Leading Revenue Cycle Improvement
Operational Performance Improvement
President, Cadence Health, Inc
Director, Contracting and Process Improvement, DeKalb Medical Center
DeKalb Medical Center has made great strides with Revenue Cycle improvements by integrating typically separate functions into a streamlined team focused on maximizing net revenue. In just two years DeKalb has used commercial products, home-grown software, and a unique department structure to revolutionize how they approach Managed Care Contracting, Denials Management, CDM maintenance, charge capture, and clinical trials. In this presentation they will share tips and tricks you can implement to achieve the same type of cash increases - Since 2003 average inpatient payment increased $1,000 per case, 1Q 2005 saw over $2.6 Million in denials collections, and CDM efforts resulted in an increase in net revenue of $7.3 Million for the year ending 3Q 2004.
In this session Amanda and Adrienne will outline DeKalb Medical Center's Revenue Cycle strategies and tools. DeKalb has a unique process and staff all aligned to help maximize net revenue. They will outline analytical use of several systems, both commercial and home-grown, for denials management, insurance verification, contract modeling, CDM maintenance, clinical trials, and charge capture. Throughout the presentations they will use case studies to show the audience tips and tricks for effective contract negotiation, charge capture, and denials. Amanda Hardy will outline the new leadership structure she has designed to integrate all of these areas into one revenue-focused team. DeKalb Medical Center has seen tremendous results over the last 2-3 years from these efforts. Average Inpatient Payment per Case has increased $1,000 from CY 2003 and in first quarter of 2005 DeKalb collected over $2.6 Million denied dollars. Their CDM efforts were rewarded with an increase in net revenue of $7.3M for a cash impact of $2.8M in the year ending September 2004. Finally, when DeKalb began working towards profitable clinical trials they met their yearly goal of $100,000 in the first quarter - In just the first quarter of 2005 they have posted $64,000 in payments.