I Work for a Regular Nursing Home, Essay Example

I work for a regular nursing home. About seven years ago my company employed Stockamp Associates; a consulting company as a step to improve revenue cycles. The outcomes have made me appreciate both of the articles so much because their contents can directly be identified to my experience. One area that caught my eye most on the potential improvement of revenue cycles mentioned in the articles is the “Top 10 Revenue Cycle Mistakes.” I support the idea that hospitals need to partner with banks to provide loans for financially incapacitated patients to pay their bills (Stuller, 2005, p.33). This is an idea that will help my organization to improve revenue collection and reduce bad debts and write offs encountered. How ever my experience does not support the statements that hospitals have a high percentage of patients who pay their bills in full and that it is a natural extension for the case manager to be assigned the role of working with individual patients and reporting to financial department (Stuller, 2005, p36). Only the international patients-Sheiks, royalty and foreign executives that are treated in the U.S manage to do this. In my 15 years experience, case management reports either through the quality department, nursing executive, or the Chief Medical Officer.

I may not be currently working in a hospital or patient care setting, but agree with most of the ideas in the articles that are applicable to my organization. For instance, the idea that nursing homes, hospitals, outpatient clinics that purchase their branded pharmaceuticals from Astellas should report their revenue cycle metrics to operational manager than rely on retrospective reports (Stuller, 2005, p.33) which has been a common problem with our organization.

Most of the ideas I noticed in these articles were more of commonsense to me. It is very straight forward that you can’t get rid of all the claim denials but you can reduce the number. Guyton and Lund (2003, p. 32-38) says that these appear as a result of either administrative or clinical circumstances. The ideas in these articles have made us to improve our revenue cycle management by moving from monthly billing to weekly billing (Stuller, 2005, p. 33) which has increased our revenue collection.

Both Guyton and Lund (2003, p. 72-78) and Stuller (2005, p.32) are for the idea that electronic billing can be effective in revenue management but this is only possible with adequately trained personnel. This can directly identify with my organization since most pharmacies do not take the idea of adequately training the staff seriously.

Revenue cycle transformation works to improve accountability, decrease variability, increase integration and strengthen information management (Guyton and Lund, 2003, p. 72-78). This transformation would present negative aspects for my organization. Being a non-profit making organization, there is lack of funds to facilitate all the requirements.

Generally all the ideas in the revenue articles were applicable and some were applied directly to my organization. One aspect that caught my attention was the idea that claim denials are as a result of administrative or clinical circumstances (Guyton and Lund, 2003, p. 72). Another good aspect that is applicable to the hospital is the one on improving patient payments. Patients don’t always pay on time until the next time they present themselves for treatment even though they get their bills monthly. Solutions to this that are never applied but of great help would be obtaining a contact person to be contacted when bills are not settled and starting a specific group that deals with financial problems and budgeting.  Guyton & Lund (2003, p. 78) says that hospitals which are going to implement these ideas on revenue transformations will have a competitive advantage in the healthcare market.

References

Guyton, E., & Lund, C. (2003). Transforming the revenue cycle. Health Care Financial Management, 57(3), 72–78

Stuller, E. (2005). Top 10 revenue cycle mistakes. Health Care Financial Management, 59(1), 32–38.