revenue cycle

In this insightful episode, we had the pleasure of speaking with Ken Hogue, a seasoned professional in revenue cycle management. Ken shared his deep-rooted connection to healthcare, influenced by his family's background in the field, and his passion for being a mediator and executive in the space.

Ken's journey began with a desire to improve the healthcare system without being directly involved in patient procedures. He has worked with notable organizations like Change Healthcare and Rochester Regional Health and is currently the Senior Director overseeing the entire revenue cycle for both hospital and physician sides.

During our conversation, Ken recounted the challenges of implementing Epic EMR during the pandemic and the transition to virtual operations. He emphasized the importance of advancing the organization in growth and proficiency, grooming future leaders, and ensuring financial success.

Ken manages a staggering $1.4 billion in revenue, five hospitals, hundreds of physician practices, and leads a team of 540 individuals. He discussed the evolving landscape of healthcare regulations and the need for effective communication and compliance to navigate these changes.

We delved into the intricacies of the No Surprises Act and price transparency, exploring how Ken's organization is publishing information online and providing patient estimates to meet compliance and improve patient engagement.

Ken also highlighted the role of business intelligence (BI), artificial intelligence (AI), and automation in healthcare. He shared success stories of increased efficiency and the importance of understanding workflows to ensure the effectiveness of automated processes.

[00:02:09] Implementing Epic during the pandemic.

[00:04:24] Administrative burdens and communication.

[00:08:35] Healthcare regulations and patient education.

[00:15:30] BI, AI, automation.

[00:18:39] Automation and workflow design.

[00:20:17] Success through automation.

[00:25:36] Implementing over 100 ideas.

[00:29:00] Creating a career ladder.

[00:32:30] Advancement and work-life balance.

[00:35:37] Career paths and mentorship.

• [00:00:02] Introducing Denise Corbisiero, COO of Integrity Billing
• [00:00:20] Choosing Mental Health Industry: Challenges & Struggles
• [00:08:10] Tough Recovery & Insurances Hurdles
• [00:11:34] Embracing Change: AI’s Role in Reducing Workload
• [00:13:38] Underlining Customer Relationships: Turnover and Internalization
• [00:16:00] Accelerating Benefit Verification: Leveraging SaaS
• [00:19:21] Future of Automation: Streamlining the Appeals Process
• [00:21:54] Preferred Systems for Behavioral Health
• [00:23:21] Defining Success and Making Connections

Frank Corcino, has been in healthcare for the past 38 years. Starting in the healthcare debt collection business, he made a strategic shift into cash acceleration with early-age receivables. Currently Frank serves as a National Market Leader for Financial Operations in OnPoint Healthcare Partners, a boutique consulting firm in Texas. He acknowledged the ongoing struggles of hospitals with expense management, automation, and the need for a hybrid model of operations. As hospital operating incomes are at an all-time low and claim denials are growing, Frank sees technological solutions such as AI and NLP as vital to streamlining processes and reducing issues in revenue cycles. He mentions the successful use of software programs like OnPoint's virtual assistant in transcribing clinical notes for doctors, saving valuable hours each day. The episode ended with Frank discussing how he sees the future of healthcare, the likelihood of more outsourcing in the future.

Show notes

• [00:00:00] Introduction: Frank's 38 Years of Healthcare Experience
• [00:00:17] Early Career: From Collections to Cash Acceleration
• [00:02:34] Current Role: National Market Leader at OnPoint Healthcare Partners
• [00:04:09] Challenges in Healthcare: Seeking Efficiency amidst Struggling Automation
• [00:06:23] Solutions to Cash Flow Issues: Better Management of CDM
• [00:08:52] Staff Shortage: Transition towards Younger, Low-cost Managers
• [00:10:27] Addressing Hospital Financial Struggles: The Role of Technology
• [00:14:07] Streamlining Process: The Impact of Robotics and OCR Scanning
• [00:16:56] Impact of AI and NLP: Accurate Clinical Notes for a Smooth Revenue Cycle
• [00:18:51] Patient-Physician Separation: Unique Technologies to Enhance Care and Payments
• [00:24:22] Future in Healthcare: Openness to Alternative Solutions
• [00:26:00] OnPoint's Virtual Assistant Tool
• [00:28:50] Frank's Future Plans

IRIS - https://info.onpointhealthcarepartners.com/iris-virtual-clinical-assistant-0

U.S. Sen. Lamar Alexander (R-Tenn.), chair of the Senate Health Committee, appears to be ready to shepherd his 165-page draft legislation on surprise balance billing for a vote next week. 

In their push to get legislation prohibiting such billing through before the August recess, both the House and Senate have held hearings in the past two weeks on the various approaches to the problem. Those hearings have made the industry battle lines clearer, in terms of how the various industry sectors think that out-of-network providers should be compensated by payors. 

Although no single approach appears to be significantly favored at this point, Matthew Albright, former Centers for Medicare & Medicaid Services (CMS) official reports the lead story during this edition of Monitor Mondays. 

Other segments to appear during the live broadcast include:

• RAC Report: Healthcare attorney Knicole Emanuel returns to the broadcast to report on the latest audits by Recovery Audit Contractors (RACs) and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group.
  
  
• SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on social determinants of health (SdoH), has the latest news on this trending topic that is attracting significant media attention.
  
  
• CMS/IRF Settlement:  As reported by RACmonitor, the Centers for Medicare & Medicaid Services (CMS) agreed last week to settle appeals for inpatient rehabilitation facilities (IRFs) following a two-year dispute with the industry. Reporting on this developing story will be Angela Phillips, president of Images & Associates, and one of the nation’s foremost IRF authorities.
  • Links from Ellen's segment: Commonwealth Fund, Kaiser Family Foundation 1, Kaiser Family Foundation 2,  Harvard TH Chan School of Public Health, Medicaid Work Requirements Chart
• News from OMHA: The Office of Medicare Hearings and Appeals (OMHA) has expanded its Settlement Conference Facilitation (SCF) program, and it is now open to the appellant community. Healthcare attorney Andrew Wachler, a managing partner at Wachler and Associates, reports on how these expanded eligibility requirements provide new opportunities for appellants. 
  
  
• Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers.
  Links from David's segment: 
  • Supreme Court Case that says CMS must follow a more stringent process for issuing new rules than the Administrative Procedure Act requires.
  • Fraud Alert: Genetic Testing Scam
• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.