AAHAM / COPAM Retreat Annual Education Conference

1. AAHAM / COPAM RetreatAnnual Education Conference Lyman SornbergerExecutive Director, Patient Financial ServicesCleveland Clinic Foundation September 16 -17, 2010

2. Agenda • Definition of Accountability • Global Metrics • Scheduling • Financial Clearance • Registration • HIM Coding • Edits • Billing • Collections • Customer Service • Monitoring Productivity and Quality • External Controls

3. Definition of Accountability • Subject to giving an account: answerable • Capable of being accounted for : explainable

4. True or False? Processes supporting the Revenue Cycle are the result of evolution, not design? External requirements and changes are usually responded to by the addition of work-arounds and patches and not by fundamental process redesign? True The result is: • Non Standardization • Compliance Risk • Excessive Hand-off’s • Decreased Patient Satisfaction • Increased Cost • Untimely Data Capture

5. True or False? Accountability for the Revenue Cycle are not usually fragmented and incentives are generally aligned with the health systems mission and financial goals? False The end-result is: • Sub-optimal financial outcomes and frustration among management and staff. • Difficulty changing behavior. • Management fails to focus on process and focuses on functional outcomes. • Responsibility and Authority are not vested in the same results.

6. Performance Evaluation and Measurements The ability to monitor, assess, and improve Revenue Cycle performance relies upon the establishment of clear metrics and tools that define and COMMUNICATE performance expectations. Attributes of effective PERFORMANCE metrics are that they are: • Clearly Defined • Quantifiable • Accessible • Objective • Relevant to Desired Outcomes • Leading and Lagging • Cascading and Multi-Level

7. Global Metrics

8. ALL CLEVELAND CLINIC ENTITIES*Compass Based

9. ALL CLEVELAND CLINIC ENTITIES*G/L Based

15. Scheduling

17. Financial Clearance

19. Registration

21. HIM Coding

25. Edits

27. Claims

30. Billing

33. Collections

35. Customer Service

37. Innovations: Follow-Up Tracking and Productivity System

38. Agenda • Customer Service Follow Up and Productivity System • Patient Complaint Tracking System • Hospital Billing Productivity and Financial Results System Patient Financial Services l 08/19/2010

39. Follow-Up and Productivity Tracking • Old Way of Thinking: • Productivity = “Take as many calls as you can” or “Touch as many accounts as you can” • 21 CEO level complaints per month • Handwritten Paper Tracking Lists • New Way of Thinking: • Quality. Are we delivering what we promise to the patient? • 10 CEO level complaints per month • Customer Surveys • Productivity • Motivating Results Reporting • Automated Work Item Measurement Patient Financial Services l 08/19/2010

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