Monica Richey, vice president of physician revenue cycle for One Grady, shared insight on the strategy in a recent episode of the HealthLeaders Podcast.
In this week’s episode of the HealthLeaders Podcast, Monica Richey, vice president of physician revenue cycle for One Grady, revealed what has been working for the subsidiary of Atlanta-based Grady Health System.
During the conversation, Richey attributed the system’s numerous automated solutions to its successful cost containment in revenue cycle.
“I would definitely say we’ve tapped into other areas of automation and streamlining our processes even within Epic,” she said, noting the system’s electronic health records platform. “Using the tools we have to minimize work effort, costs, and really increase efficiency across the board.”
Richey estimates that 40-50% of One Grady’s revenue cycle processes are automated. Leveraging an existing user interface, she and her team have been able to build out additional automated solutions for professional and hospital billing.
They’ve also implemented some solutions around their front-end operations to enhance the patient financial experience.
Staff still play an important role in revenue cycle operations though, such as the team of medical coders that manage exceptions. With the system having two academic groups alongside their employee group, Richey said there are different nuances that must be reviewed to ensure they remain in compliance.
Denials and prior authorizations are consistent issues in revenue cycle operations and One Grady manages to stay on top of them by identifying issues within denials, communicating with payers, and engaging in discussion in joint committee meetings.
“Beyond that,” Richey said, “we’re having to be very intentional and strategic about the way in which we handle denials and really dig into how we operationalize our workforce to be able to manage those denials.”
Looking towards the rest of the year, Richey plans to focus on ways to lower the costs of coding and submitting cleaner claims. Prior authorization is another area she’s hoping to reassess to ensure that the system is being paid for the services it provides.
Jasmyne Ray is the revenue cycle editor at HealthLeaders.