Teamwork Makes the Dream Work Revenue Cycle Decoded

Hi, everybody. In today’s podcast, we’re going to talk about one of the biggest mistakes practice managers make, and that is not involving their team in solving their revenue cycle issues.  But first, Welcome to the Revenue Cycle Decoded Podcast where I help medical practice managers like you get the revenue cycle edge in your practice. I am passionate about helping you learn the skills you need to be a revenue cycle hero, advance your career, and improve your financial results.  [Opening music] Today we are talking about teamwork in revenue cycle. You have heard the phrase, “teamwork makes the dream work” and it is just as true in revenue cycle as it is anywhere else. If you have a practice where you have an incredibly involved team in all aspects of managing the revenue cycle, congratulations! You probably have an extremely high performing team.  However, some of you may be newer in practice management or newer in revenue cycle and you may be trying to take on everything yourself or solve all the problems yourself. First of all, this is a recipe for burnout.  As a practice manager, you wear many hats, and you cannot do everything in the practice on your own. There just aren’t enough hours in the day.  Secondly, if you try to solve all the problems, you are probably not going to come up with the best solutions.  You may waste days or months researching when a team member may already know the answer or a potential solution that would solve the problem. Even if you do come up with a great solution, your team will probably not be invested in making the change, and then you set yourself up for a conflict with your team, or for your team to feel blamed or to undermine your solution. 

If you manage a large practice or a practice with multiple locations, departments often function in silos. Departments may not talk to each other or may not share essential information that is needed to solve the issue. For example, you may have an issue happening in your front office processes leading to denials or rejections. The front office may not realize they need to obtain prior authorizations because the payor requirements have changed, but they weren’t made aware.  Or they may have trouble getting authorizations, or payor gateways may not work properly, or payors may be slow to provide authorizations, but the information doesn’t get communicated to the clinicians and providers. It could be eligibility verifications; it could be new people not understanding what they need to do who are still in that learning phase. So, you have these denials and rejections coming across and your accounts receivable folks are seeing them but that information may not be getting communicated up to the front desk.  We’re not necessarily closing that loop. 

It could be middle revenue cycle processes such as physicians not understanding what is required in the documentation or not understanding a medical policy or not realizing why backend coders are sending queries, to get the most accurate information in the chart. Again, maybe that information is not getting communicated back to the physicians and the clinicians to close that loop and help them understand what they need to be doing to not get denied. 

And, it could be your backend revenue cycle processes. Your accounts receivable or billing staff may be coming across an issue but like we said, it’s not getting reported across the organization and up to other departments so that they can take care of the issue or provide training. 

So having department meetings bringing in the key team members together gives them the opportunity to discuss the issues and problems and to share information across departments. You’re also bringing in your problem solvers where they can brainstorm potential solutions, come up with ideas to solve the problems and then you can implement them to see how they work.  Another benefit is that when the team is involved, they are invested in the solution