Technology can reduce days outstanding

Small changes can yield big results

Cutting accounts receivables days from 116 to 43 is a monumental accomplishment. Cutting the days at the same time your gross revenue grows from $770,000 per year to $1.6 million per year without adding extra staff to the billing process may sound like a plot for a new "unreality" TV show, but it did happen at HomeReach Homecare in Worthington, OH.

"We’ve experienced tremendous growth since we first looked at our accounts receivable days and billing process in 1999, but the changes we implemented mean that we can handle the growth," says Michael S. Ellis, RN, BSN, director of clinical services for the home-care agency.

"We’ve become more efficient, and activities related to filing claims flow smoothly," he adds.

Teams get the job done

HomeReach management started the performance improvement project to reduce accounts receivable days by setting up an overall coordination team composed of the billing supervisor, medical records supervisor, director of clinical services, and two nurse managers. This committee handled the overall implementation of communications and process changes, Ellis says.

"We relied upon smaller issue’ teams to work with the specific tasks we identified as problems in our process," he adds.

Ellis says specific issues addressed by the smaller teams that comprised staff members involved in the process, on both the clinical and billing sides, included:

  • physician order tracking;
  • electronic signatures;
  • electronic medical records;
  • data entry;
  • billing schedules;
  • funds transfer.

The most dramatic changes occurred in the medical records and signature process, he points out. "Although our information system had the capability to record electronic signatures, we had been relying on paper copies of records and field personnel traveling to the office to sign the paper," he says.

"Now we’re making full use of our system that enables field clinicians to use their point of care system to document the visit and sign’ the record," he says.

Because the system uses passwords and login codes to verify the user’s identity, the electronic signature is accepted as proof that the proper clinician prepared and filed the document, Ellis adds.

Not only did this save time because the paperwork no longer sat in the clinician’s inbox waiting for signature, but it saved time for the medical records staff that no longer had to print out paper records, he says.

"Because the record is on the database shared by medical records and billing, the billing staff no longer had to wait for medical records to send the records," he adds.

By making sure that all home health staff members were kept up to date on findings of the task forces and changes as they were implemented, everyone was very positive and very receptive to the changes, Ellis adds.