Training and communication methodologies are integral for Community Hospital Anderson

The staff of Community Hospital Anderson in Anderson, Indiana, knows a thing or two about prioritization. Not having a separate department dedicated to revenue integrity, their staff balances their revenue cycle roles with their revenue integrity-specific projects.

“For us, the priority is always on what can be done to improve or eliminate the charge error or denial edit. The staff are trained on the entire revenue cycle so they understand the bigger picture,” says Terri Rinker, MT (ASCP), MHA, revenue cycle director at Community Hospital Anderson and a National Association of Healthcare Revenue Integrity (NAHRI) advisory board member.

To make sure everyone’s on the same page, the facility has a hospital orientation for new hires. This covers hospital culture and rules. There is a separate orientation for anyone working in the revenue cycle. “Within that, we talk about how much cash we bring in each month and where that cash goes—this much for drugs, this much for salaries, this much for repair and upkeep—so that they understand how it’s related back to their household budget,” Rinker says.

After a few months on the job, new hires begin shadowing their colleagues. “They’ll sit with the different areas to understand the entire process,” Rinker says. Areas of shadowing include coding, billing, or medical records. 

To maintain communication, Rinker sends out a monthly email newsletter to everybody in the revenue cycle department. The newsletter covers the key performance indicators (KPI) and includes an attachment with an explanation of the KPIs and whether high or low is good. Getting everyone on the same page is critical, Rinker says. “It’s not just about my area or my role, it’s about the integrity of what we’re doing and how it impacts our ability to provide care for our patients.”

Meanwhile, each manager sends out his or her own monthly newsletter update. The manager newsletter focuses on department improvements, highlighting staff ideas that have been implemented. The hospital’s chief executive officer (CEO) hosts quarterly hospital-wide meetings that are made up of six to seven meetings across several days. The meeting includes everyone from nurses to housekeeping to dietary to transport personnel, Rinker says. 

Among other things, these meetings are used to ensure that all members of the staff understand the implications of revenue cycle. “Everybody needs to be thinking about what needs documenting, what needs to be charged for … It’s trying to encourage our culture to be aware of our revenue,” Rinker says.

To keep meetings interesting, the hospital often comes up with creative ways to explain functions and tasks. For example, various staff members are currently creating a fairytale to explain revenue cycle operations. Previously, the leaders of the clinical and financial departments worked together to produce a 60-minute spoof video that featured the CEO as a reporter explaining revenue cycle functions from the clinical perspective to receiving payment. In the video, to illustrate how a bill goes through the claim scrubber, the director of case management pretended to go through a car wash, Rinker says.

The biggest success of such a project is allowing everyone in the hospital to see how each role comes together so they can make improvements. In fact, the video led a group of staff members to perform internal audits, which proved a great lesson in team building for the hospital.

“The clinical people would look at the medical-record section, someone else would be looking at the detailed itemized bill, and billing people would look at the claim looking at the way pieces were there,” Rinker says. “The education that went on in that was invaluable, [as was] the teamwork. It was no longer I’m saving lives; you take care of money. We were no longer talking two separate languages.”

Apart from in-house communication methodologies, Rinker also finds value in attending conferences and external meetings.

“The value of talking with people who are going through the same struggles you are—the inspiration—and to come back motivated is invaluable. [Work] can be very routine and you can get stuck in a rut,” Rinker says. “These are things that can rejuvenate you and help you find passion in your job again. We always have it in us, but sometimes you need a group to unite that or bring it up again.”