Teamwork Makes the Dream Work

Season #1

Hi, everybody. In today’s podcast, we’re going to talk about one of the biggest mistakes practice managers make, and that is not involving their team in solving their revenue cycle issues.  But first, Welcome to the Revenue Cycle Decoded Podcast where I help medical practice managers like you get the revenue cycle edge in your practice. I am passionate about helping you learn the skills you need to be a revenue cycle hero, advance your career, and improve your financial results.  [Opening music] Today we are talking about teamwork in revenue cycle. You have heard the phrase, “teamwork makes the dream work” and it is just as true in revenue cycle as it is anywhere else. If you have a practice where you have an incredibly involved team in all aspects of managing the revenue cycle, congratulations! You probably have an extremely high performing team.  However, some of you may be newer in practice management or newer in revenue cycle and you may be trying to take on everything yourself or solve all the problems yourself. First of all, this is a recipe for burnout.  As a practice manager, you wear many hats, and you cannot do everything in the practice on your own. There just aren’t enough hours in the day.  Secondly, if you try to solve all the problems, you are probably not going to come up with the best solutions.  You may waste days or months researching when a team member may already know the answer or a potential solution that would solve the problem. Even if you do come up with a great solution, your team will probably not be invested in making the change, and then you set yourself up for a conflict with your team, or for your team to feel blamed or to undermine your solution. 

If you manage a large practice or a practice with multiple locations, departments often function in silos. Departments may not talk to each other or may not share essential information that is needed to solve the issue. For example, you may have an issue happening in your front office processes leading to denials or rejections. The front office may not realize they need to obtain prior authorizations because the payor requirements have changed, but they weren’t made aware.  Or they may have trouble getting authorizations, or payor gateways may not work properly, or payors may be slow to provide authorizations, but the information doesn’t get communicated to the clinicians and providers. It could be eligibility verifications; it could be new people not understanding what they need to do who are still in that learning phase. So, you have these denials and rejections coming across and your accounts receivable folks are seeing them but that information may not be getting communicated up to the front desk.  We’re not necessarily closing that loop. 

It could be middle revenue cycle processes such as physicians not understanding what is required in the documentation or not understanding a medical policy or not realizing why backend coders are sending queries, to get the most accurate information in the chart. Again, maybe that information is not getting communicated back to the physicians and the clinicians to close that loop and help them understand what they need to be doing to not get denied. 

And, it could be your backend revenue cycle processes. Your accounts receivable or billing staff may be coming across an issue but like we said, it’s not getting reported across the organization and up to other departments so that they can take care of the issue or provide training. 

So having department meetings bringing in the key team members together gives them the opportunity to discuss the issues and problems and to share information across departments. You’re also bringing in your problem solvers where they can brainstorm potential solutions, come up with ideas to solve the problems and then you can implement them to see how they work.  Another benefit is that when the team is involved, they are invested in the solution because they are the ones who have recommended the solution. They will be much more inclined to own the outcome and to keep working to solve the problem. And if that solution doesn’t work and they come back to the table again to discuss, then they are creating that solution, they’re owning the solution, and they are owning the process of getting to the solution so they’re going to be much more likely to want to make it work.

You’re also letting them know that you value their input and that you are invested in solving the problem for their benefit.  You’re not just trying to solve the problem to get more money for the practice, but you’re also wanting to make their work better, more rewarding, easier for them.  There are few more aggravating things in a workplace for staff than having to work around an issue every single day because either, one, the solutions proposed haven’t really addressed the problem, or they haven’t been allowed to provide their input on how to solve it.  When you’re bringing these team members into talk about the problems they’re facing in their everyday work, or getting denials and rejections resolved, or getting other revenue cycle issues fixed, you’re giving them a voice and letting them know that this problem is important to you, that you want to fix it for their benefit, and you want them to be involved in fixing it for their benefit.

When having these departmental meetings, it’s really important to have an agenda with a clear purpose and outline.  You want to ensure the meetings are productive and that you are focusing on the problem to an extent, but then you are really focusing in and honing in on the solution.  So at the beginning of the meeting, you want to provide an outline of the problem and supporting data.  That helps to set the stage for the next steps which will be to outline possible root causes and then brainstorm solutions.  Now the one thing I encourage you to do is that when you are having these department meetings, don’t let them turn into whining sessions where all everyone does is talk about the problem. You have been in meetings that have gone this way where the problem has been presented to the team and then they start talking about the problem and that’s all they focus on.  It becomes really, a whining session. And so you have to stay in control of your meeting.  You don’t want everyone focusing only on the problem and you never get around to talking about the solution.  Sometimes they turn into complaint sessions  like we’re gonna complain about the payors, we hate this payor gateway, we hate this payor… you know what it’s like, if you’ve been in practice management or revenue cycle for very long, you’ve probably heard those particular conversations.  If the meeting begins to take this track, you will have to to quickly redirect to a more productive route, because we want to spend the majority of our time focusing on the solution.  So no more than 10-20% of the time should be spent discussing the problem, and then we want to spend 80-90% focusing on the solution.

You will also not want to address too many problems at once. You really only want to pick 1-2 issues where you can identify the problems, identify the root causes and brainstorm some solutions and make a real impact pretty quickly and then move on to another problem or issue in a future team meeting. This helps to keep your meetings focused. It will help to keep your time productive and a wise use of your team member’s time.

And finally at the end of the meeting, you should have a list of actions to be done and the team members responsible for carrying out those actions.  Once you’ve been in the meeting, you’ve identified the root causes with your team, or what you think are the root causes, you’ve brainstormed some solutions, and the team has chosen one or two solutions to implement.  At that point, each team member that’s going to be involved in implementing that solution should have an assignment for an action item.  And finally at the end of the meeting you should also have a time and date for a future meeting to review the results because you’re going to want to come back and discuss how the solutions were implemented, were they implemented effectively, were they good solutions or do you need to go back to the drawing board. 

So that is my encouragement for you today is to bring that team into your revenue cycle issues so that you can all get around the table and solve it together. This works even if you are small team. Even if it’s just you and your physician.  Having those regular meetings with an agenda to discuss any problems or issues and then focus most of your time on the solution. If you need help getting started with team meetings to iron out revenue cycle issues, I’ve created a very simple sample agenda you can use, and you can download it for free at\teamagenda.   Thank you for joining me today and I look forward to serving you with more Revenue Cycle Decoded podcasts.