What’s the value of a single cash management solution?

Aug. 29, 2017
Bob Zimmerman, RCM Solutions Manager, Healthcare, Hyland

It has been reported that as many as 289 people in a health organization touch any one bill. In the case of recently merged organizations with multiple billing teams and differing back-end billing systems, the challenges of consolidating cash posting and reconciling payments from various payers across an enterprise quickly can become mind-numbing.

Merger challenges organization to streamline cash management

This is exactly how Healthcare Organization Z found itself in 2015 after two healthcare organizations merged. And, as with any merger, this one brought forth a host of duplicate systems, workflows, and processes—some more efficient and cost-effective than others. For this organization, two separate billing teams existed for both hospital and professional teams as well as a centralized finance department that is positioned to support all of these groups. With four total teams, a problem became glaringly evident: The teams could not accurately reconcile their accounts against their many bank accounts and the finance department and balance everything to the general ledger.

Once Healthcare Organization Z recognized the need to streamline processes and identify the source of internal issues, Hyland experts were consulted based on industry expertise and revenue cycle product offerings in this area. Initially, the internal and Hyland teams held a discovery phase with the accounts receivable and finance teams to scope out the final solution requirements.

The initial project scope identified several areas of potential improvement and helped define goals within the centralized business offices and finance department to help automate their treasury reconciliation procedures. Upon further discussion and several on-site assessments, it was concluded that the need to capture payment/remittance information at the incoming data source was imperative to the success of the project. This approach would enable all payment transactions to be captured in a single workflow lifecycle and allow for segmenting data as needed, then integrating that data into each independent billing entity/system from where a particular transaction originated.

With a well-defined scope, a project team dedicated to the initiative was assembled with internal professionals directly involved in the process from start to finish. The Healthcare Organization Z team recognized the need to choose a platform that would be flexible enough to support their needs as they continued to grow and centralize cash reconciliation processes. As a result, the project team selected the OnBase by Hyland revenue cycle management (RCM) single cash management solution.

Single cash management solution smoothes business processes

The OnBase RCM single cash management solution fundamentally creates a business application layer on top of enterprise content management and workflow solutions. OnBase was selected to support all information capture, data validation and segmentation, and host system integration and reconciliation back to the bank. This enables data to be pulled in from across the organization and presented when needed—a 100% capture solution to bridge the gap between cash posting and reconciliation.

In order to streamline business processes and combine work tasks, the Hyland and Healthcare Organization Z project teams found that the best practice is to capture data one time and extend its use in four ways:

  1. post payments in the proper billing system for the patient,
  2. utilize for keyword indexing in OnBase,
  3. reconcile to the bank deposits, and
  4. use for productivity and performance monitoring, and to provide metrics for reporting.

Reconciliation problem solved, appeals management streamlined

The overarching goal was to solve the critical bank reconciliation problem. OnBase, the system to do that, was implemented and is operating successfully today. As an added benefit, Healthcare Organization Z realized an additional $150 million in year-over-year cash flow improvements based on enabling one-click access to denial/defect data that brought efficiency to appeals management.

Having been “live” on the system for more than a year, both the hospital billing and professional billing teams offer positive reports. The project teams continue to identify process improvements arising from the implementation design, and there is an improved understanding of why this shift in work processes will pay off in efficiencies gained downstream with the follow-up staff. Additionally, the centralized finance department has reported very favorable results in their ability to reconcile cash—saving staff time and eliminating the need to rely on manual spreadsheets for tracking.

System ties teams together, boosts bottom line

In terms of the projected accounts receivable and cash flow improvements, the Healthcare Organization Z hospital billing team has realized an increase in cash postings of greater than $150 million, with approximately $7 million of that arising from accelerated cash flow. The professional billing team reported that it is running approximately 3% to 5% over its cash goal year-to-date.

In summary, consolidation onto a single cash management solution can lead to significant benefits in today’s complex health systems. A single platform for cash management that captures all remittances—regardless of where they are received or the team that processes them—provided the capability to deliver a true enterprise-level reconciliation solution for Healthcare Organization Z. In addition, one consistent workflow for storage and retrieval of all patient finance related documentation delivered results from which any health system would certainly benefit.

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