Samaritan Health Services, a nonprofit network of hospitals, physician clinics, and health services located on the central Oregon coast, is a young organization. Launched in 1997, SHS has grown from one to five hospitals and 85 clinics, caring for over 290,000 patients and offering four insurance plans to over 28,000 members. While the exuberance of youth sparked a great deal of expansion, it also brought forth millions in revenue cycle losses due to poor processes.
Early on, SHS had the foresight to create a central business office to help coordinate its facilities. Nonetheless, some revenue cycle basics got overlooked—namely workflow. Poor processes caused A/R to balloon to 58 days, and unposted cash to hover at $25 million. Dawnell Buell, SHS vice president of revenue cycle, recounts that six years ago, when she moved to SHS from the more tech-savvy Providence Health Services in Renton, WA, she quickly realized that the CBO was hamstrung by manual procedures, paper documentation, limited storage, and two disparate patient accounting systems.
In fact, nearly 85% of the payers that worked with SHS (including the organization's own plan) were sending information by paper, forcing manual entry and posting.
"Here we are an integrated health system and we're getting a manual remittance from our own payer. We were getting 600-800 pages of remittance a week, and it was taking multiple staff to administer our own health plan and manually post payments," she says. "Our processors have to reconcile the funds before deposit, so our cash posting process was just painful. We were using a lot of paper processes and we were in dire need of change."