Presentation recap: nThrive Partners with Wake Forest on Financial Clearance Gaps

By Kevin Smith, Vice President, Product Management | Posted: 04/25/2019

nThrive health information technology solutions drive revenue cycle and patient satisfaction success

This week at NAHAM 2019, held in Orlando, Fla., I had the privilege of co-presenting with Gina Freeman, director of Patient Access at Wake Forest Baptist Medical Center, on “The Power of Partnering to fill Financial Clearance Gaps.” nThrive and Wake Forest, which is located in Winston-Salem, N.C., began working together in 2017 as one of nThrive’s first full business outsourcing Patient-to-PaymentSM engagements.

Looking back, I marvel at the vision shown by the Wake Forest leadership as they sought a holistic way to transform their revenue cycle management, responding to changes brought about by health care reform. In particular, they were quick to recognize a shift in cost burden, with patient liability growing due to high deductible health plans (HDHP). With so much riding on financial clearance to respond to this change, they focused considerable attention on Patient Access, transforming their front-end revenue cycle operation with nThrive’s industry-leading health information technology solutions and advisory services to better serve patient financial needs and overall patient satisfaction.

Moving the Revenue Cycle Needle

In just two short years, the results of this relationship have been enormous, both in the way of better serving patients, providing a quality improvement in health care, and optimizing the health care organization’s financial health. Here are just some of the financial highlights Gina shared with us:

  • Cash as a % of expected grew from 88.5% to 92.3%
  • Point-of-service collections rose 29%, from $2.5M average per month to $3.5M
  • Initial denials as a percent of gross revenue dropped from 10.4% to 7.8% adjusted
  • 2.9M claims have been accepted electronically by payors using nThrive claims management technology
  • Accounts Receivable days dropped from 65 to 45.1 days
  • Press Ganey Patient Satisfaction score rose to 94%

The Wake, nThrive journey

Of course, the journey is just as important as the results. To this point, Gina took us back to the early days of the relationship, recounting how the nThrive Transformation project worked with front, middle and back revenue cycle teams to recognize revenue cycle management opportunities to spur significant financial improvement. As part of their analysis they identified four critical areas:

  • Increase Point-of-Service Collections
  • Reduce Denial write-offs and increase Denial Recovery
  • Reduce aging Accounts Receivable
  • Implement a process of continuous improvement/li>

“We used a three-fold approach encompassing people, process and technology to deliver revenue cycle improvement,” Gina explained.

Improving financial clearance made a big difference across the board, helping to grow cash collections while also reducing the cost to collect by addressing the top four Patient Access Challenges:

  1. Validating patient demographics
  2. Obtaining authorizations
  3. Verifying insurance
  4. Calculating and collecting patient liability

Partnering for Success

Full business outsourcing on the order of Wake Forest is just one way health care organizations can engage with nThrive to transform their Patient Access operation and boost revenue cycle performance. With the launch of the new nThrive Financial Clearance Center (FCC), located in Raleigh, NC, it is now possible to leverage this same level of expertise and technology without physically embedding resources and technology inside an organization. Health care organizations can also utilize nThrive’s health information technology for their own use.

When engaging the FCC, patients are financially cleared on scheduled services by:

  • Validating demographic information
  • Verifying Eligibility and Benefits
  • Determining service approval
  • Obtaining payor authorization
  • Determining propensity to pay
  • Calculating patient liability
  • Performing pre-service collections

Like Wake Forest, health care organizations that engage with nThrive can expect to see higher margins and a reduced cost to collect. Most experience a 10 to 50% denial prevention cash acceleration and an increase in POS revenue from 2 to 8%. While outsourcing may feel like a big leap, it is trend that is expected to continue to grow. According to a Black Book study, approximately 80 percent of hospitals are vetting or considering some form of partial or full revenue cycle management outsourcing in 2019.

Are you ready to explore financial clearance outsourcing for your health care organization? Download the nThrive Financial Clearance Center overview today. Want to talk to an nThrive health information technology or advisory services expert? E-mail us at solutions@nThrive.com or call us at (678) 323-2500.