Revenue cycle optimization helps Pershing Health System reduce AR days
Pershing Health System taps Oracle Health’s Revenue Cycle Uplift Program to improve staff adoption, key performance metrics, and its bottom line.
“The Oracle team helped us adjust our workflows and reduce re-work with claims edits to save us time. They also looked at other areas, like coding and registration, and advised us on what steps we should take in order to improve our workflows.”
An integral part of the rural community in North Central Missouri, Pershing Health System uses cutting-edge technology typically found only in large urban hospitals to serve its patients. However, following the COVID-19 pandemic, leaders at Pershing realized attrition had created knowledge gaps in how business operations staff were using its revenue cycle solution.
“I’d estimate we were using 10 to 15% of the tools Oracle Health had available, and I could tell it was impacting our organization,” says Ken Baranski, chief financial officer. “We weren’t taking advantage of the 3M coding agreement to help clear accounts for billing, and we were using manual processes. We were also seeing incorrect information hit our statements because we were creating workarounds and weren't using the system as it was designed.”
In 2022, the health system participated in Oracle Health’s Revenue Cycle Uplift Program to improve key performance indicators and optimize how employees were using the system. As part of the program, the CommunityWorks Revenue Cycle Optimization team was engaged to use a data-driven approach to assess the organization’s processes, adoption of the system, and system configurations.
One of the metrics that Pershing Health System wanted to focus on was accounts receivable (AR) days, which help measure the amount of time it takes to receive payment on a claim.
“Before we did the uplift, our AR was really high. We reached out to the CommunityWorks Revenue Cycle optimization team because we knew we couldn’t continue that way,” says Alex Bartlett, director of patient accounting. “The Oracle team helped us adjust our workflows and reduce re-work with claims edits to save us time. They also looked at other areas, like coding and registration, and advised us on what steps we should take in order to improve our workflows.”
The organization also worked with an Oracle Health operational revenue cycle executive to learn about industry best practices and establish a multi-disciplinary revenue cycle action team on site. Because revenue cycle departments often function in silos, the multidisciplinary team was created in order to encourage proactive collaboration on billing issues that could delay reimbursement.
After participating in the program and establishing a Revenue Cycle Action team, Pershing Health decreased discharged, not final billed (DNFB) by 63%1 and lowered AR days by 28.7%,2 meaning fewer invoices or statements were being held up in the system. Processing claims in a timely manner is especially important for rural healthcare organizations so facilities can continue to provide medical services to populations that otherwise wouldn’t have access.
“For a lot of insurance companies, you have to get a claim out within a certain time frame. If we miss that window, then there’s a good chance insurance isn't going to pay us,” says Bartlett.
The organization also increased its average daily revenue by 5.8%,3 while subsequently increasing payments by 17%.4
“It’s important to get that hard work turned into cash. We knew that if we could improve our AR, then we wouldn't have cash issues. That was the goal,” says Ken Baranski, Chief Financial Officer at Pershing Health System.
Looking back at the optimization, leaders are optimistic about continuing to deepen their knowledge of the system.
“We’re getting to the point where we’re starting to see processes and their patterns, and we’re learning. Whether it be a claim going out for the first time, or generating self-pay statements, we're seeing how the system is designed to work. If we see something that's working time and again, we identify that so we can use it to our advantage. That way if we have to do something slightly different, we know and can easily expect how the system is going to handle it,” says Baranski.
1 Comparing the monthly average baseline of 21.9 DNFB days (from May 1, 2021, to April 30, 2022) to the monthly average of 8.1 DNFB days after engaging in the revenue cycle uplift program (from May 1, 2022, to February 28, 2023).
2 Comparing the monthly average baseline of 80.4 gross AR days (from May 1, 2021, to April 30, 2022) to the monthly average of 57.3 gross AR days after engaging in the revenue cycle uplift program (from May 1, 2022, to February 28, 2023).
3 Comparing the baseline average daily revenue of $96, 544 (from May 1, 2021, to April 30, 2022) to the average daily revenue of $102, 113 after engaging in the revenue cycle uplift program (from May 1, 2022, to February 28, 2023).
4 Comparing the monthly average baseline of $1,306,149 total payments (May 1, 2021, to April 30, 2022) to the monthly average of $1,530,102 after engaging in the revenue cycle uplift program (from May 1, 2022, to February 28, 2023).