In 2008, the financial situation was dire for Vail Valley Medical Center. Receivables were averaging 170 days and topping out at 198 days. Rather than being dependably consistent, cash flow exhibited erratic highs and lows. Days cash on hand was at a low of 58. Bad debt was eating more than 12% of revenue, and a consultant brought in to examine the situation suggested writing off more than $13 million in receivables so the Medical Center could start with a clean slate.

New leadership was brought in and found that many of the problems were process-related. For example, fewer than 50% of all claims were being submitted electronically because there was no process in place to determine if an electronically submitted claim actually made it through to the payers system. Many of the claims that were making it through were being deniedand the Medical Center didnt have a locked-down process for dealing with denials. Because Vail Valley Medical Center sees a high number of international patients during its tourist season, the Center often had to deal with international insurers. These insurers would frequently call to request discounts, and there was no consistently defined process for offering these discounts. Subsequently, international insurers were being given discounts as high as 25% and these discounts werent tied to a specific pay-within time period. Further contributing to the Medical Centers financial woes was the inability to accurately estimate a patients self-pay portion for procedures. Close to 50% of these estimates were off significantly in many cases, by thousands of dollars and the Medical Centers policy was to write off the difference between what a patient had been quoted and what the procedure actually cost.

Three new technology systems including RelayHealths Tier 2 Peer Reviewed RelayFinancial Assurance Plus (formerly known as ePREMIS) were implemented on an aggressive timeline to help correct workflow and other technological deficiencies. Additionally, leadership implemented standardized processes and policies for claims processing, discounting services and dealing with denials.

In less than two years, the Medical Center has:
Move from less than 50% of claims going electronically to more than 90% of claims being submitted electronically
Gone from a high of 178 days AR aging to a high of 78 days AR aging and that number continues to drop
Increased collection efficiencies by moving from one payer auto-posting to more than 20 payers auto-posting
Increased point-of-service cash collections by 15%
Moved cash flow from an erratic rollercoaster to a smooth bell curve
Went from 58 days cash on hand to 166 days cash on hand
Reduced its bad debt from more than 12% to just under 4%
Gone from 50% bad estimates to 0
Collected more than $1.4 million in payments via the Web in just six months
On target for an A- rating by end of May 2010
Moved from being a broken organization to being a successful organization.

In this session, our presenters will offer participants strategies and tactics that they can implement in their own organizations to improve claims efficiencies, reduce bad debt, improve cash collections and normalize cash flow. Examples include:
Changing attitudes about change: how to reassure your staff during periods of great change
Dealing with international payers: three tactics for consistent results
Improving claims efficiency: Steps your organization MUST take to optimize your revenue cycle