A hospital perspective on revenue cycle

  • Let's start off by discussing the episode of care for a patient at Fresno Surgical Hospital. How has the experience changed during your tenure as the Chief Financial Officer?
    I am coming up on my 10-year anniversary with Fresno Surgical Hospital, and I've been in the healthcare payments industry for close to 15 years. From the day I started to now, so much has changed for patients when it comes to their role in revenue cycle. Previously, there was little discussion around payments during the patient's episode of care. Now, about 40% of our patients owe some type of balance - whether it be in the form of a deductible, co-pay or co-insurance. 

  • How have these trends changed the patient experience? 
    We find that simple and upfront communications work best with patients when talking to them about their payments. Patients often do not have a comprehensive understanding of their benefits and how it applies to their surgery. A majority of our surgeries are scheduled in advance, so we saw an opportunity to touch base with patients before the surgery to discuss their benefits and how they applied to that procedure. Our current process is to have an RN call the patient to schedule the surgery and discuss medical history, then a billing clerk will call to discuss benefits and any potential payment responsibility. 

  • What is your approach to collecting patient balances?
    Our patients and their healthcare is our first priority at Fresno Surgical Hospital. We strive to make the billing process as painless as possible for the patient. As a hospital, patient balances tend to be higher than they would for other types of providers, so we offer the option to set up a payment plan to pay down balances over time. Patients love having the option of a "set-it-and-forget-it" way to pay their balance. They never receive paper statements or have to re-enter their payment information, instead they just get email notifications about the transactions. 

  • Any best practices or lesson learned to share that may help others dealing with the same trends? 
    I don't know if I would call this a lesson learned, but it is important to establish benchmarks when implementing any new process. It must be cost effective, reliable and efficient. Just like any healthcare organization, we are not lucky enough to have limitless resources, so our process must help us do our jobs well without taking so much time and money that it gets in the way. 

  • Looking forward, what changes do you have planned for the patient experience with revenue cycle? 
    We have some very cool things on the horizon, such as introducing text messages for billing notifications. We are on our phones 24/7, so adding this as a communication channel may help to better connect with patients. Beyond that, my goal is to make everything digital. I want to  remove paper completely out of the revenue cycle process. To me, paper clogs things up when in checking eligibility and collecting balances - it just slows us down! 

About the author:  As CFO of  Fresno Surgical Hospital, Bruce has brought significant improvement to revenue cycle processes and cash collection. Bruce has over 20 years of experience in patient accounting and healthcare finance.