Houston Healthcare Embarks Upon New Method For Managing Revenue
Enhancing revenue by identifying opportunities for maximum reimbursement is the primary goal of Houston Healthcare’s new Revenue Management Department. The creation of this function provides a long-term infrastructure within the organization to help identify trends and opportunities for improving coding and billing to maximize reimbursement, while also providing an audit process to ensure appropriate coding and billing for compliance.
“Creating a Revenue Management Department will help us capture revenue at the point of service, code and charge appropriately, produce an accurate bill and collect expected payments,” says Frank Powell, Chief Financial Officer for Houston Healthcare. “By developing this department, we will be better equipped to protect and secure all revenue that is appropriately due to our organization.”
During the next three years, Houston Healthcare will utilize software from Integrated Revenue Management, Inc., (IRM), a California-based company that works with healthcare providers to implement proven revenue management processes which result in positive economic performance. IRM offers extensive expertise in the areas of charge description master management, physician documentation, electronic data interchange, utilization review, third-party claims administration and denial management to help healthcare organizations identify solutions and achieve results.
Houston Healthcare’s new Revenue Management program will be led by a Director, overseeing a staff including a charge master analyst, managed care analyst, collection specialist, charge entry specialist and code based reimbursement analyst. The department staff will also include a registered nurse with experience in charge auditing. Powell projects that the program will exceed $6.6 million in net revenue during the first three years.
“Many hospitals in Georgia and throughout the country have found success in maximizing their net revenue by implementing revenue management programs,” Powell says. “This initiative will greatly benefit our organization by ensuring compliance while helping us work with the managed care plans and insurance companies to receive proper payment for our services.