Interview with: Michael McGhee,
Vice President - Practice Leader,
HGS EBOS LLC
“We see significant revenue leakage
across ...
About HGS EBOS LLC
HGS EBOS has been providing revenue cycle management services for the US health care Provider industry ...
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Preventing Leakages across the Healthcare Revenue Cycle - Michael McGhee, HGS EBOS LLC

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Michael McGhee of HGS EBOS LLC, a solution provider at the marcus evans National Healthcare CFO Summit Fall 2013, on better healthcare revenue cycle management.

Interview with: Michael McGhee, Vice President - Practice Leader, HGS EBOS LLC

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Preventing Leakages across the Healthcare Revenue Cycle - Michael McGhee, HGS EBOS LLC

  1. 1. Interview with: Michael McGhee, Vice President - Practice Leader, HGS EBOS LLC “We see significant revenue leakage across the revenue cycle, from the front end to the back end,” says Michael McGhee, Vice President - Practice Leader, HGS EBOS LLC. “With the Affordable Care Act, healthcare organizations should prepare for an influx of volume and further strains on their cash flow. They must seek ways to automate business processes to create more cost-effective organizations,” he advises. From a solution provider company attending the marcus evans National Healthcare CFO Summit Fall 2013, in Los Angeles, California, October 20-22, McGhee delivers his thoughts on healthcare revenue cycle management and how to take advantage of opportunities to boost the bottom line. How could hospitals prepare for the future from a revenue cycle perspective? Accountable or affordable care will bring tens of millions of new customers to our provider clients. This could overwhelm their financial systems and put a strain on claim generation and timely payment. Organizations must prepare for what could be a very challenging business environment. According to your website, your organization can bring 10-12 percent returns from value-adds and process improvements. How? Payers are very aggressive in challenging the validity of claims, leading to denials and delays in reimbursement. We see revenue leakage across the continuum, from patient registration, making sure a patient is eligible, proper authorization for service, pre-authorization referral, all the way to the back end with the quality and timeliness of billing and follow-up. A focus on prevention could mitigate extra work on the back end, which is where revenue loss occurs. Revenue loss occurs in the business office, but it is typically generated by something that did not happen correctly initially, upfront. The challenge for most healthcare CFOs is headcount. Do they have the number of staff needed to stay with a claim throughout its lifecycle? Hospitals can recover significant amounts of lost revenue if they leverage automation and supplemental work force opportunities. Our proprietary technology allows us to take data feeds from clients and automate resolution steps, thereby minimizing human intervention while reducing costs. What insights could organizations gain from this technology? Our powerful analytics engine looks at the root cause of payment delays and denials across the revenue cycle. If we then take that root cause and reengineer the business process, we can eliminate or greatly reduce that delay going forward. Most organizations do not have a business intelligence capability for this kind of deep-dive analysis. What trends could healthcare CFOs capitalize on today? The biggest trend we are seeing is a significant commitment to revenue cycle technology. As an industry, healthcare has been slow in upgrading technology beyond their clinical systems. Now the expectation is that new financial systems will solve all the problems. I believe there will always be a need for additional wrap-around technologies to address some of the shortcomings of even the best systems that are being implemented today. Digitization of healthcare records is another important trend with its own challenges. It is creating inconsistencies and difficulties integrating with other systems but the opportunity is there for us as consumers to have control over our own health information. The move to ICD-10 in October 2014 is a major milestone that many providers are preparing for, but we are unsure how well that conversion will work. Because of the complexity of the code set, coder productivity may be reduced by as much as two thirds placing greater demands on our clients’ ability to bill claims timely. A focus on prevention could mitigate extra work on the back end Preventing Leakages across the Healthcare Revenue Cycle
  2. 2. About HGS EBOS LLC HGS EBOS has been providing revenue cycle management services for the US health care Provider industry for over 12 years. HGS EBOS supports hospital systems, multi- specialty physician groups, laboratory services and DME providers in their efforts at improving their financial health. HGS EBOS has a hands on partnership approach to managing all its clients and as a part of the engagement, we bring over 10-12% returns in terms of value-adds and process improvements to our clients. www.teamhgs.com About marcus evans Summits marcus evans Summits are high level business forums for the world’s leading decision-makers to meet, learn and discuss strategies and solutions. Held at exclusive locations around the world, these events provide attendees with a unique opportunity to individually tailor their schedules of keynote presentations, case studies, roundtables and one-on-one business meetings. For more information, please visit: www.marcusevans.com Upcoming Events CFO Summit - www.cfosummits.com National Healthcare CXO Summit - www.nhcxosummit.com To view the web version, please click here: www.nhcfosummit.com/MichaelMcGhee The Finance Network – marcus evans Summits group delivers peer-to-peer information on strategic matters, professional t r e n d s a n d b r e a k t h r o u g h innovations. Please note that the Summit is a closed business event and the number of participants strictly limited. About the National Healthcare CFO Summit Fall 2013 This unique forum will take place at the Westin Long Beach, Los Angeles, California, October 20-22, 2013. Offering much more than any conference, exhibition or trade show, this exclusive meeting will bring together esteemed industry thought leaders and solution providers to a highly focused and interactive networking event. The Summit includes presentations on revenue cycle management, the future of healthcare, bundled payment models and ensuring efficiency through a clinical and financial EHR system. www.nhcfosummit.com Contact Sarin Kouyoumdjian-Gurunlian, Press Manager, marcus evans, Summits Division Tel: + 357 22 849 313 Email: press@marcusevanscy.com For more information please send an email to info@marcusevanscy.com All rights reserved. The above content may be republished or reproduced. Kindly inform us by sending an email to press@marcusevanscy.com

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