Revenue Cycle Optimization Exceeds High Target within 10 Months

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Situation

The 325-bed flagship hospital of a non-profit, community-directed health system that serves communities throughout northern and central Wisconsin, had strong operating margins, but leadership desired to accelerate revenue cycle performance through enhanced processes and efficiencies.

Solution

The hospital partnered with Prism to identify and implement revenue cycle improvements. Prism and representatives from Patient Access and Patient Financial Services formed focused, collaborative teams to lead initiatives. The project exceeded its high target of $2.3 million within 10 months, delivering $2.8 million in benefits. Key initiatives included:

  • Increased net revenue by converting eligible Self-Pay patients to Medicaid across the hospital. Development of weekly reporting and monitoring tools resulted in a 95% Medicaid screening rate.
  • Increased point of service collections through establishing scenario-based training, departmental goals and daily tracking tools.
  • Exceeded denials management goals by identifying targeted oppor-tunities, restructuring workflow and developing tools to decrease the avoidable adjustment rate and improve staff production and quality.
  • Transitioned bad debt collections to a multi-vendor, performance-based structure to incentivize agency competition.

 

“Prism exemplifies the true spirit of teamwork and collaboration. Working with their Revenue Cycle experts has led to better communications, improved reporting and increased revenues.”

Vice President, Revenue Cycle at Wisconsin Flagship Hospital

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Mukesh Gangwal

Managing Director

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