Case Study

Transformed revenue cycle processes for real bottom-line results.

Numbers, whether time or money, don’t lie. At a 1,000-bed health system in the Northeast, the numbers told a story of mounting unpaid self-pay accounts that spent more than 120 days in accounts receivable (A/R) and ended as bad debt. Quite simply, our client’s revenue cycle equation – which relied on in-house efforts and piecemeal vendors – did not work and put the very core of their mission of care at risk.

         

Case Study - Health Self Pay
Industry
Healthcare
Services
Business Process Transformation

The Problem

Sutherland’s team of revenue cycle management experts knew exactly the need our client faced: to flip the numbers fast without sacrificing the personal interaction with patients, and to transform their revenue cycle processes to focus on real, billable dollars.

All self-pay and charity care accounts were transferred to Sutherland. After doing an initial assessment, we created a goal of increasing receivables by 20 percent within six months.

The Sutherland Transformation

Sutherland followed a methodical, results-focused chain of efforts in a 120-day window per account to chase down the dollars owed to the organization. The efforts included multiple channels - email, letters, and phone calls - to patients to do the following:

  • Verify coverage options for government assistance, such as Medicaid, or the client’s reduced fee program so that the hospital could be paid, even if it was at a reduced rate
  • Discuss and develop payment plans or coverage options, so that patients felt relieved of pressure directly from the hospital and wouldn’t have to resort to the detrimental process of filing for bankruptcy
  • Conduct ongoing Medicaid eligibility verification checks, including twice-yearly checks for any account that has been priced for charity care

Because automated calls lead to a lower ROI, Sutherland used live voice recorded calls while still keeping the volume of calls high. In many cases, field representatives visited patients who needed in-person assistance. Back at the client’s site, Sutherland stationed representatives, working in tandem with their staff and talking directly with patients to eliminate extra work.

A prominent health system in the northeast needed to transform their revenue cycle processes to create real, bottom-line results.

The Results

Within months, the transformed processes along with Sutherland’s dedicated resources, delivered a 59 percent increase in self-pay cash collections. A/R days also dropped to an average of 30 days from nearly 60 days. The client and Sutherland continue to uncover root problems to streamline and automate processes.

Today, Sutherland is expanding its work to analyze and improve all of our client’s accounts that are aging without follow-up and to clean up old receivables accounts. The partnership continues to grow and we recently helped implement additional process improvements centered around improving the patient and employee experience through design thinking and journey mapping.

Case Study - Health Self Pay - Fact 1

ED Cash Collection

Case Study - Health Self Pay - Fact2

Self Pay Cash       

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