Rural and Community Hospital Services

The road to CASH

isn’t paved with

good intentions…

At re|solution, we’ve built our reputation on more than a decade of improving revenue cycle operations for healthcare

providers throughout the country. We provide revenue cycle process and technology solutions that result in both immediate

and sustainable improvements to a provider’s cash flow, profitability and revenue cycle efficiency. In addition to finding the cash

that falls through the cracks in revenue cycle and billing processes, our on-site approach establishes a knowledgeable and

confident business office staff that operates with greater efficiency, higher productivity and better financial results.

Just as healthcare itself must meet the specific needs of each patient, re|solution offers a full spectrum of revenue cycle

services – customized to meet the unique needs and constraints of each of our clients in the communities they serve.

re|solution’s technology solutions and its renowned educational, mentoring approach can improve every aspect of your revenue

cycle. We are proud to say that we have provided an overall net CASH gain to every one of our clients.

• Poor cash flow?

• Days of cash on hand < 20 days?

• High AR over 90 days?

• Recent loss of key personnel?

• Lack of qualified and/or

experienced personnel?

• Cost to collect higher than 3%?

• Recent system conversion?

• APC Index < 3.0?

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The road to CASH is paved with ACTION!

• Revenue Cycle Assessment

• Cash Acceleration

• Interim Staffing

• Virtual Business Office

Outsourcing

• Reimbursement Review

• Self Pay Management

• Charge Capture Review

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• Cash is up

• Receivable days down

• Increased reimbursement

• Education and mentoring

of staff on-site

• Improved processes and

procedures

• Roadmap for long-term

success

• Peace of mind

Call re|solution today at 1.800.355.0410

For a FREE Benchmark Indicator Analysis,

visit us at www.ereso.com

re|solution provides highly effective, tailored solutions to the business

challenges faced by hospitals, outpatient facilities, physician practices,

clinics, DME and home health providers.

363 centennial pkwy – suite 105, louisville CO 80027 • phone 303.530.0396 • toll free 800.355.0410 • www.ereso.com

Map of Engagements

At re|solution, we’ve built our reputation on more than a decade of improving revenue cycle

operations for healthcare providers throughout the country. We provide revenue cycle process and

technology solutions that result in both immediate and sustainable improvements to a provider’s cash

flow, profitability and revenue cycle efficiency. In addition to finding the cash that falls through the

cracks, our on-site approach establishes a knowledgeable and confident staff that operates with greater

efficiency, higher productivity and better financial results. Visit us at www.ereso.com.

re|cover

re|cover

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Cash Acceleration Cash Acceleration Cash Acceleration

Immediate Cash Immediate Cash Immediate Cash

Other benefits include:

Reduced days in A/R

Improved bottom line

On-site training

Proprietary reporting tools

Improved management information

Sustainable results

Peace of mind

Real Life Results Real Life Results Real Life Results

Carson Tahoe Regional Medical Center (“CTRMC”) is a 140 bed facility just south of Reno, Nevada.

With over 30,000 patient visits per year, CTRMC had a negative adjustment to their net Accounts

Receivable of nearly $6,000,000 when their management embarked on a process to find any and all

opportunities for cash and bottom line improvement.

re|solution was engaged and assigned all insurance accounts over 90 days. During the first quar-

ter of the engagement, cash collections were 40% higher than cash collections for the same quarter

in the prior year.

In addition, re|solution provided added services for CTRMC’s business office staff, such as training

in billing and follow-up techniques and a detailed revenue cycle assessment at no additional cost.

The hospital administration was ecstatic about the increased cash flow. The improvements identi-

fied and implemented by re|solution were continued after the engagement ended.

MethodologyMethodologyMethodology

Experienced and knowledgeable analysts work your aged accounts

On-site training and mentoring of your staff insures long-term improvements

Inefficiencies identified and recommendations made for customized process improvements

Safety net of re|solution resources provide post engagement support

Post engagement quarterly benchmark reports verify your success

“The re|solution team was so helpful and

had so many good ideas that they quick-

ly gained the trust of the full-time staff.

Everyone was happy to have them on

board and soon realized the value of

their expertise.”

John Wilker, Chief Financial Officer

Portneuf Medical Center

For additional information:

[email protected]

toll free 800-355-0410

www.ereso.com

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Interim Staffing Interim Staffing Interim Staffing

Immediate Access to Proven, Immediate Access to Proven, Immediate Access to Proven,

Qualified PersonnelQualified PersonnelQualified Personnel

Other benefits include:

Cash increases with improved staff skills

On-site knowledge transfer produces competent

local employees

On-site training/mentoring increases skill retention

Temporary or long-term placements

Real Life Results Real Life Results Real Life Results

Lavaca Medical Center (“LCMC”) is a 25-bed community hospital in south central Texas providing a

wide range of inpatient and outpatient services. LCMC’s business office manager resigned. Months

of searching for a replacement resulted in no qualified candidates, so LCMC identified an individual

from another department to become the new business office manager.

re|solution was engaged to mentor/train the individual selected. During the first three months of the

engagement, the on-site re|solution interim business office manager managed the business office

while the new business office manager shadowed and learned effective business office manage-

ment. During the second three months, the new business office manager managed the business

office and the on-site re|solution interim business office manager provided support while writing

policies and creating a reporting structure.

During the six month engagement, LCMC also underwent a difficult system conversion. Cash

remained relatively steady even with the turnover and system conversion problems. The new busi-

ness office manager received continued support from the re|solution interim business office

manager who remained a resource after the training/mentoring engagement ended.

MethodologyMethodologyMethodology

You select from our elite reserve of qualified personnel

Mentoring option for training managers or higher level personnel

Implementation of unique reporting and productivity tools with monthly reports to measure

employee performance

Safety net of re|solution resources provide post engagement support

“Your placement of an interim busi-ness office manager helped us begin the process of implementing the rec-ommendations made in your assess-ment. Your continued support in the months following the engagement, including assistance in interviewing candidates for the permanent busi-ness office manager, enabled us to put the blocks in place during this transitional period as we worked to-ward long-term stability.”

Bob Ellzey, President/CEO Laird Memorial Hospital

For additional information:

[email protected]

toll free 800-355-0410

www.ereso.com

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System Conversion A/R Wind DownSystem Conversion A/R Wind DownSystem Conversion A/R Wind Down

OverviewOverviewOverview

Your new system conversion date is nearly here. You and your leadership team and staff have dedicated a

large amount of time to implementation, planning and training while at the same time trying to maintain current

operations. System implementations are complex and at times can be overwhelming, and despite your best

efforts, key performance indicators can begin to move in the wrong direction.

ChallengeChallengeChallenge

You and your staff are working hard, but…

Cash collections are decreasing

A/R days are increasing

Your staff is having difficulty completing their current work while building and training on the new system

Key managers are required to dedicate time preparing for the implementation

There is pressure to retire your old legacy system early to reduce costs

SolutionSolutionSolution

re|solution’s System Conversion A/R Wind Down (re|wind) solution combines our highly trained staff, with

proven experience in A/R liquidation and cash acceleration during system conversions, with the efforts of your

staff.

Our re|wind solution creates a synergy that:

Provides a cost effective alternative to working your post conversion A/R internally

Ensures that your pre and post conversion cash collections remain at or exceed current performance

Allows your revenue cycle leadership and key personnel to focus on successful implementation and training

ResultsResultsResults

Maintaining pre-conversion performance in cash collections, A/R, and bad debt expense is the key to an effec-

tive and ultimately successful system conversion. Our re|wind solution will deliver the following results:

Significantly increases the likelihood of a successful system conversion

Consistent cash collections before, during, and immediately after the conversion

Assists with maintaining other key revenue cycle performance indicators at current levels

Potential reduction of system maintenance costs by early retirement of old legacy system

For additional information:

[email protected]

toll free 800-355-0410

www.ereso.com

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Training and MentoringTraining and MentoringTraining and Mentoring

Improved Skills Increase CashImproved Skills Increase CashImproved Skills Increase Cash

Other benefits include:

Training provided by highly skilled revenue cycle management experts

On-site, one-on-one training insures retention

Create well-trained staff without recruiting new personnel

Application of proprietary software to monitor employee progress and performance

Sustainable business office process improvement

Training ProgramTraining ProgramTraining Program

re|train is a cost-effective way to provide new or less experienced business office staff and manage-

ment with receivables management skills. The service is conveyed one-on-one by a re|solution

revenue cycle operations expert. Throughout the training, your staff completes a series of written

and oral exercises to verify comprehension and retention of the material. re|solution also applies

proprietary software to monitor employee performance.

MethodologyMethodologyMethodology

Review and compare your facility’s key revenue cycle indicators to those of best practice

organizations, with instructions on how to use benchmarking to monitor, manage and improve

business office performance

A re|solution revenue cycle operations expert will provide in-depth instruction on:

Bad debt and contractual reserves

A/R management influences on the income statement and balance sheet

Determining if changes in A/R are due to revenue fluctuations or process breakdowns

Understanding the causes of key indicator variances and options for corrective actions

Utilizing the Aged Trial Balance and other reports as management tools

Create a responsibility matrix that optimizes the skills of individual staff members in assignment

of key business office functions and processes

Develop performance expectations and productivity standards including prioritizing tasks and

developing effective time management strategies. Apply proprietary re|solution management

tools and motivational techniques to improve revenue cycle performance

Daily performance tracking, monthly site visits or calls to review progress and answer questions.

Verbal exit conference and written report for hospital senior management at the conclusion of

the engagement

For additional information:

[email protected]

toll free800-355-0410

www.ereso.com

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Insourced Business Office

Guaranteed Performance Improvement

Other benefits include:

Transparent pricing—no surprises

Guaranteed bottom line increase

No more staffing issues

Improved dashboard reporting

Implementation of new technology

Peace of mind

Real Life Results

“We had been without a

business office manager and our

issues were severe. The

transition was relatively easy, and

the results practically immediate.

re|solution took over only the

necessary positions, trained

those we desired to have stay,

and the billing office began to

function efficiently. I can’t say

enough good things about our

experience with re|solution”

Mike Click, CEO

Brownfield Regional Medical Center

When Brownfield Regional Medical Center (“BRMC”) in NW Texas engaged re|solution, BRMC’s

AR days were at 131, compared to a peer average of 48 days, days of unbilled AR was at 27

compared to the peer average of only 10, and total AR was at $4.5 million. re|solution was selected

to “insource” the business office by hiring all BRMC employees and placing a seasoned business

office manager to lead the revenue cycle.

re|solution assumed responsibility for BRMC’s 21 revenue cycle employees. During the re|store

engagement, re|solution reduced the outstanding AR to less than $2 million and decreased the total

business office staff needed to run the operation by implementing process improvement and

increasing operating efficiencies. After several years, re|solution assisted BRMC in returning to an

in-house Business Office once operations were stabilized and BRMC desired to bring the work back

in-house.

Methodology

All costs of the revenue cycle assumed by re|solution including cost of other revenue cycle

vendors

Pricing set at current costs plus 10%

Guarantee that additional reimbursement will exceed 100% of additional costs or contract may

be terminated

Manage and train current staff

Optimize current patient accounting system

New technology introduced to improve reimbursement

Monthly accountability, productivity and benchmarking reports

For additional information: [email protected] toll free 800-355-0410 www.ereso.com

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Guaranteed Revenue Improvement ProgramGuaranteed Revenue Improvement ProgramGuaranteed Revenue Improvement Program

OverviewOverviewOverview

Using a comprehensive initial assessment of the revenue cycle, re|solution identifies areas where

the facility has not received the reimbursement for which it is entitled. The assessment looks at all

phases of the revenue cycle including: scheduling, registration, charge capture, coding, billing,

collections and reimbursement. The assessment will identify claims to be rebilled, changes in pro-

cess that will generate additional dollars and other opportunities to move towards a best practices

revenue cycle. re|solution guarantees that the cost of the assessment will be covered by opportu-

nities found for additional reimbursement.

Once the initial assessment is completed, re|solution works with two departments each quarter to

assist them in improving charge capture, documentation and coding practices to insure that the

facility is being paid the correct amount for all services that are performed. In addition, for a year

following the assessment, re|solution will monitor the implementation of each recommendation to

insure effective implementation. Once again, re|solution guarantees that the cost of this quarterly

implementation and monitoring is covered by additional reimbursement.

ChallengeChallengeChallenge

The challenges faced by rural and community hospitals are enormous. The same charge capture,

coding and reimbursement issues that plague larger facilities also affect rural and community

hospitals with less resources to insure compliance and appropriate reimbursement for services

provided. re|solution’s re|grip program provides a safety net to insure that the provider receives all

the monies they are due.

BenefitsBenefitsBenefits

Using proprietary technology, interviews and a proven continuous improvement and monitoring pro-

cess, this no-risk program allows personnel at the departmental level to work with the revenue cycle

personnel in optimizing reimbursement. This is the key to an effective revenue cycle when you can

get the clinicians and the business people working together. The process also allows the facility to

explore other opportunities for improvement such as point of service collections, denial manage-

ment, self pay management, contract payment review and EHR implementation for meaningful use.

This safety net gives our clients the peace of mind that all services are being reimbursed at an ap-

propriate level.

For additional information:

[email protected]

toll free 800-355-0410

www.ereso.com

Benchmark Indicator Analysis

How does your facility compare nationally with other facilities of your respective size?

re|solution is a hospital expert, providing superior accounts receivable management, revenue cycle analysis, training, APC and CDM reviews, interim staffing and an array of other business office services. If you are interested in knowing how the efficiency of your business office compares with demographically similar facilities, please complete the form below and return it to us by fax or email. In return, we will provide you with a benchmarking analysis. We will also make ourselves available for discussion and/or explanation of the data.

Please complete the from below and fax to (303) 648-5589 or email to [email protected]. You may also complete this information online at http://www.ereso.com/benchmark/benchmark-indicator-analysis-form. Your information is confidential.

Name

Company

Street Address

City State Zip

Phone Ext. Fax

E-mail Address

1. Bed Size

2. Beds in Service

3. Average Daily Census

4. Total Accounts Receivable $

5. Cash Receipts per Month $

6. Gross Revenue per Month $

7. Accounts Receivable $ Over 90 days $

8. Monthly Cost of Admissions/Registration Staff (including benefit load) $

9. Monthly Cost of Business Office Staff (including benefit load) $

10. Administrative Write Off $ Per Month (not including contractuals) $

11. Bad Debt Write-Off $ per Month $

12. Charity Write-Off $ per Month $

13. Number of Open Accounts

14. Number of FTEs in Business Office (excluding admissions)

15. Percentage of AR in Self Pay > 90 days

16. Number of Days of Cash on Hand

17. Amount of $ Discharged But Not Final Billed (DNFB) $

18. When was your ChargeMaster last updated? (mm/dd/yy)

19. Date Data Compiled (mm/dd/yy)

20. What is your Patient Accounting System

Please feel free to contact us with any questions.

800.355.0410 www.ereso.com

Benchmark Indicator Analysis (BIA)

Category Descriptions

1. Bed Size – The total # of licensed beds.

2. Beds in Service – The total # of operational beds.

3. Average Daily Census – The average daily inpatient census.

4. Total Accounts Receivable – The total dollar amount of any open patient accounts where monies are owed the organization for services provided. This does not include accounts in bad debt status.

5. Cash Receipts Per Month – The actual cash received by the organization as payment for services rendered on any patient accounts for the monthly reporting period.

6. Gross Revenue Per Month – The total amount of charges on accounts for patient services rendered for the monthly reporting period.

7. Accounts Receivable $ Over 90 days – The total dollar amount of all open accounts that are older than 90 days. This does not include the accounts in bad debt status.

8. Monthly Cost of Admissions/Registration Staff – the total of salaries/wages including benefit load (i.e. health benefits, payroll taxes, and other non-direct payroll costs) for ALL individuals (staff and management) that work in admissions/registration Admissions/registration staff and management includes but is not limited to: schedulers, insurance verifiers, financial counselors, pre-registrars, registrars, etc. and all supervisors, managers, and/or directors of this staff.

9. Monthly Cost of Business Office Staff – the total of salaries/wages including benefit load (i.e. health benefits, payroll taxes, and other non-direct payroll costs) for ALL individuals (staff and management) that work in the Business Office. Business office staff and management includes but is not limited to: cash posters, refund specialists, billers, insurance and self-pay collectors, analysts, data entry, charge master specialist (based in business office), receptionists, customer service and all supervisors, managers, and/or directors of this staff.

10. Administrative Write Off $ Per Month (not including contractuals) – the dollar amount of accounts that are written off to codes other than bad debt and charity. An example would be denied accounts that could not be overturned and will not be paid.

11. Bad Debt Write Off $ Per Month – the dollar amount of accounts that are written off to bad debt.

12. Charity Write Off $ Per Month – the dollar amount of accounts that have been approved and written off to charity care.

13. Number of Open Accounts – Number of open accounts being worked by the business office. Do not include those accounts that have been assigned to outside collection agencies or specific financial classes that are assigned to an outsource vendor for follow up.

14. Number of FTEs in Business Office (excluding admissions) – Active number of full time employees that are performing business office functions (i.e. management, supervisors, billers, collectors, posters, etc).

15. Percentage of AR in Self Pay > 90 days – Dollar amount of self pay as a percentage of accounts receivable that are greater than 90 days old. Do not include any accounts that have been referred to an outside collection agency. This can be determined by taking the total dollars in AR > 90 that are self pay and dividing it by the total dollars in AR >90.

16. Number of Days of Cash on Hand – This is the actual amount of cash on hand divided by average cash usage per day for hospital expenses.

17. Amount of $ Discharged But Not Final Billed (DNFB) – Dollar amount of accounts on patients that have been discharged and the billing has not been sent.

18. When was your ChargeMaster last updated? – The last date that your ChargeMaster was completely updated using the latest available code changes and respective pricing?

19. Date Data Compiled – The date the information was compiled on your Information System. (i.e. These numbers are from my March Month End Data – so the date would be 3/31/12).

20. What is your Patient Accounting System? – This is the hospital’s main Health Information System (i.e. Meditech, Dairyland, CPSI, Siemens’s, HBOC, HMS, etc).

800.355.0410

www.ereso.com

Prepared: April 8, 2013

Facility Name: Sample Hospital

Your Information:

Facility Bed Size: 250

Average Daily Census: 41.9

Total Accounts Receivable: $7,722,450

Cash Receipts per Month: $1,808,374

Gross Revenue per Month: $2,843,505

A/R Over 90 Days: $3,840,899

Monthly Cost of Admissions Office: $45,000

Benchmark Indicator Analysis

Monthly Cost of B.O. (billing/collections): $40,000

Write Offs per Month - Administrative: $135,675

Write Offs per Month - Bad Debt: $207,817

Write Offs per Month - Charity: $86,487

Write Offs per Month - TOTAL: $429,979

Number of Open Accounts: 9,250

Percent A/R in Self Pay: 20.00%

Discharged Not Final Billed: $1,500,000

Data Provided: Enter Date Compiled

Name of provider: Enter Contact Name

For additional

information:

re|solution

P.O. Box 270903 Robin Bradbury

Louisville, CO 80027 CEO

800.355.0410 303.318.4292 direct

www.ereso.com [email protected]

Sample Hospital

81.47

45.93

39.18

0 10 20 30 40 50 60 70 80 90

Sample Hospital

Peer Group Average

Best Practices

Gross Days in A/R Outstanding

$0.047

$0.023

$0.014

$0.00 $0.01 $0.02 $0.03 $0.04 $0.05 $0.06 $0.07 $0.08 $0.09 $0.10

Sample Hospital

Peer Group Average

Best Practices

Cost to Collect per Dollar

7.31%

2.23%

1.50%

0% 1% 2% 3% 4% 5% 6% 7% 8% 9%

Sample Hospital

Peer Group Average

Best Practices

BAD DEBT Write-Offs as a Percentage of Revenue

`

81.47

45.93

39.18

0 10 20 30 40 50 60 70 80 90

Sample Hospital

Peer Group Average

Best Practices

Gross Days in A/R Outstanding

$0.047

$0.023

$0.014

$0.00 $0.01 $0.02 $0.03 $0.04 $0.05 $0.06 $0.07 $0.08 $0.09 $0.10

Sample Hospital

Peer Group Average

Best Practices

Cost to Collect per Dollar

7.31%

2.23%

1.50%

0% 1% 2% 3% 4% 5% 6% 7% 8% 9%

Sample Hospital

Peer Group Average

Best Practices

BAD DEBT Write-Offs as a Percentage of Revenue

3.04%

1.08%

0.60%

0% 1% 2% 3% 4% 5% 6% 7% 8% 9%

Sample Hospital

Peer Group Average

Best Practices

CHARITY Write-Offs as a Percentage of Revenue

49.7%

24.0%

19.0%

0% 10% 20% 30% 40% 50% 60% 70%

Sample Hospital

Peer Group Average

Best Practices

A/R Greater than 90 Days as a Percentage of Total A/R

15.8

10.1

5.0

0 2 4 6 8 10 12 14 16 18

Sample Hospital

Peer Group Average

Best Practices

Days in Discharged Not Final Billed

Hospital Peer Group Difference Cash Opportunity

AR Days Reduction 81 46 36 $2,142,599

Days over 90 Reduction 49.7% 24.0% 25.8% $995,686

DNFB Reduction 15.8 10.1 5.77 $347,542

Cost to Collect Reduction 0.047$ 0.023$ 0.024$ $272,318

Bad DebtWrite off Reduction 7.3% 2.2% 5.1% $866,441

Charity Write off Reduction 3.0% 1.1% 2.0% $334,663

Opportunity AnalysisSample Hospital

April 8, 2013

Hospital Best Practices Difference Cash Opportunity

AR Days Reduction 81 39 42 $2,549,483

Days over 90 Reduction 49.7% 19.0% 30.7% $1,186,817

DNFB Reduction 15.8 5.0 10.83 $652,554

Cost to Collect Reduction 0.047$ 0.014$ 0.033$ $379,161

Bad DebtWrite off Reduction 7.3% 1.5% 5.8% $990,987

Charity Write off Reduction 3.0% 0.6% 2.4% $416,556

Overview

The need Marshalltown Medical and Surgical

Center needed help to identify key

areas of opportunity to quickly

improve cash flow. The facility wanted

to identify all organizational and

process changes required for best

practice revenue cycle.

The Solution Marshalltown Medical and Surgical

Center deployed re|grip™

complemented by an experienced

re|solution manager to identify missed

opportunities for reimbursement while

providing training to key staff and

implementing sustainable and proven

improvements to the facility’s

processes.

The Benefit Marshalltown Medical and Surgical

Center with the re|grip™ assessment,

assisted by re|solution, quickly billed

over $2,500,000 in missed charges

resulting in over $600,000 in

additional cash for MMSC.

Improvements to process, CDM

and Charge Capture will ensure

long term sustainability.

Marshalltown Medical & Surgical Center finds additional cash

An assessment and redesign of business processes combined with guaranteed cash results leads to improving staff understanding and skills, optimizing the revenue cycle

Marshalltown Medical & Surgical Center (MMSC) is a 125 bed acute care facility nestled in the heart of Iowa. It is the only full-service medical center serving the community and surrounding areas. It provides more than 60,000 residents with 24 hour emergency care, a state-of-the-art Diagnostic Imaging department, Cardiac Catheterization Lab, Rehabilitation Center, and a host of outreach programs. MMSC also owns and operates four primary care medical clinics in Marshalltown, Conrad, State Center, and Toledo. Their mission is to create and continually improve services that respond to health care needs within the community. They are dedicated to teamwork, integrity, and providing compassionate quality care to patients and families.

Safeguarding Community Services MMSC’s leadership, while focused on addressing the needs of the community they served, was concerned with the integrity of their revenue cycle. A lack of cash threatened their ability to meet the healthcare needs of their community. Facing the numerous challenges of current healthcare reform and the threat of decreased reimbursement for Medicare and Medicaid, MMSC needed to quickly identify areas in which they were missing opportunities for optimal reimbursement.

Balancing Community and Revenue Cycle Integrity MMSC leadership selected re|solution to assess their current revenue

cycle and offer recommendations for proven, scalable, improvements to

revenue cycle performance and integrity. In keeping with their

commitment to community and rural healthcare facilities, re|solution

guaranteed to find more cash opportunities than the assessment cost or

the difference would be refunded. The review was completed and

recommendations for improving business and operational processes and

specific key areas of opportunity to optimize reimbursement were

presented to MMSC’s leadership.

Todd Burch –COO for MMSC said, “re|solution’s Guaranteed Revenue

Improvement Program was a huge success for our facility. While we

appreciated the additional cash found and process improvements

implemented, the real benefit was capturing more dollars for the same

services going forward. re|solution was easy to work with and

immediately put our staff at ease. Great program.”

re|g

rip™

“re|solution’s Guaranteed

Revenue Improvement Program

was a huge success for our facility.

While we appreciated the

additional cash found and process

improvements implemented, the

real benefit was capturing more

dollars for the same services going

forward. re|solution was easy to

work with and immediately put

our staff at ease. Great program.”

- Todd Burch – COO, Marshalltown

Medical & Surgical Center

A Solid Foundation Provides Sustainable Measureable

Results MMSC leadership collaborated with re|solution following a full

assessment and the identification of key areas of opportunity for

additional billing assistance needed to move quickly in billing missed

charges. The re|solution team, together with MMSC staff, identified and

billed $2,500,000 in missed charges, resulting in $600,000 in much-needed

additional cash for MMSC.

As part of the re|grip program, re|solution professionals in partnership

with the MMSC team, developed new processes and implemented tools

the facility uses to create and sustain improvements. Along with billing

assistance, re|solution performed the Charge Capture review,

departmental training and education process, and a Chargemaster review

to optimize reimbursement. The on-site, re|solution Project Manager

provided resources, skills, and suggestions for process improvements to

increase cash performance.

re|solution provided a full scope of services during the Guaranteed

Revenue Improvement Program:

Determined deficits and areas of improvement

Provided the resources, tools and training to increase staff

knowledge, confidence and skills

Provided billing and collection of identified accounts to increase

cash

Guaranteed for Peace of Mind Locating unbilled charges and the education of MMSC’s staff while

generating just over $600,000 in additional cash for the hospital is

impressive, but more significant are the process improvements and the

knowledge transferred to Marshalltown Medical & Surgical Center’s

business office staff for long term sustainable results.

For more information Visit us at www.ereso.com, or call us at 1.800.355.0410

Overview

The need Dallam Hartley was facing serious

financial impact from significant

revenue cycle operational issues;

revenues had declined, DNFB was

unstable, and long standing coding

issues and training needs had gone

unaddressed. Deficits in staffing added

to the challenging situation.

The Solution In partnership with re|solution, Dallam

Hartley deployed re|store™.

re|solution placed a Revenue Cycle

Manager onsite to assist with training

current staff, securing additional

staffing, stabilizing the DNFB and

billing. The staff worked aggressively to

meet milestone goals.

The Benefit Dallam Hartley realized a net benefit of

nearly $500,000, eliminated billing

compliance exposure, and increased

cash by approximately 4% on flat

revenue. The engagement continues to

focus on moving all key performance

indicators even closer to best practice

levels. Dallam Hartley has requested

that re|solution also assume

responsibility for clinic billing

operations due to superior

performance.

Dallam-Harley Counties Hospital District increases cash and reduces expenses

Insourcing partnership reduces billing and follow up costs,

increases cash flow and compliance, providing the benefits of

outsourcing without eliminating staff or taking processes

offsite.

Dallam Hartley Counties Hospital District (DHCHD) is located in the

northwest corner of the Lone Star state and is committed to being the

primary quality healthcare resource for Dallam-Hartley counties and the

surrounding areas. DHCHD is a 25-bed acute care facility offering Level IV

trauma services, inpatient and outpatient services, 24-hour emergency

room, surgery, nursing, laboratory and radiology. They are dedicated to

excellence in patient care, offering a wide spectrum of clinical expertise,

supported by an exceptional range of technology and staff.

Ensuring Community Services Like many rural and community providers, DHCHD faced serious financial

impact from significant revenue cycle operational issues. Executive

leadership recognized that staffing deficits, new and changing healthcare

regulations, economic challenges, a lack of billing and compliance training

and coding issues were directly impacting cash. They were seeking a

meaningful long term solution to decrease waste and improve efficiency.

Executive Leadership reviewed a variety of options to quickly and

positively resolve operational issues and improve cash flow. They

determined partnering with re|solution for a full insource with

transparent pricing would best support these goals.

Making a Smooth Transition DHCHD’s leadership and re|solution collaborated to create an

Engagement Management Action Plan for an efficient insource transition.

The plan outlined a variety of milestones and goals designed to optimize

revenue cycle operations. DHCHD employees were transitioned to

re|solution, retaining jobs in the community.

Leroy Schaffner – CEO for DHCHD said, “re|solution’s focus on process

improvement and best practices has improved and streamlined our billing

and follow-up, while at the same time increasing our cash flow.”

re|s

tore

™

“re|solution started the project and

quickly assessed our operation.

Then they created a comprehensive

management action plan to

address the issues they found and

drive improvements. Their

monthly reporting package is great

and we’re seeing data and analyses

that we’ve never had access to

before. They implemented their

claims management technology

which helped to increase cash

collections for us. They also

brought in other revenue cycle

experts (coders, charge capture

specialists, etc.) as needed to help

train our staff. We’re very happy

with re|solution and greatly value

our partnership with them.”

- Donny Pettit– CFO, Dallam Hartley

Counties Hospital District

Quickly deploying productivity initiatives and training

creates a solid foundation for future performance While a typical outsource removes jobs from the community and does

nothing to reduce expenditures, re|store™ insourcing eliminates these

dilemmas. re|solution assumed responsibility for the day to day

operations and immediately began work on implementing the

Engagement Management Action Plan. An experienced re|solution

revenue cycle manager was placed onsite to support training and

mentoring the current staff and also took responsibility for managing the

additional re|solution team brought on-site to assist in swiftly improving

cash flow.

Highlights of the best practice plan included:

Immediate compliance training/testing to staff

Reduce and stabilize DNFB

Resolve long standing coding issues

Conduct a charge capture review

Train ER registrars and clinic staff

Revise Self-pay letters and statements

Implementation of re|discover claims management technology

Guaranteed Performance – Peace of Mind re|solution quickly provided additional staff upon transition to ensure

revenue cycle improvements proceeded quickly. The business office staff

immediately completed compliance and billing training and testing

eliminating billing compliance exposure by utilizing best practices. Cash

increased nearly 4% on flat revenue.

re|solution collected additional cash and DHCHD realized a net benefit of

nearly $500,000. DHCHD has requested that re|solution also assume

responsibility for clinic billing operations due to superior performance.

The engagement continues to focus on moving all key performance

indicators even closer to best practice levels.

For more information Visit us at www.ereso.com, or call us at 1.800.355.0410

Overview

The need An outstanding AR of $2,926,000, of

which $1,179,000 was over 90 days

and Gross Days in AR exceeding 117,

Muenster Memorial needed help to

reduce their AR. Another immediate

need was to address Discharged Not

Final Billed (DNFB) which had climbed

to $735,000 or nearly 29 days of gross

revenue.

The Solution Muenster Memorial deployed

re|cover™ complemented by an

experienced re|solution manager to

assist in assessing staff, providing

training and re|solution tools left

behind for ongoing improvement and

success.

The Benefit

Muenster Memorial with processes

implemented by re|solution’s

experienced staff and use of

proprietary tools reduced their AR

over 90 days from $1,179,000 to

$474,000 and DNFB decreased from 29

days of gross revenue to 5 days, an

83% reduction. The AR clean-up

generated over $700,000 in cash

collections while the DNFB reduction

accelerated another $300,000 in cash

for the hospital, and increase of over

$1MM in an 18 bed facility

Muenster Memorial Hospital achieves a significant reduction of Accounts Receivable and DNFB

Assessment, training and a reduction in Accounts Receivable completed, increasing both staff confidence and performance.

Muenster Memorial is an 18 bed, Critical Access Hospital located in Cooke County, Texas. Since 1964, MMH has served Muenster and surrounding communities with the same philosophy; the value of patient care depends on the outcomes achieved and resources used. MMH’s dedication to serve the community with integrity, compassion, public service, efficiency, and support create an atmosphere of trust, and open communication.

The Muenster Hospital District’s staff and Board are driven by a vision to work with the community to provide total healthcare needs as well as to inform and educate to improve the wellness of the community.

Ensuring Community Services Like many Critical Access healthcare providers today, MMH faced an

immediate need to reduce $2,926,000 in Accounts Receivable of which

$1,179,000 was over 90 days with Gross Days in AR exceeding 117.

Addressing the Discharged Not Final Billed (DNFB) which had climbed to

an unacceptable amount, nearly 29 days of gross revenue had become

critical. MMH’s Board and leadership determined that to accomplish these

goals they needed to improve organizational structure, identify staff

deficits and implement a training program to address working procedures

and standards while quickly reducing the AR and DNFB. They realized that

changes were needed to ensure their continued success in Cooke County.

Balancing Community and Revenue Cycle Integrity Needing immediate improvement, leadership partnered with re|solution

to assess the situation, provide training and improve processes while

augmenting MMH staff to reduce the nearly 3MM in outstanding AR and

minimizing bad debt. Providing local staff with additional training kept

jobs in the community while increasing employee skills and confidence.

Lynn Heller – Former CEO for MMH said, “Our accounts receivable had

grown to a level that was unmanageable by our staff. My options were to

hire additional staff or bring in someone who knew what needed to be

done, and had the expertise to get it done. The return on investment has

been outstanding. A major benefit was to reduce the volume of accounts

receivable accounts to a level that is manageable by our staff. Of course,

collecting a bucket full of additional payments has been good too!”

re|c

ov

er

™

“Our accounts receivable had

grown to a level that was

unmanageable by our staff. My

options were to hire additional staff

or bring in someone who knew

what needed to be done, and had

the expertise to get it done. The

return on investment has been

outstanding. A major benefit was

to reduce the volume of accounts

receivable accounts to a level that is

manageable by our staff. Of course,

collecting a bucket full of

additional payments has been good

too!”

- Lynn Heller – Former CEO, Muenster

Memorial Hospital

A Solid Foundation through Training, Mentoring and

Proprietary Tools is Key to Measureable Sustainable Results MMH leadership worked closely with re|solution focusing on each item

identified to make the necessary improvements. An experienced

re|solution project manager (RPM) was placed onsite to assist in training

and mentoring the current MMH staff and also took responsibility for

managing the additional re|solution team brought on-site to assist in the

critical cash acceleration project. re|solution immediately began work on

implementing improvements, providing the resources, skills, and

processes necessary to quickly increase cash performance.

The goal was to reduce accounts receivable as quickly as possible and to

provide the guidance and tools necessary for MMH to measure staff

productivity and create sustain improvements.

re|solution provided a full scope of services during the cash acceleration:

Interviewing leadership and staff to determine deficits

Providing the resources, tools and training to increase staff

knowledge, confidence and skills

Collecting on assigned accounts to quickly decrease aged accounts

receivable

Reducing the DNFB for additional cash

Guaranteed Performance – Peace of Mind Reduction of MMH’s AR over 90 days from $1,179,000 to $474,000 and

DNFB decreased from 29 days of gross revenue to just 5 days, an 83%

reduction, generating just over $1,000,000 in cash for the hospital. The

improved performance indicators are impressive, but more significant are

the process improvements and the knowledge transferred to Muenster

Memorial’s business office staff.

For more information Visit us at www.ereso.com, or call us at 1.800.355.0410