CHS was unable to effectively manage billing and reimbursement across the organization which resulted in an increase in billing costs, fall in collection rates, and accounts receivable rose to a point where the value of the acquisition was diminished in some cases. In addition, poor claim management also had a negative effect on billing and reimbursement. The findings from the audit allowed CHS to take a step back and look at the key components that impacted the organization negatively.
CHS began with assessing the current state of affairs. The assessment focused on three functional areas: financial, technical, and operational. First, the financial side was examined looking at the accounts receivable, its metrics and collection rates, denials, and denial management. Next, the assessment addressed the technical side looking at the systems, applications, and processes involved in the entire process. Finally, the operational side was looked at taking into account the staffing, vendor relationships, and workflows.
CHS realized that significant amounts of revenue were potentially lost daily due to inaccurate pricing, charging, coding of services and supplies related to …show more content…
The transition would go into effect immediately. Although, the complete transition can take a couple years so CHS has decided to pursue a phased approach. The advantages of a centralized billing model are economies of scale, consistency, dedicated expertise, improved billing accuracy standardized reporting and monitoring, and opportunities for enhanced IT systems (Murphy, 2017). In addition, by having a single location for billing functions, CHS will also be able to reduce duplicative administrative duties, cut back on some supplies and resources, control miscommunication between the various billing departments, and create more centralized customer
CHS began with assessing the current state of affairs. The assessment focused on three functional areas: financial, technical, and operational. First, the financial side was examined looking at the accounts receivable, its metrics and collection rates, denials, and denial management. Next, the assessment addressed the technical side looking at the systems, applications, and processes involved in the entire process. Finally, the operational side was looked at taking into account the staffing, vendor relationships, and workflows.
CHS realized that significant amounts of revenue were potentially lost daily due to inaccurate pricing, charging, coding of services and supplies related to …show more content…
The transition would go into effect immediately. Although, the complete transition can take a couple years so CHS has decided to pursue a phased approach. The advantages of a centralized billing model are economies of scale, consistency, dedicated expertise, improved billing accuracy standardized reporting and monitoring, and opportunities for enhanced IT systems (Murphy, 2017). In addition, by having a single location for billing functions, CHS will also be able to reduce duplicative administrative duties, cut back on some supplies and resources, control miscommunication between the various billing departments, and create more centralized customer