Revenue Cycle Management for 501(a) Organizational Development

Managing Growth & Development of 501(a) Hospital Organizations

Many hospitals are establishing networks of ambulatory providers under a 501(a) organizational structure. Other organizational structures may be used, but in establishing hospital-owned practices, no matter what the specific legal form of organization may be, it is critically important to effectively manage the growth and development of the provider network being created. And it is very difficult to identify and contract with new providers, appropriately engaging and transitioning them into the hospital’s network, and also properly addressing the myriad of practical issues associated with that transition.

Transitioning Providers in Your 501(a) Organization to New EHR and Revenue Cycle Management Systems

New providers are typically accustomed to a legacy software platform (including a legacy EHR software in many cases), are subject to run out of their old AR balances on that legacy system, have legacy staff that may or may not transition to hospital employment, may not be optimally suited to a position in the new organizational structure, or that may struggle with workflow changes that are necessary to optimize clinical results and revenue cycle management.

In managing the issues associated with new provider onboarding, it is unfortunately the revenue cycle management that often is neglected. And that often results in regrettable and unnecessary diminishment of reimbursement revenues and profitability, usually only identified in arrears.

Supporting Your 501(a) Organization & Maximizing Financial Results

Precision is highly experienced from the revenue cycle perspective, effectively managing core revenue cycle processes and workflow associated with 501(a) development. But Precision is also experienced in “filling the gap” upstream from core revenue cycle support, supporting as necessary the hospital staff charged with ambulatory provider development, including the hospital’s IT staff and software vendors.

Precision is able to effectively ensure that revenue cycle results are optimized throughout the process of developing a hospital-owned practice network, no matter when that revenue cycle is challenged by legacy software issues, new software platform transitional issues, staffing-related transitional issues, hospital system interface issues, financial reporting and database management, or otherwise. Precision will custom tailor its revenue cycle support to fit the hospital’s needs, ensuring financial success to the endeavor.

"My pediatric practice, Children's Clinic, has worked closely with Precision for many years in an effective partnership that has contributed greatly to the management of our practice. In order to best serve patients, the "business side" of things must run extremely well. Precision appeals insurance low pays on drugs and provider services, communicates coding updates and specialty-related and billing changes, tracks office collection of copays and patient balances, compares our coding levels to national distributions and identifies our denial and rejection issues, to name just a few. Monthly meetings with Precision allow us to review month end reports, identify opportunities for improvement and constantly "raise the bar" on our performance as a practice. In today's difficult economic environment, Precision is a business partner we can count on."