1. Revenue Cycle Management Industry Trends and Tips to Improve Efficiency Bob Svendsen, Chief Executive Officer February 7, 2013

2. CHMB – Who We Are Service Technology Results
3,500 + physicians (13,000 + end-users)
500 + staff in 24/7 work-cycle
Locations – San Diego, Irvine, Oakdale and Chicago
Customers Located Across U.S.
Remote Workforce – 15 Different States
Largest Install of Allscripts PM
450 + Allscripts PM Databases Built, Deployed and Supported
30,000 + Implementation Hours Annually
1,000 + physicians supported on EHR
Founded in 1995
Privately Held
Inc Award Winner ( )
Profitable and Well Funded for Growth
Partners w/ Allscripts since 2007
Star Reference Site
Deeply Connected Across Multiple Disciplines
Enterprise EHR//PM and Professional EHR/PM
Hosting, Implementation and Support
RCM Services
HCLS Partner w/ Dell since 2003
Service
Technology
Results
Physician Centric
Physician/Hospital Alignment
ACO
Leading Technology Leverages Staff Efforts and Allows Repurposing of Staff
End-to-End Revenue Cycle Solution Optimizes Results

3. Key Industry Trends Consolidation New Business Models
Connectivity and Interoperability
Reliance on Data
Unfunded Mandates

4. Risk Factors Rate of Change Exceeds Capabilities
Scalability of Infrastructure… Human/Tech
Stuck in a Silo
Business Intelligence
Resource Constraints

5. Reconciliation, Tracking & Auditing
Revenue Cycle Management Success
Dedicated Revenue Cycle Team
Team Model - Dedicated Team with Support Infrastructure to Enable Optimum Performance
Workflows Complement Technology
Auditing + Accountability = Performance
Executive Leadership
Claims
Advocacy
Rev Cycle Team
Account Manager
Data Entry
Payment Posting
Patient Calls
Appeals
Follow-Up IT
Compliance
Reporting/
Analytics
Document Imaging
Reconciliation, Tracking & Auditing
Information Services
Conversions
Interfaces
Application Support

6. Blocking and Tackling RCM Basics
1) Policies, Procedures and Processes – Documented
2) Accuracy and Timeliness of Information – Clean Claims
3) Time of Service Collections and Self-Pay Collection – Policy and Technology
4) Productivity Measures – Clinical, Administrative and Financial Staff
5) Claims Submission – Process, Process, Process…
6) Work Aging Buckets Proactively and Consistently – Know your AR
7) Review and Audit Coding – EHR Charge Capture Spotlights Physician Challenges
8) Review and Enforce Contracts – 5% or More
9) Application Expertise – New Products with Increasingly Enhanced Capabilities
10) Manage to Goals - That which gets measured gets done!
Noun blocking and tackling (idiomatic, US)
Basic tasks or skills in an undertaking or occupation.

7. Key Revenue Cycle Metrics Days in AR 39.5 Net Collection % 99.1
AR Over 90 Days %
First Pass Clean Claims % 97.1
Other Benchmarks:
Service Date to Receive Date
Receive Date to Post Date
Denial Rate
Contract Performance
Results will vary by practice as many factors contribute to overall revenue cycle success

8. Allscripts/CHMB RCM Services  Shifting the Responsibility
Allscripts/CHMB Responsibilities…
PM SYSTEM HOSTING
Provide for PM System Access for Authorized Users
Provide for System Failsafe, Backup, & Redundancy
PM SYSTEM IMPLEMENTATION & TRAINING
Best Practice Based PM System Implementation & Training
DATA ENTRY & POSTING
Posting Charges
Posting Payments (Patient & Insurance)
INSURANCE FOLLOW-UP
Claims Submissions / Patient Statements
Insurance Follow-Up/Correspondences
Filing appeals & follow-up and tracking status
Reporting denials & underpayments
Liaison with payers
PATIENT COLLECTIONS
Patient account inquiries
Requests for correct/updated information
Letters to delinquent/no-pay accounts
Phone calls to delinquent/no-pay accounts
Prepare accounts to send to collections
Client Staff Responsibilities…
PATIENT REGISTRATION
Patient Demographic Capture
Insurance Card Scanning & Documentation Capture
PATIENT SCHEDULING & PRE-VISIT MANAGEMENT
Patient Appointment Scheduling
Batch & Real-Time Eligibility Processing
Eligibility & Appointment Confirmation Exception Follow-up
MISSING INORMATION FOLLOW-UP
Attend to Work Queue with Data Requests for Missing Information

9. Resource Re-Allocation
A change to the status quo fosters opportunities to evaluate operational resources and priorities… particularly at the staff level. New technology, new business models and a changing marketplace all create new opportunities for deploying staff resources in a new more effective model.
Charge Entry Clerks = Charge Review Specialists
Biller/Coders = Physician Educators
Patient Registration Clerks = Patient Financial Services Reps
IT Specialists = Business Intelligence Analysts

10. Summary
Understand the Impact of Industry Trends – Financial, Technical and Human
Assess Risk Factors to Your Organization – How Much Risk Can You Absorb?
Find Alignment Balance – Are You Aligned with All Stakeholders?
Evaluate Core Competencies – Policy, Procedure and Process
Take Care of the Basics – Blocking and Tackling
Measure and Manage to Goals