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Sutter Health Organization adapted the mantra as stated within the “no margin, no mission, which increased the importance strategy for optimizing margins in this time of high-deductible health plans as well as higher copayments which is to collect more cash from its patients which also would include self-pay patients” (Souza & McCarty 2007). All staff must be consistent with communicated with its patients as well as knowledgeable with such information. Sutter health organization researched as well as created a plan for its self-pay patients and within
Running Head: WEEK 5 SELF-PAYMENTS ARE PRIORITY 5three months of implementing this policy the organization seen an increase in its collections on such accounts, however during the implementation process Sutter Health identified three key areas that needed restructured in order for the collections of out of pocket expenses to be collected within a timely manner. As stated within the text the first area that had been identified was that “PFS staff could not access real-time information on key financial and operational indicators such as A/R days and cash collections” (Souza & McCarty 2007). The second was that the “hospitals’ accounting system did not allow managers to isolate and analyze select data and or generate reports on demand” (Souza & McCarty 2007). And lastly “the central business office (CBO) staff also suffered from the lack of real-time information” (Souza & McCarty 2007). By identifying these issues Sutter health was able to improve the collection issues as wellas reduce the number of outstanding A/R days. There first focus was on managing the setup which would allow management to ensure timely decisions and make the appropriate actions. This also entailed the development set of managerial reports relevant towards actions that management were responsible for taking on. This information would only be useful if the appropriate choices had been made. Within these metrics the organization had established through reporting purposes it was to include gross, billed as well as unbilled A/R days, percentages of A/R in aging categories as well as major payor sources that were associated to them. When the applicable report had been identified an automation, report had been put in placefor each account manager to customize reports for tracking of departmental as well as induvial goals, they were also able to generate ad hoc reports without submitting special request. Sutter health revised how its denied claims would be managed as well as implemented a procedure/policy that managed the process from preventing claim denials as well as timeliness ofappeals.
Running Head: WEEK 5 SELF-PAYMENTS ARE PRIORITY 6Claims Submission Flow Chart: Retrieved from:The following claims flow chart shows the claims submission process and the order of how claims are generated, as you can see the first step within any healthcare organization is the
Running Head: WEEK 5 SELF-PAYMENTS ARE PRIORITY 7collection of patient information.