Educating Professionals in Healthcare's Cash Flow Cycle

Educating Professionals in Healthcare’s Cash Flow Cycle

DEKAYE Consulting, Inc. is pleased to announce this year's course curriculum! In response to an increasing demand from our clients, we are pleased to announce our formal offerings designed to provide staff, supervisory and management personnel with a series of programs tailored to help those personnel involved in the operational sequences performed by the departments that comprise healthcare’s cash flow cycle. Entitled our Emphasis on Education programs, we believe that "Investing in Your Staff Can Reap the Largest Rewards."

Programs for Supervisors and Staff

In order for our clients to better serve their patients, we have found that healthcare professionals are often unable to receive exposure to the types of hands-on, practical enrichment that our In-service educational programs provide. With reductions in some travel budgets, attendance at seminars and conferences may be limited or curtailed. In order to bridge that gap, our instructional programs are designed to bring the training to your site, and offer programs to help both supervisors and managers, as well as staff perform more efficiently and effectively.

Our programs are usually based on a three (3) part sequence so that the learning dynamic can be reinforced over a period of time. The courses are geared to accommodate the departments that comprise the cash flow cycle: Admitting and Registration (Access), Patient Accounting (Patient Financial Services), Medical Records (Health Information Management) and Utilization Management. Each program is generally scheduled for three 1-1/2 hour classes, and we recommend the use of a classroom or conference room setting. Availability of an overhead projector should be considered standard. For classes where videotape instruction is provided, you’ll need to make arrangements for the availability of the appropriate audio-visual equipment.

Depending on the program content, we use a combination of lecture, group participation, videotape instruction, and role-playing exercises. We prepare a course book for each participant, and provide for an evaluation and review process. We will provide each attendee with a certificate of course completion so that your department may evidence participation in educational programs to help you meet JCAHO requirements. We will also be available to participate in any formal "graduation ceremony" your department or Human Resources division may sponsor to acknowledge staff’s course completion, and evidence the importance of continuing education.

Course Curriculum
While we have provided a listing of the courses that are now available. Several of the programs are described in more detail elsewhere in our web site, and for selected programs, a brief course description outline follows. Since we can customize our programs to meet your specific needs, many of our programs can be tailored to full day programs or workshops. We will also work with you to provide multi-disciplinary Team Building programs.

Course Description Outlines

Improving Supervisory Skills will provide your supervisors and managers with a better understanding of organizational structure, defining their roles and responsibility, as well as a discussion of management style. Emphasis will also be placed on evaluating procedural compliance, and assessing each department’s contribution to the accounts receivable (A/R) process.

We will introduce numerical and graphical tools to help them learn to analyze the present conditions of the department and the A/R function in total. There will be a discussion of change management, why it may be needed and how it can be effected. The sessions will conclude by addressing how to plan and implement change. The format for this course will combine lecture and practical application using the medical center’s own data to construct realistic models.

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Measuring and Monitoring Performance - Productivity and Efficiency! Key words for managers approaching the turn of the century. Yet many of our supervisors and managers are very weak in the analytical and numerical skills needed to develop standards of performance, and correctively identifying task times and workflows. The course will teach basic numerical relationships such as averages, percent change, and the relationship of the mean, median and mode as it applies to healthcare measurements. Setting realistic standards and devising ways to easily report productivity will be introduced and discussed.

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How to Conduct the Patient Interview will provide staff with tools and techniques to improve their ability to collect patient demographic and financial data. In addition, with the growing emphasis on managed care, we will discuss how special plan requirements such as pre-certifications and increased patient deductibles and co-payments need to be handled. In addition to the lecture format, we have show videotapes and perform role-playing exercises.

With the increasing competitive market, all facilities have placed an growing emphasis on customer satisfaction. We will work on improving "meet and greet" skills, as well as ensuring that staff’s command of medical center policy and procedure is accurate and up to date. Finally, an assessment of the information that the medical center makes available to the public, its patients and its physicians will be discussed and evaluated.

Course Highlights

  1. Provides the staff with tools and techniques

  2. Improving the ability to obtain patient demographic and financial data.

  3. How to handle special plan requirements

  4. What to do about pre-certifications, patient deductibles and co-payments

  5. Improving "meet and greet" skills

  6. Ensuring the staff's command of hospital policy

  7. Making sure procedure is accurate and up to date

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Improving Collections and Customer Satisfaction - Competition! Not only to be financially secure, but to do it without alienating our customers. The course stresses the recognition of the patient as customer, and the importance of achieving high customer satisfaction, and understanding how a negative impact influences the physician as well as the patient. The staff will be introduced to new approaches to collections, with a major emphasis on up-front collections. Learning how to overcome a patient’s objection to paying while maintaining a "caring" concern for the patient will be stressed.

The hour-and-half video was filmed in front of a live hospital audience with staff from the admitting, registration and patient accounts department participating in the question and answer sessions, and taking part in the real-life "role-playing" exercises.

Course Highlights

  1. Discussion of the impact of managed care has affected healthcare's cash flow cycle.

  2. Discussion of the operational impact on the admitting and patient accounts departments.

  3. Awareness of new pressures to collect both data (e.g., prior approvals and authorizations) and cash (e.g., deductibles and co-payments) at the time of service.

  4. Importance to have a written financial policy statement that addresses up-front patient payment arrangements.

  5. "Caring Increases Collections" philosophy

  6. How to prepare before the patient interview begins

  7. Importance of the pre-admission process

  8. How to avoid overlooking opportunities to help your patients pay

  9. Deductibles and co-payments

  10. The importance of the physician/hospital data exchange is emphasized

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Patient Financial Sevices 2005 and Beyond - Technology, Mergers and Consolidation, and Outsourcing have already changed the landscape of the business office. Learning how to cope with the needs of the Enterprise network, MSOs for affiliated physicians and the challenges of managed care will continue to transform the patient financial services department. This course will prepare staff for the changes as healthcare providers re-invent the departments that comprise the cash flow cycle.

Course Highlights

  1. Discussion of operational improvement strategies for Admitting and the Business Office

  2. Improving patient interview skills and data collection and integrity

  3. How to attain our "personal best" in performance and productivity

  4. Providing the right environment for patients to satisfy their financial obligations

  5. Addressing customer satisfaction requirements

  6. Understanding how competitive forces are operating on the Business Office

  7. Adjusting/redefining financial policy to meet managed care contractual terms

  8. Helping patients better understand their contracts

  9. Developing customer loyalty

  10. Learning to overcome patient's objections and gaining commitment to paying bills

  11. Improving collections by offering alternative payment conveniences

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Understanding the Managed Care Environment has become a challenge for all sectors of the health care community. This class is specifically designed to provide the staff with an introduction to the factors and characteristics that have influenced this change from a "regulatory" to a "market" driven industry. In addition to changes at the state and federal level, we will examine the operational impact that has resulted.

The course will discuss the changes in the local landscape, the mergers of institutions and the new affiliations between and among hospitals and physicians. Part of the discussion will include an exercise designed to identify the major managed care plans that are represented at the medical center, and to review their special requirements.

Course Highlights

  1. The impact of managed care on the healthcare community

  2. Why hospitals and physicians are merging and consolidating

  3. Examining the "competitive" vs. the "regulatory" environment

  4. Studying the impact and reaction of patients

  5. National and regional reaction

  6. Operational impact on Admitting and the Business Office

  7. How pre-certifications and prior approvals influence registration procedures

  8. What to do to collect increasing deductibles and co-payments

  9. Using electronic transactions to reduce administrative overhead

  10. Educating patients, providers and payors

  11. Maintaining customer satisfaction and market share

  12. Gauging the impact of the "top 5 plans" at your facility

  13. Impact on financial policy and cash flow cycle operations

  14. Improving data exchange between physicians and hospitals

  15. Workbook includes glossary of terms, and graphic description of managed care impact and electronic transaction solutions

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Performing Our Roles As Professionals - Admitting as the Ambassadors, Patient Financial Services as the Envoys. Throughout the cash flow cycle, our staff needs to be more conscious of the importance of their role. Absenteeism, boredom, performance, and other pitfalls need to be avoided. The need to create a new "work ethic" in an era when downsizing and re-engineering has sapped the morale and esprit de corps that once dominated these departments will be discussed. This course will re-visit a more traditional era and compare how the new environmental changes can become an advantage to those who now staff these departments.

Course Highlights

  1. Improving our self-confidence in patient situations

  2. Understanding policy and procedure

  3. Learning how to ask for money in order to collect the patient responsibility

  4. Preparing yourself for the patient interview

  5. Learning to use the resources of the computer system and patient financial history

  6. Why "account notes" are important

  7. Sources of verification for various patient demographic and financial data

  8. Conveying and demonstrating good interviewer attitude

  9. Re-working the policy and procedures surrounding managed care's impact on operations

  10. Role playing situations (Actual role playing by patient accounting professionals)

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Stop the Aging Process! takes an in-depth look at how A/R strategies need to be developed. In addition to recognizing the "danger signs" associated with a deteriorating A/R position, there will be a focus on identifying and addressing issues and impediments faced by the departments that comprise the cash flow cycle.

Course Highlights

    1.    Understanding the importance of developing an A/R Strategy
    2.    Identifying vulnerabilities and weaknesses in the cash flow cycle
    3.    Defining best possible outcomes
    4.    Recognizing signs of a deteriorating A/R
    5.    Using analytic tools and key indicators of performance to determine your starting point
    6.    Assessing resources and capabilities
    7.    Targeting payers to pursue for payments
    8.    Develop an actual A/R strategy
    9.    Assess A/R assertiveness and aggressiveness
    10.   Review payer checklists for tasks and activities to be taken

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Outsourcing: When is it Time to Let Go? is a program that helps organizations answer this question. The course will discuss the analysis of the investment in A/R, and the alternatives available to the organization. It will contrast the similarities and differences relative to outsourcing within the PFS and medical records departments, and will develop a rationale for supporting a "go" vs. "no-go" decision.

Course Highlights

    1.    Understanding today’s competitive marketplace
    2.    Why administrative simplification is important
    3.    Placing emphasis on electronic transactions
    4.    What is outsourcing anyway?
    5.    Defining conditions where outsourcing makes sense
    6.    Calculating costs and benefits of an outsourcing decision
    7.    What makes outsourcing attractive?
    8.    Is outsourcing the right decision?
    9.    Case studies: comparison and discussion
    10.  Making a "go" vs. "no-go" decision

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So You Want to be a (Better) PFS Director examines the critical success factors necessary to meet the challenges posed by today’s healthcare financial environment. With the growing importance of generating cash in an ever-tightening regulatory environment, the PFS Director must develop and maintain a series of skill sets to orchestrate effective operational workflow that utilizes staff, systems and other resources efficiently.

Course Highlights

    1.    Identifying the challenges facing today’s PFS Director
    2.    Understanding the PFS perception by others in the organization
    3.    Developing strategies to address: APC’s, Compliance, Denials and A/R Management
    4.    Discussing the qualities and characteristics of successful managers
    5.    Taking a leadership role in problem-solving and setting direction
    6.    Effecting strong organizational management
    7.    Managing successfully during a period of change
    8.    Developing management style
    9.    Sharpening survival skills in today’s healthcare financial environment

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Surviving The Business Office Merger: Operational and Cultural Preparedness - This program will address both the operational and cultural preparedness requirements facing the patient accounts department in view of an potential merger, the aftermath of a recent affiliation, or CBO (Central Business Office) formation. This program is geared to a Chief Financial Officer and Patient Accounts Director and key manager focus, and addresses the planning and preparation tasks necessary to effect an efficient and successful new entity. The program can be expanded to add managers and supervisory staff so that they, too, can become participants in this planning process. The course is intended for CFOs, Patient Account Directors, Managers and Supervisors.

Course Highlights

  1. Consolidation of the Patient Accounts or Patient Financial Services department.

  2. How to achieve "economies of scale"

  3. Discussion of operational combinations necessary to reduce redundancy

  4. Systems (platforms), duplication of effort (in billing and collection and follow-up tasks), staffing, etc.

  5. Identifying the cultural differences of the combining organizations that affect future staffing patterns.

  6. Examining the style of the senior staff who will select the key department managers for the patient financial service areas.

  7. Process to define and identify new roles and responsibilities that maximize productivity and ensure regulatory compliance.

  8. Definition of how managers at each of the merged facilities might prepare for the consolidation process.

  9. Discussion of "best practices."

  10. Topics also include goal setting, obstacle identification, and (people-to-people) communication skills.

  11. Review on what the CFO's and other senior financial managers should consider in order to preclude the likely number of staff defections that generally coincide with the announcement of a merger or CBO (central business office) formation

  12. Learning management techniques to retain the best employees.

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Improving Data Collection and System Entry - In this section, we will explore how effective the staff is in the human/system interface. With the reliance on technology, this course helps to identify operational areas where staff needs to better understand how to best use and better understand how the hospital information systems (including ADT, Patient Accounts and Medical Records), standalone verification and tracking systems combine to support the operations of the departments that comprise the cash flow cycle. The importance of "account notes" and the use of other visual "system" cues that can be used to highlight problem accounts will be discussed.

Course Highlights

  1. Exploring how effective the staff is in the human/system interface. identify operational areas where staff needs to better 

  2. Help your staff to better understand and how to use the hospital information systems

  3. ADT, Patient Accounts and Medical Records

  4. Standalone verification and tracking systems combine to support the operations of the departments that comprise the cash flow cycle.

  5. The importance of "account notes"

  6. The use of other visual "system" cues that can be used to highlight problem accounts will be discussed.

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Overcoming Claim Denials

This program will address the need to recognize the varying degrees of errors committed--both internally and externally driven. Despite the vagaries of managed care contracts, and occurrences of the often rejected "clean claim," strategies to overcome claim denials are presented with the realistic expectation that viable "solution sets" can be developed and implemented.

The program will suggest ways to get started, as well as to move to a more advanced level of proactive and positive claims adjudication activity. The program will help attendees to redirect current efforts to address backlogs, as well as newly denied cases when they return to their organizations.

Course Highlights

  1. Learn how to identify the extent of all types of denials

  2. Differentiate between "soft" and "hard" denials

  3. Examine the impact that "corporate compliance" has on the denial correction process

  4. Develop an understanding about building a "data defense," and how it can be used to alert and protect your facility

  5. Discover reasonable, yet winning strategies for appealing denials

  6. See how the formation of "Cash Assurance Teams" can help effect successful operational control

  7. Formulate comprehensive denial inventories to assure that all claim rejections have been analyzed and accounted for

  8. Discuss the similarities, differences and effectiveness of different state-wide programs and regulations

  9. Review the roles and responsibilities of each of the departments that have active roles in the claims denial management cycle

  10. Create project workplan tasks and responsibilities to facilitate the management of these conditions

  11. Analyze the operational and financial impact on the institution

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We invite your inquiries as to how our Emphasis on Education programs can be implemented at your facility.

For more information about our services, or Strategic Alliance Partners, please write to us at: Adkcmpa@aol.com or DKConsult1@aol.com

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D E K A Y E Consulting, Inc.
231 Oakview Avenue, Oceanside, NY 11572  Phone: (516) 678-2754   Fax: (516) 825-4458
URL: http://www.dekaye.com E-Mail: Adkcmpa@aol.com or DKConsult1@aol.com