asking for financial information, schedule interviews with the directors of the departments, and do in-person interviews with the managers of the departments.
We also use questionnaires based on best practices for each interview. It includes questions like “Are you doing this process? Are you doing this particular activity?” And interviewees answer “yes” or “no.” At the end of this interview, we end up with a scorecard. The red category indicates that there are some problems in these areas because they’re not doing what they should be doing to meet best practices. The yellow category means they need some help in these areas, and the green category means they are doing well. Through our review, the client will get a scorecard as well as a list of recommendations to get them out of the red category and into the yellow and green categories.
Based on this, we take a look at all the recommendations for improvement and determine where we can get the most “bang for our buck.” We go through a full prioritization process and say “Let’s start with this particular issue because we estimate it will not take much time and money to resolve. It will take a small investment of time and money, but will have a big impact.” We follow this process with each individual issue and predict how much we’ll need to invest to solve each issue, and what the return on investment will be.
After completing the process, we end up with a prioritized list of issues that need to be addressed. C-suite executives can then have the confidence of knowing where they need to focus their energy when it comes to staff, resources, and consulting. They can address the hotspots they have based on real information that we provide. Then we do benchmarking to compare where they are in relation to better performers in terms of financial performance. We produce a report that outlines what we found in the scorecard, where the hotspots are, and provide recommendations that we feel need to be addressed.
This has been very successful over the past 20 years because it “turns on the lights” for a lot of CFO’s and directors. I hear things like “Wow, we’ve been focusing on the wrong thing.” We also want to help them implement what we recommend so at the end of a twelve-month period they can see that cash on hand has increased, their performance metrics have improved, and other changes have been implemented. Our goal is to help them implement these changes because oftentimes, they do not have the internal wherewithal, talent, time, and budget to do it effectively. We don’t want this to be another assessment that sits on a shelf. We want to take these detailed assessments that highlight issues and help organizations overcome them.
[Look for part two of this three-part blog series next week!]