Different Perspectives on Optimizing your RCM CBO

Report
Different Perspectives on
Optimizing RCM and Your CBO
Ron Anderson
Director of Business Development
1
 Key Components and Effective
Management of a Remote Workforce
 Hybrid Outsourcing Options via
Shared RCM Services
CHMB Inc. - Background
Leading provider of business services and technology solutions for healthcare organizations
• Since 1995
• Largest privately held RCM company serving
physician based organizations based in California
• 3 Primary Service Lines
– Outsourced Revenue Cycle Management Services (85%)
– Professional Services (5%)
– HIT/IS Services (10%)
CHMB 360 Surround Services
Domain Expertise
Scalability
Single Source
CHMB History - Where We've Been
CHMB Opened for Business 9-25-95
(3,000 SF in Mira Mesa business office building)
Scripps Mercy signs contract
Year
Employees
1995
1997
10
35
Data Warehouse developed… service offering greatly enhanced
2001
70
Company moves to 16,000 SF in Escondido
2003
104
Implementation begins on document imaging system… the paperless office
2004
119
IT Department formalized… IT infrastructure upgrade begins
2005
131
Work-from-home initiative expands… workflows modified and improved to accommodate new
workforce
2006
155
Migrate from legacy PM to Allscripts PM & Allscripts Business Partner
Business offering expanded to include electronic health records (EHR) services
2007
180
Clinical Services department is added to supplement growing EHR Implementation business. 1st
acquisition completed
2008
250
2nd Acquisition completed - Orange County. Strong operational office in Irvine, CA
2009
300
3rd acquisition completed - Northern California. Added Consulting services to business offerings
2010
320
4th acquisition completed – Midwest
Added CBO Operational and Optimization services to business offerings
2011
350
Allscripts begins offering RCM Services
Combination of Allscripts software and CHMB RCM Services
2012
360
Providing RCM, IT and Professional Services for over 4,000 physicians in all 4 time zones
Signed 1st EPIC Client – Northwest Community Hospital, IL
2014
375
RCM CBO Remote Workforce
(Telecommuting)
 Key components
 Set up
 Monitoring
 Managing
Telecommuting - Remote Work Force
Telecommuting is more prevalent than ever and will continue to
grow as more companies and employees see the benefits of such
an arrangement. It can be very successful and actually a
competitive advantage in the talent marketplace to
attract/retain top talent, regardless of their physical location.
However, leveraging the benefits of telecommuting comes with
being mindful of the potential issues that can exist and taking
steps to mitigate those issues to create a successful
telecommuting arrangement. This is even truer for non-exempt
telecommuters
CHMB Remote Workforce
 Key driver was increasing overhead costs,
primarily real estate
 Key considerations
o Compliance
o IT and Security
o HR
o Monitoring Productivity
o Managing Workflow
Compliance
 Workers Compensation
 Ergonomics
 Legal review
 Work from home compliance
 Has to be voluntary
IT and Security
• All remote access is through remote desktop services so all data
remains on the servers
• No information can be downloaded to PC’s
• No printing options for remote staff
• Secure vpn access. With timeout after 30 minutes of inactivity. It
disconnects VPN
• Screen locks on terminal server sessions set to 15 minutes of
inactivity
• PM and EHR application time outs after 30 minutes of inactivity
• Passwords change every 90 days for windows (Active directory), PM
and EHR
• Inquire user identify for all systems. No generic id's allowed.
HR Considerations
from a HR compliance perspective
 Timekeeping of hours for non-exempt staff
 Ensure compliance with meal/break period requirements for
non-exempt staff
 Safety; even though the employer doesn’t control the
worker’s premises in a telecommuting situation, the employer
is still responsible for worker safety. Employee injuries during
the course and scope of the employment will be workers’
compensation claims.
 Protecting proprietary or other private information (HIPAA, for
example) at the off-site location
 Mandatory state/federal employment posters still required to
be provided, even for remote workers
HR Considerations
from a HR compliance perspective
• Telecommuting may be a reasonable accommodation under the federal
Americans with Disabilities Act (ADA) and California’s disability
regulations. Even if the employer doesn’t have a Telecommuting program,
may need to provide this arrangement as an accommodation in specific
circumstances. (CA’s disability regulations specifically list “permitting an
employee to work from home” as a reasonable accommodation.
• If employees work in varying states, need to understand any state specific
regulations and comply accordingly.
– For example, Massachusetts just enacted a mandated Sick Pay
regulation which could result in a need to comply. Also, there may be
specific compliance issues in certain cities (San Francisco has certain
rules)
• Ensuring that the state payroll taxes associated with each state in which
telecommuters work is followed and paid accordingly. Also other state
reporting requirements related to payroll.
HR Considerations
Telecommuting Program Components
Best to have a systematic approach to a Telecommuting Program to
include:
• Criteria for assessing whether an employee can work remotely.
• Telecommuting Agreement signed by the employee and the
employee understand this arrangement is a privilege, not a right
(with the exception of an ADA accommodation)
• The hours the telecommuter is expected to work so that it is
aligned with business needs.
• The manner in which home office expenses and expenses for
travel/parking at the company will be handled for periods when
the worker comes on-site
• How managers will manage work performance/productivity and
adherence to company policies
HR Considerations
Telecommuting Program Components
• Logistics to support telecommuters (support staff, equipment, office
supplies, etc)
• When the telecommuter will be required to come on-site (meetings, client
visits, etc)
• Any special policies that might be necessary, such as abstaining from using
their children to help with work tasks and the applicability of policies
related to computer/phone usage.
• Clarity about whether the employer will assist with costs of moving, if the
telecommuter moves.
• How termination of employment will occur in terms of removing
computer access and the return of company equipment. Make sure there
is a clear written inventory of all company owned equipment.
HR Considerations
Work at Home Agreement Components
• Expected Duration of arrangement
• Conditions that could require return to office location
to work
• Employee Rights and Benefits
• Equipment usage
• Reimbursement of incurred expenses
• Maintenance of company equipment
• Use of employee’s personal equipment (particularly
related to protecting information as the personal
equipment may not be configured to provide
appropriate protections)
HR Considerations
Work at Home Agreement Components
• Notification requirements to the employer of equipment
malfunctions/failures to that the employee can perform
the work necessary.
• Work environment expectations at remote site
• Job safety requirements
• Expectation of job performance/productivity
• Compliance with all policies/regulations
• Timekeeping requirements
• Defined work day/work week
• Process to set up remote work and expected time-frame
until remote work is ready
Challenges
• Employee Communications
Probably the biggest challenge in a telecommuting arrangement
after the above are handled is how to keep remote workers
engaged and feeling a part of their company and their
team. There are many small and larger methods to keeping the
remote worker involved, and one of the most important is
continuous bi-directional communication.
• Employee satisfaction surveys
• Company Newsletter
• Periodic Company Newsletter/Webinars
Monitoring Productivity
 Productivity standards
(AR follow-up, charge entry & payment entry)
o Integrated with data from our PM system
o Down to the user/employee level
 Managing/Monitoring
o Electronic workflow
o Electronic timekeeping (PayNet)
Performance Metrics
Performance Metrics
AR Production Summary
Key Outcomes
 Enabled us to retain good employees that
move or are geographically challenged
 Enabled us to hire employees who don’t live
near one of our offices
 Don’t have to have bricks and mortar office
for all employees enabling further growth
RCM Shared Services – Hybrid models
Shared Services is a hybrid or partial outsourcing
of certain tasks and processes between and
internal CBO and an outsourced business
services vendor
Why a Shared Services Model?
 Local labor pool limitations
 Space limitations
 Allows you to focus internal staff and
resources on key aspects of Revenue Cycle
Key Considerations
 Identify problems in the Revenue Cycle
 Define what needs to be done internally and what
makes sense to outsource
o
o
o
o
Patient communications
Data Entry
Follow-up
Patient Collections
 Define expectations and responsibilities
 Monitor and Measure by analyzing results
o Productivity
o AR Metrics
 Finding the right vendor to work with
Shared RCM Services Examples
 Early Out AR sent to outsource vendor
(e.g. AR over 60 days)
 Internal CBO
o Front End – Registration, Verifying Eligibility,
Scheduling
o Middle – Charge Entry, Claims submissions
 Outsource Vendor
o Back End – Payment Posting, Claims status checks,
AR Follow-up/Denials, Patient Collections
For Additional Information Contact:
Ron Anderson
Director of Business Development
Office: 760.520.1340
Cell:
619.813.3892
Email: [email protected]
Web: www.CHMBInc.com

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