BOONE, NC – While they’re not doing the dollar volume of their big-city brethren, small hospitals in rural settings face unique financial pressures and must manage all aspects of the revenue cycle.
That’s why the Appalachian Regional Healthcare System is ramping up efforts to do a better job of managing financial operations at its three hospitals.
The system, which operates Watauga Medical Center, a 117-bed regional referral facility, and two smaller critical access hospitals in Linville and Blowing Rock, recently signed a contact to replace legacy billing systems with the revenue cycle management system of Alpharetta, Ga.-based HealthPort.
The recently-formed system serves the high country surrounding Boone, N.C., and making the most of financial performance is crucial in performing the system’s mission, said Rayanna M. Moore, system director of revenue cycle.
“It’s maybe harder for us to respond when there’s a quick (Medicare) rule change,” Moore said. “We don’t get any more time to respond than (urban hospitals), and we do more with fewer people. We tend to have people wearing multiple hats in one setting.”
Appalachian Regional’s previous billing system required a lot of maintenance, and Moore doesn’t have the staff to “babysit” the billing system and keep up with the constant stream of Medicare changes.
HealthPort offers an Internet-based approach, through which the company follows Medicare changes and updates its rules accordingly. It also improves management of claims and other transactions regarding their status.
Appalachian Regional’s new revenue cycle management application will direct claims quickly to payers. That’s a benefit to the system because if a claim is rejected and needs further documentation, billing staff can immediately answer concerns and resubmit the bill.
That will equal a day in accounts receivable, compared with the previous system, Moore said.
HealthPort’s grasp of Medicare also enables it to provide an estimate of what it will be paid for its services, which was difficult to determine before.
“We had been at Medicare’s mercy and we had to go into the Medicare systems to figure out what kind of money we could expect,” Moore said. “It’s very important for us to know what kind of money we’ve got coming in.”
The application will be implemented at Watauga Medical Center first. The whole changeover is expected to take about three months.
Beyond that, the system is working at improving its ability to capture charges and better determine what charges it’s entitled to bill for, Moore said.