Author: Maxwell Healthcare Associates
Posted: September 20, 2022
Everything Impacts the Financials! The financial health of an agency is an incredibly important process, especially when everything affects the financials. Tune into our latest podcast with our Director of Finance & RCM Consulting, Eddie Vetter, to learn more about actions your agency can take for optimization. Read the transcript below to follow along.
HOST: Welcome to the MHA corner podcast where we talk about news and developments in the post-acute space.
Today we’ll speak with Eddie Vetter, Director of Finance and RCM Consulting for MHA.
He’ll talk about revenue cycle issues in the industry and what agencies can do to address them.
Eddie, welcome to the podcast.
HOST: So, Eddie, you have an extensive background, what is your background and what do you do for MHA?
EDDIE: I come from a couple of large home health and hospice providers where I lead revenue cycle teams through major transitions. A couple of different EMR implementations and mergers. Before that, I lead finance operations in other industries. But most recently I’ve worked as an independent consultant for MHA for about 3.5 years. That’s where I’ve gotten to see and solve a ton of different challenges for post-acute providers.
HOST: Eddie, as you know a lot is happening in the industry, what are the issues that agencies need to address now?
EDDIE: Well, you know that everything impacts the financials, I’d say that first many agencies need to make sure their processes and their system setup are at 100% for day-to-day operations to run smoothly. But then, 2 major areas to watch for are changes in the marketplace and changes to their internal processes. For example, clinical leadership might make a change in their system to optimize visits for value-based purchasing. But no one realizes that some of that data was tied into the billing structure, several months later aging is impacted, claims are being denied, and there’s a lot of work to backtrack and figure out what’s happened. Another great example is that commercial payors change their requirements all the time, often with little notice or explanation. Suddenly, United Healthcare wants 15 units or adds lesser than language to their master provider agreement. Now claims are being rejected or short-paid and until someone figures it out there’s a lot of bad debt.
Another example right now really is the tight labor market. Turnover happens, sudden a biller or billing manager leaves and takes with them the knowledge of a specific payor requirement or internal process. We see lots of issues just like this.
HOST: Interesting, so what can agencies do to address these issues?
EDDIE: Agencies really need to understand and have insight into issues before they become problems. We’ve developed a financial health and oversight service to provide that proactive oversight. In the aging, for example, we find operational guidance from payor requirements and potential cashflow issues. A detailed review of the DSO can review operational processes that need to be updated, by digging into adjustment reasons we can identify operational or financial process errors. Finding these types of items proactively will save an agency thousands in write-offs and hours of valuable executive time.
HOST: So, let’s get into it, what is the Financial Health and Oversight service?
EDDIE: When I worked as a consultant for MHA, I noticed that I would go into an agency to help solve a problem. We might even do an assessment to address any issues and ensure they were operating smoothly, but then a year later we had to go back for something else, an issue that arose from a change in the market or their internal processes. So, we developed this service as a direct answer to that challenge. To help agencies proactively respond to changes before bad debt and costs get out of hand. That’s our financial health and oversight service.
HOST: And then finally, Eddie, is there anything else you’d like to add about the Financial Health and Oversight service that would benefit agencies?
EDDIE: Well, the way it works for us is within a couple of weeks of their month-end close we’ll come in and perform an in-depth review of financial and operational data to provide executives with detailed insight into the interworkings and challenges of their revenue cycle. To help identify issues before they become problems, then we provide guidance on the best resolution for those issues, this gives agencies the tools they need to stay ahead. I like to think of this service as providing executives with a deep dive into the weeds, where we can take a specialized look at what’s going on and then zoom out for the executive view and highlight the issues and provide expert guidance on how to solve them proactively. I’d love to share an example with anyone who’s interested in our monthly report out and the types of insight we typically provide.
HOST: Thanks for listening to the MHA Corner podcast. If you’d like to learn more about the Financial Health and Oversight service, contact us at [email protected].