Rebound Orthopedics and Neurosurgery is northwest Oregon’s and southwest Washington’s most preferred independent orthopedic and neurosurgery practice—according to independent market research. With 16 locations in Portland, Vancouver and Lake Oswego, the 75-provider group offers customized treatment plans and an array of surgical, nonsurgical and expert medical care. Rebound’s team of sports medicine specialists serve as the team physicians for the Portland Trail Blazers, the Portland Winterhawks and several collegiate and high school teams. Known for its forward-thinking culture, the organization incorporates the latest techniques and technological advances into care. In tandem with this philosophy, Rebound also partnered with MedEvolve to transform its revenue cycle performance through effective solutions powered by workflow automation and advanced analytics.
Improving operational margin is an imperative for today’s physician practices. It’s what keeps financial executives and practice administrators up at night, as capitalizing on every revenue opportunity is key to future positioning and sustainability.
As shifting reimbursement models place more financial responsibility on patients, healthcare organizations must not only have a holistic strategy that proactively addresses the full life cycle of billing processes but must also have the resources to support it. Like all practice groups in today’s healthcare climate, Rebound Orthopedics and Neurosurgery faced difficulties associated with unprecedented shortages of qualified billing staff.
“We needed better systems in place to ensure we were making the most of existing staff and not simply throwing resources at patient accounts and claims,” said Will Mowe, executive director of Rebound Orthopedics and Neurosurgery.
The challenge was having visibility into staff activity and performance. Because EMR and practice management systems do not have the analytics capabilities to produce the level of granularity and visibility to answer key questions such as: “How much work effort does it typically take for my staff to resolve a claim?” and “Who are my most effective team members?”
Rebound chose MedEvolve’s effective intelligence solutions to address every touchpoint of the revenue cycle processes—from pre-registration to backend collections. These include:
- RCM Workflow Automation
- Financial Clearance Automation
- Real-Time Revenue Cycle Analytics
- Patient Financial Engagement Solutions
To draw deeper insights from the organization’s existing repositories, a centralized data warehouse was implemented to bring together data from practice management systems, EMRs and the workflow automation solutions. Goals for the expanded roll-out of technology included:
- Reducing dependence on labor
- Ensuring a highly effective labor force
- Minimizing the work effort needed to achieve result
- Rapidly identify and improve revenue cycle breakdowns
- Reduce avoidable write-offs
- Maximize zero-touch resolution rate
“Through the combination of workflow automation and task management offerings, our aim was to drive down the cost to collect while simultaneously increasing net revenue to maximize margin for the practice,” Mowe said.
The foundation of a zero-touch claim starts on the frontend. To that end, Rebound rolled out MedEvolve financial clearance solutions, centralizing and automating all pre-registration functions. This ensures that all patient information is captured accurately pre-visit and that patient responsible balances are netted prior to visit. It also enables Rebound to run estimates and collect deposits prior to surgeries and high-cost procedures.
Mowe and his team also rolled out RCM workflow automation to provide the needed level of intelligence to ensure staff were not only productive, but also effective, in their work. These tools highlight tasks that have potential to produce the most ROI, rather than having staff waste time on claims need little to no attention. Visibility into daily activity allows Mowe to better understand the effectiveness of billing staff, identify opportunities for improvement and hold staff accountable.
On the backend, a review process was implemented to reduce first-pass denials by identifying opportunities for process improvement. This strategy focused on surgical authorizations, coordination of benefits, coding and PT benefits that were exhausted. In addition, mobile engagement tools and patient financial counseling helps recoup any missed patient responsible balances.
Rebound has achieved notable outcomes since the expanded technology roll-out and is benefiting from smarter processes.
- The organization is realizing better bottom-line performance with fewer FTEs.
- Zero touch claims that require no human intervention now account for 62.2% of total
- Overall closed balance NCR is 98%—above the industry benchmark of 97%
- 57% of self-pay revenue comes from mobile engagement
“The higher Rebound can drive its zero-touch claims percentage, the more likely our organization will get paid the highest level of reimbursement—and with fewer people” Mowe said.
In addition, the workflow automation infrastructure enables a virtual workforce, which deliver greater staff satisfaction. “Along with a more impactful revenue cycle, we get the added benefit of having tools that will better attract and retain key talent. That’s critical in today’s market,” Mowe added.