In this era of healthcare reform with its deteriorating payer mix and increased pressures on bottom lines, healthcare providers are looking to stabilize and/or improve its margins in any way possible.  Here are 10 ways the healthcare team at Dean Dorton Allen Ford recommends as potential avenues to generate additional cash:

1. Increase the focus on point of service collections – Identify, communicate, and collect.  Implement the right processes and tools so that your front-end staff can collect more dollars at the time of service.  Make it part of the job description and set the expectation that patients pay at the time of service.  It is critical to provide the appropriate level of training and scripting for front-end staff.  Other areas to consider include payment estimator software, an integrated eligibility verification process and multiple payment options, including online portals.
2. Underpayment recovery – Is your organization getting reimbursed timely and accurately based on the terms of your contract?  Some estimates show that as much as 3% of net revenue is left on the table due to receiving less than the expected reimbursement.  Organizations should have a coherent approach to identify these claims and compare actual reimbursement to the expected rate.
3. Discharged Not Final Billed (DNFB) – DDAF recommends that no more than six (6) days of average daily revenue be sitting in DNFB at any given time.  If total A/R in DNFB exceeds six days of revenue, then there may be process or staffing issues that need to be addressed.  Too many dollars in DNFB may result in delayed payment or timely filing write-offs.
4. Denial Recovery – Third party payer denials must be tracked and resolved on a daily basis.  Hospitals should dedicate its most skilled resources to prevent, appeal, and resolve denied claims.  This team should be well coordinated and include representatives from Finance, Managed care, Patient access, Case management, Health Information Management, and Patient Financial Services.
5. Cash Acceleration – Priority accounts must receive proactive, aggressive follow-up.  Design your collector work queues to include those accounts that have the most significant impact on cash and Accounts Receivable.  Remember, 80% of your billed Accounts Receivable can be managed thru just 20% of your account volume.  Most providers just don’t have the luxury of giving the same amount of effort to every account.  It may be appropriate to outsource some portions of the billed receivable, such as small dollars or aged A/R.
6. Secondary scrub of Medicaid days for Disproportionate Share (DSH) – With the right technology and methodology, hospitals can identify between 2% and 5% in additional Medicaid-eligible days.  These days can be added thru a re-opening of an already settled cost report and provide significant additional revenue.  There may also be Medicaid billing opportunities if eligibility is identified for patients who were previously classified as self-pay or charity.
7. Charge Description Master (CDM) review and strategic pricing – A review of the CDM can identify missed revenue opportunities and/or compliance risks.  Strategic pricing can also lead to potential gains in net revenue.
8. SSI member management – Proactively managing a hospital’s SSI ratio on a prospective basis can have a significant positive impact on additional DSH reimbursement.  It is important to identify patients who are likely SSI eligible to maximize reimbursement.
9. Coding and charge audit – It is advantageous for providers to undergo a review of its documentation as it relates to coding and charge capture.  This type of analysis can reveal missing and/or incomplete documentation and potential compliance risks missed revenue.
10. Bad debt analysis – Take a look at the types of accounts and balances that are being transferred to bad debt each month.  Review a 12-month history to determine the various patient types, frequent flier patients, and traditional co-pay/deductible amounts that are going uncollected and being transferred to bad debt.  There may be some trends that can lead to process improvement opportunities to collect more of those dollars.