Two Most Important Ingredients for an Effective Hospital Revenue Cycle

Two of the most important ingredients to a successful healthcare provider revenue cycle are frequently overlooked in today’s current corporate environment.

According to Charlotte Carlson, who for years was in charge of Patient Financial Services at UMC Health System in Lubbock, Texas, it’s not necessarily the technology or the tools. It’s the people … and lots and lots of time.

Carlson, who is profiled in one of this week’s case studies, has spent more than 30 years in healthcare. At 69, she should have retired years ago, but UMC has kept her around for a reason. Over the course of her career, she’s worked in almost every facet of the revenue cycle. She understands how Patient Financial Services interacts with Coding and Billing and Patient Access. That’s why she was snapped up two years ago by her current boss, Micky Allen, to help build UMC’s first revenue integrity department.

It’s the People

Carlson has seen trends come and go.  “We worked with microfiche,” she recalls. “Everything was manual, information was 10 days old, and we were happy to get it. The business office had about 95 people and we currently have 35.”

Technology got better and improved efficiency, but it still came down to people. “If I’m fixing a problem, my mind was always, ‘I don’t want to do this ever again.’ I need my people to be smart and to pay attention to the things a machine can’t do for them.”

As Carlson points out in the case study, revenue integrity is not a fad and is here to stay. But it is not something completely new. “PFS was also compliance,” she says. It was also the department that established the standards for what UMC should charge for and what it should not.

“I pushed honesty in billing to the max,” she says. “I’m sure I left money on the table.” For her, she would not bill for anything that she could not get up in a courtroom and “swear what I had done.”

In the old days, on those rare occasions where a boss or VP would ask her do something she didn’t think was 100 percent proper, “I would write it down and ask them to sign it,” she says. “They would never sign it.”

Plenty of time

For employees to be effective, UMC looks at the long term. “Everybody has years and years of service, including our administration,” she says. “A new employee in PFS takes 3 years before they make me money.”

In her own case, Carlson says, “I’m old and wanted to know, ‘How do I get out of here?’” Her replacement was ready to take over — a 40 year old who has been working at the hospital since she was 17 – but still required some mentoring. William Eubanks, one of UMC’s vice presidents and another long-timer with around 24 years of service (“I’ve got shoes older than that,” laughs Carlson), came to Carlson about joining Allen’s department. That way she could transition out of PFS but still pitch in when needed, and at the same time “I could help Micky build that department,” she says. Eubanks had found the perfect solution. “That ‘kid’ is brilliant,” she says.

Ready to retire

With the Revenue Integrity Department up and running and the new manager of PFS ready to take over, Charlotte says she plans to retire this December, but not completely. “I want to come in two days a week, stir up a lot of dust, then go home and drink coffee,” she says.

To read more about Charlotte and UMC:

Building a Revenue Integrity Department from Scratch

The Secret to Effective CDM Maintenance?