Скачать презентацию Leveraging collection agency data to close internal revenue Скачать презентацию Leveraging collection agency data to close internal revenue

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Leveraging collection agency data to close internal revenue holes Bad Debt Agency Data Increased Leveraging collection agency data to close internal revenue holes Bad Debt Agency Data Increased Revenue & Decreased Future Debt 888 -592 -2146 Presented by: John S. Kline

“Outside the Box” Collection Agency Data Address correction reports: address, phone, name changes Insurance “Outside the Box” Collection Agency Data Address correction reports: address, phone, name changes Insurance or TPL payment listings: missed opportunities Service type and location payment reports: where are the holes? Presumptive Charity or Score Modeling reports: patient specific background First 30 day listing payment report: low hanging fruit missed Drill down reconciliation reports – pivot tables not just sheets Drill down aging reports - showing ATB

Address data to minimize future mail returns. (SSN, phone, and name redacted) Address data to minimize future mail returns. (SSN, phone, and name redacted)

Insurance and TPL payment information Values Row Labels # of Ins Pmts $ of Insurance and TPL payment information Values Row Labels # of Ins Pmts $ of Ins Pmts 6 $5, 761. 78 5 $12, 806. 85 Sample Client 2 Inpatient 7 $219, 020. 65 Sample Client MICU 1 $434. 46 BCNJ MANAGE CARE 13 $28, 583. 49 Sample Client Outpatient 7 $23, 403. 33 Sample Client 2 Outpatient • Verify Information Registration • Procedures $238, 023. 74 Sample Client 2 Outpatient Internal Audit 19 Sample Client Outpatient • Government • Non. Government AETNA PPO, MC, EP, POS 3 $4, 321. 00 Sample Client 2 Inpatient 1 $492. 47 Sample Client MICU 2 $366. 69 17 $2, 468. 40 13 $1, 780. 37 Sample Client 2 Outpatient 2 $220. 66 Sample Client MICU 2 $467. 37 832 $716, 451. 05 MEDICAID Sample Client Outpatient Grand Total

Expanding Insurance and TPL payment Data Drill Down BCNJ MANAGE CARE Payment Audit 13 Expanding Insurance and TPL payment Data Drill Down BCNJ MANAGE CARE Payment Audit 13 Pmt_date Found Revenue $28, 583. 49 Client_Acctno Primary_insurance Pmt_Type Applied Balance Service_date PT_Svc_Type Pt_Type_S_Des ##### BCNJ MANAGE CARE 3/23/2015 IDP $2, 025. 00 $4, 042. 85 8/11/2014 EMR EMERGENCY ##### BCNJ MANAGE CARE 3/16/2015 IDP $1, 867. 50 $307. 50 8/30/2014 EMR EMERGENCY ##### BCNJ MANAGE CARE 3/16/2015 IDP $2, 137. 50 $0. 00 6/9/2014 EMR EMERGENCY ##### BCNJ MANAGE CARE 3/9/2015 IDP $100. 00 $0. 00 9/10/2013 EMR EMERGENCY ##### BCNJ MANAGE CARE 3/23/2015 IDP $2, 125. 00 $50. 00 10/3/2014 EMR EMERGENCY ##### BCNJ MANAGE CARE 3/16/2015 IDP $2, 125. 00 $50. 00 7/27/2014 EMR EMERGENCY ##### BCNJ MANAGE CARE 3/23/2015 IDP $254. 19 $0. 00 7/5/2014 MCU MICU/SOUTHSTAR ##### BCNJ MANAGE CARE 3/18/2015 IDP $112. 50 $0. 00 1/19/2014 MCU MICU/SOUTHSTAR ##### BCNJ MANAGE CARE 3/30/2015 IDP $1, 162. 55 $1, 883. 90 5/29/2014 OBS OUTPATIENT ##### BCNJ MANAGE CARE 3/16/2015 IDP $492. 47 $0. 00 9/13/2014 OBS L&D/OBSTETRICS ##### BCNJ MANAGE CARE 3/9/2015 IDP $8, 496. 29 -$0. 02 1/17/2014 PTH OUTPATIENT ##### BCNJ MANAGE CARE 3/25/2015 IDP $7, 614. 49 -$4, 795. 88 7/25/2014 SDS SAME DAY SURGERY ##### BCNJ MANAGE CARE 3/16/2015 IDP $71. 00 $0. 00 12/17/2013 VIM RECURRING

 Values Row Labels # of Ins Pmts $ of Ins Pmts EMERGENCY 650 Values Row Labels # of Ins Pmts $ of Ins Pmts EMERGENCY 650 $224, 177. 60 EMR 600 $181, 744. 32 EPB 50 $42, 433. 28 61 $36, 161. 94 11 $26, 976. 18 32 $30, 494. 56 OBS 19 $16, 622. 46 OUT 12 $5, 375. 81 PTH 1 $8, 496. 29 832 $716, 451. 05 Same data, different use. Identifying location problem areas. MICU/SOUTHSTAR MCU NURSERY NBN OUTPATIENT Grand Total Location Problem areas? Service Type

Presumptive Charity Intelligent Charity, for those who need it. Through a cross-section of the Presumptive Charity Intelligent Charity, for those who need it. Through a cross-section of the Federal Poverty Guideline, and each patient’s unique propensity to pay, agencies create the automated ability to identify those patients who need assistance most. The models are typically Form 990 compliant and fully customizable to each of client’s needs and can be based off the client’s very own patient population historical data, for a specific level of accuracy.

Propensity to Pay – Phase 1 Consumers & Businesses Addresses & Phones e. Mails Propensity to Pay – Phase 1 Consumers & Businesses Addresses & Phones e. Mails & IP Addresses SSNs & DOBs Household composition Property & Mortgage Occupation & Income Lifestyles & Hobbies Over 300 billion current & historic consumer records. 300 Terabytes of data. Catalog, Internet & MOTO Purchases Multiple Identity Databases Demographic & Asset Data Who made the purchase What they purchased When they purchased How much they spent Aggregated Credit Data Consumer Credit Bureau Report Statistics aggregated at a zip+4 Additional Sources Internet Domain Data Risky addresses & Phones Known fraud addresses Validation databases Bankruptcy & Deceased

Propensity to Pay – Phase 2 Propensity to Pay – Phase 2

Presumptive Charity – Phase 1 Reports to show breakdown of Client Presumptive Charity Scores Presumptive Charity – Phase 1 Reports to show breakdown of Client Presumptive Charity Scores

Presumptive Charity – Phase 2 Reports to show Charity Score in relationship to the Presumptive Charity – Phase 2 Reports to show Charity Score in relationship to the Propensity to Pay

 • First 30 days of list payment report • Client ability to audit • First 30 days of list payment report • Client ability to audit the days in agency (DIA) for payment types • Fast agency payments tied to certain locations of service easily identified Client Code CL Acct No List Date DIA Pmt Dte Ini Bal SAMPLE CLIENT 4020650117 3/16/2015 10 3/26/2015 $1, 000. 00 SAMPLE CLIENT 4019061466 3/16/2015 14 3/30/2015 SAMPLE CLIENT 4020524353 3/16/2015 14 3/30/2015 SAMPLE CLIENT Pmt Amt Curr Bal Pmt Type $49. 17 $950. 83 VI $882. 90 $706. 32 $0. 00 VI $250. 00 $0. 00 DP 4020447803 3/16/2015 7 3/23/2015 $1, 692. 30 $275. 30 SAMPLE CLIENT 4020447803 3/16/2015 7 3/23/2015 $1, 692. 30 $490. 31 SAMPLE CLIENT 4020603934 3/16/2015 7 3/23/2015 $2, 175. 00 $2, 125. 00 SAMPLE CLIENT 4020692564 3/16/2015 7 3/23/2015 $35. 00 SAMPLE CLIENT 4020488443 3/16/2015 8 3/24/2015 SAMPLE CLIENT 4020547388 3/16/2015 8 3/24/2015 Pmt Reference Srv Date Location Service Type 121408 10/24/2014 OBS L&D/OBSTETRICS 268441 12/7/2013 MED TELEMETRY 11 PATIENT PAYMENT 9/25/2014 MED SEMI-PRIVATE $926. 69 DP 18 PATIENT PAYMENT 9/11/2014 OUTPATIENT $926. 69 DP 69 PATIENT PAYMENT 9/11/2014 OUTPATIENT $50. 00 IDP 89 NJ / OUT OF STATE 10/3/2014 EMR EMERGENCY $15. 00 $0. 00 DP 39 PATIENT PAYMENT 10/24/2014 EMR EMERGENCY $21. 35 $0. 00 MC 06034 ZWEB 9/22/2014 IMS RECURRING $544. 54 $326. 94 08521 B 9/26/2014 EMR EMERGENCY $62. 02 VI

Importance of Reconciliation Reports: Immediate answer to audit questions. Agency Adjustments Agency remits Agency Importance of Reconciliation Reports: Immediate answer to audit questions. Agency Adjustments Agency remits Agency Closures Values Row Labels Sum of TRUE Sum of DBBAL Sum of CLIENT BAL Sum of DSAMTCAN ACCOUNT NOT ON RECON 3, 001 $4, 214, 971 $0 $0 223 $0 $80, 576 $0 AGENCY BALANCE GREATER 33 -$4, 606 -$10, 561 $0 AGENCY BALANCE LESS 19 $10, 349 $47, 298 $0 285 $319, 642 $347, 050 $0 BALANCE MATCH 13, 734 $15, 017, 655 $15, 017, 550 $0 RECALLED STILL ASSIGNED SECOND PLACED MATCH 31, 421 $0 $17, 761, 621 104 $0 $179, 588 $184, 896 53, 106 $19, 551, 388 $35, 749, 890 $19, 146, 936 ACCOUNT ON RECON NOT W APEX AGENCY BALANCE LESS RECENT PAY RECALLED STILL ASSIGNED SECOND PLACED MISMATCH Grand Total

Avoid the agency black hole inventory! Row Labels CREDIT BALANCE ACCT Balance % of Avoid the agency black hole inventory! Row Labels CREDIT BALANCE ACCT Balance % of Balance # of Accounts DEBTOR HAS ATTORNEY Balance % of Balance # of Accounts INSURANCE PENDING Balance % of Balance # of Accounts PAYMENT PLAN Balance % of Balance # of Accounts SPANISH FOLLOW UP Balance % of Balance # of Accounts SPECIAL CIRCUMSTANCE Balance % of Balance # of Accounts NEW LISTING ISCORE SYSTEM INITIATED Balance % of Balance # of Accounts Total Balance Total % of Balance Total # of Accounts 1 -30 Days 31 -60 Days 61 -90 Days 91 -120 Days 121 -150 Days 151 -180 Days 181 -365 Days Grand Total -$148 -$68 -$1, 873 -$544 -$6, 869 -$13, 776 -$49, 464 0. 01% 0. 03% 0. 00% 0. 01% 0. 09% 0. 25% 1 1 3 1 1 9 25 $6, 060 $29, 054 $4, 224 $5, 183 $59, 499 $775, 351 $1, 208, 377 0. 07% 0. 05% 0. 07% 0. 15% 0. 00% 0. 37% 1. 73% 7 7 5 7 15 37 175 $460, 074 $136, 484 $493, 148 $119, 400 $67, 760 $111, 024 $613, 536 $2, 490, 150 0. 43% 0. 23% 0. 56% 0. 23% 0. 32% 0. 18% 1. 10% 3. 91% 43 23 57 23 32 18 111 396 $28, 430 $24, 686 $41, 278 $25, 000 $39, 120 $19, 092 $80, 835 $430, 599 0. 43% 0. 28% 0. 57% 0. 41% 0. 45% 0. 26% 0. 88% 4. 07% 43 28 58 41 46 26 89 412 $15, 050 $16, 202 $1, 967 $10, 997 $10, 697 $14, 284 $1, 837 $71, 118 0. 11% 0. 07% 0. 08% 0. 13% 0. 10% 0. 05% 0. 67% 11 7 8 13 13 10 5 68 $785 $25 $3, 062 0. 01% 0. 00% 0. 01% 0. 07% 1 1 7 $196, 297 2. 32% 0. 00% 2. 32% 235 $2, 308, 922 $760, 969 $1, 871, 337 $1, 220, 711 $1, 404, 157 $865, 167 $2, 387, 089 $12, 922, 263 22. 19% 7. 04% 16. 65% 13. 24% 16. 16% 11. 21% 7. 58% 100. 00% 2, 245 712 1, 684 1, 339 1, 635 1, 134 767 23, 490

Thank you for your time. Insurance follow up Accurate registration Patient pay follow up Thank you for your time. Insurance follow up Accurate registration Patient pay follow up Increased Revenue 888 -592 -2146