Hope House NIATx Change Project January – September 2012

The Aim Increase Fee For Service from current rate of 60-70% to 100% receivable. This project goal was selected due to the need for Hope House to supplement government funding sources with fee-for-service revenue. In order to do that, management of our fee-for-service opportunities and point of service collections were reviewed.

Change Flow charts were developed so that processes can be consistent throughout the agency and so all staff can be familiar the processes and expectations. Agency terminology has been standardized so that everyone is “speaking the same language”. Agency roles and responsibilities are being better defined to provide information to all staff as to “who is responsible for what” and how different areas interface. Mechanisms for tracking authorizations and utilization of services requested were developed an implemented. Mechanisms for identifying clients with balances or who had financial responsibility for treatment were developed.

Results for FFS Accounts Receivable

Next Steps Continue to monitor authorizations and utilization rate. Continue to monitor denied services and reasons. Continue to monitor expected and actual point of service collections Educate clinical staff on service authorizations, and their responsibility to the process.

Impact: Lessons Learned All staff members, regardless of discipline or department, are important in the fiscal responsibilities of the agencies. Clinical staff must take ownership of how the services they provide impact the financial aspects of the agency. Understanding that fiscal responsibility and quality service delivery do not need to be mutually exclusive.