Todd Mallon, CFO of Advocare, says the organization has a near-perfect net collection ratio.
Improving net collection rates and overall revenue cycle management processes is top of mind for revenue cycle leaders and adding in new solutions and automation to streamline those operations has been a must for many organizations.
Todd Mallon, CFO of Advocare, one of Pennsylvania and New Jersey's largest independently physician-owned and physician–governed multi-specialty medical organizations, recently spoke with HealthLeaders about implementing new technology to streamline the health system's revenue cycle management operations.
With over 650 providers and 3,000 staff across over 150 independent care centers that facilitate roughly two million patient visits annually, Mallon said it was essential to simplify its revenue cycle.
Since implementing new technology from eClinicalWorks to help with its revenue cycle management operations, Advocare now has a 99% net collection ratio. As the industry standard ratio for net collections is 95%, Advocare is now operating well above average and experiencing the positive effects of that change across all of its care centers.
"I spend much less time discussing processes and denials with our accounts receivable teams. We now have the space and flexibility to focus on expanding our operations and meeting the needs of more patients in our community," Mallon says.
HealthLeaders: What sort of problems were you seeing in your revenue cycle that made you realize you needed to implement a change? What was your main driver?
Todd Mallon: Our net collection ratio was the strongest indicator that we needed to change our revenue cycle management solution. The net collection ratio measures how effectively our practice collects reimbursement for services from patients and payers. This metric has always been a top identifier of financial success in healthcare organizations.
However, our net collection ratio was continuously dropping with our previous practice management system. I felt like I spent most of my time at every financial review meeting discussing accounts receivable, denials, and current processes to get to the core of this issue. This meant our teams were spending most of their time fixing the day-to-day operations, which limited our ability to grow and provide high-quality care to more patients. So, our main driver for changing our revenue cycle management was to equip our finance and accounts receivable teams with the support and resources they needed to improve our net collection ratio.
HealthLeaders: What was the process of implementing new technology, and who was involved with the decision-making at your organization?
Mallon: Everyone on our leadership team supported the decision-making process. Between our CEO—who provides a medical perspective, the admin team and myself—who provide the financial and operational perspective, and our task force—comprised of multiple physician leaders across all of our specialties, we wanted all stakeholders represented in the decision-making process.
Leading up to the implementation, we had several meetings with our vendor to define specific goals, metrics, and deliverables to improve our net collection ratio. Once we aligned on the basic workflow and back-end operations, the next step was training. The system was new for everyone—from our CEO to the providers to the management staff—so we needed a lot of support to train our people. Without proper training, we were unlikely to see our net collection ratio improve.
Before the launch, a select group of our staff went to Boston for a complete overview and training of the new system. Three months before the launch, our vendor's team trained our providers so they would feel confident with the system. We also provided pre-launch training courses to the rest of our staff. However, even after the training, the team was available for a quick phone call or chat to answer questions or troubleshoot a potential issue with the system or workflow.
HealthLeaders: How long did it take for your organization to fully implement the technology, and how did implementation work since your practice spans so many clinics?
Mallon: Launching the system was challenging, and we could not have implemented the technology smoothly without the vendor's support. We rolled out the new solution across all 150 health centers in one day. We went all in from the beginning, and we needed to start strong.
We had eClinicalWorks trainers at every care center for about a week to two weeks after the launch to help with the transition process and to train additional Advocare staff. During the implementation, we trained internal staff as point people for the solution so they could carry on with further implementation and staff training.
HealthLeaders: Since implementation, what positive outcomes have you noticed?
Mallon: The most noticeable positive outcome is our increased net collection ratio. Several things contributed to this increase.
First, we now have a dedicated eClinicalWorks team that handles our day-to-day collections and follow-ups to ensure we receive claims on time. To create an efficient workflow, the team helped us set up ready-to-bill rules to ensure care centers complete reports accurately. We can create alerts for missing information or incomplete claims. In addition to these in-workflow rules, the team notifies us of any issues, which gives us plenty of time to gather additional information from providers or communicate the next steps with payers.
Second, our vendor's team also handles denial appeals for our care centers. So, if a denial comes back for a claim from a specific center that needs to be addressed or changed, they will help that center submit an appeal and track the claim progress within our system. Once we receive payments, they handle the cash collections and posts them internally so we can keep track of our revenue in real time.
HealthLeaders: What are some keys to success you could share with another organization looking to do the same for their facility?
Mallon: The first key to success I'd share with other organizations looking to improve their revenue cycle is to know where you currently stand. Know your net collection ratio and how many days your accounts receivable is outstanding. Once you have a baseline, you can set goals and implement strategies to improve workflows and increase collections. And once you have these measurements, keep track of them and update them regularly. We have regular meetings with our team to discuss our current metrics, compare them to our revenue and collections goals, and adjust our workflow and operations as needed. Everything needs to be measurable to be successful, especially in revenue cycle.
Second, train your team on the new technology. Especially for multi-site healthcare operations, it is imperative to have people at each care center who can monitor the solution’s success and train new staff as needed. Now each care center runs at its best. It is also easier to open new care centers because we have a unified system.
Finally, choose a health IT vendor that listens to and learns from your organization. Open communication between a health IT vendor and a practice customer can benefit both parties. For example, based on our experience with their technology and conversations between our staff and the eClinicalWorks team, they came up with a mass lock button that would lock multiple charts at once to minimize clicks and improve billing efficiency. The most valuable part of our partnerships is open communication. We are willing to learn from them, and they are willing to learn from us. Because of this open communication, our providers and staff leverage more efficient workflows and our net collections increased. Through them, we are also exposed to new opportunities to improve health IT solutions.
In the end, patients get a better experience, and everyone wins.
“I felt like I spent most of my time at every financial review meeting discussing accounts receivable, denials, and current processes to get to the core of this issue. This meant our teams were spending most of their time fixing the day-to-day operations, which limited our ability to grow and provide high-quality care to more patients. ”
Todd Mallon, CFO of Advocare
Amanda Norris is the Revenue Cycle Editor for HealthLeaders.