A Case for the Revenue Recovery Professional

For about 25 years now, I have dedicated my career to learning and understanding the nuances of what is referred to the “Business Office”. We all know that the term remains in active conversations, but sometime in the mid 90’s, the term “ARM (Accounts Receivable Management)” evolved to “RCM (Revenue Cycle Management) “ morphing it into a much broader buzz word for identifying the perceived journey of how an encounter becomes a payment from a very narrow lens. Regardless of what you call it, it takes an extraordinary effort to maintain these production processes.

We often look at those Central Billing/Business Offices to guide us in our decisions further up the chain of service, but often times became the unsung heroes in the quest for improving the revenue cycle. In other words, billers, accounts receivable representatives, coders, patient access representatives and their management helped organizations are here to keep the lights on, the door open and help get the latest and greatest equipment to treat patients.

And yet, my travels have taken me to conversations where inexplicably the conversations turn to where cuts to cost are often aimed at these functional units. Inevitably, automation is discovered, capitalized, championed, and implemented without a trained workforce to support the “thinking outside of the box” solution.

In “keeping up with the Jone’s” the whole system from supply chain individuals to stockholders rely on these emerging retrained, knowledgeable professionals. This evolution also requires that we take the time to nurture a new wave of professionals, change or get left behind. That means doing the same for this cycle which are in the hands of capable, creative folks that centered their talents and time on our industry. News stories break each day and word of mouth announcements are made whereby mega-mergers and resulting consolidations are made. Employees are shifted, cut and survivors are left to figure out how to incorporate another’s previous tasks. Subscribe to any healthcare newsletter. Throughout this, the “cycle” is expected to churn and deliver a plethora of ceiling blowing cash and data that will transport us to the next level.

Having managed staffs of all sizes, taking on greater scope of responsibilities, championing the improvement efforts all have measurable impacts to hospital, medical group and a whole host of providers including ambulatory services, billing companies and sole practitioners. Large or small each have commonalities, namely, the staff that support them at various levels. We must keep our Providers focused on the needs of the patient and the health of the community. We MUST maintain and invest in the needs of those “central business office” professionals at all levels, so that we can all rest a little easier, not stay up late at night wondering where are we coming up with the operational income shortfall and keep those doors open.

The Bottom Line

When organizations reorganize to streamline processes, drive costs down and bring up revenue by pushing back on your revenue chasing professionals, ask yourself, is that really prudent? After all, when was the last time an insurer or guarantor just decided to give you money “just because”. Someone has to help you and help you with the best tools your money can buy.