Where Visibility Meets Actual Recovery

By: Michael Koory – Regional VP of Sales – Mid America

In the last post ( Read it Here) I discussed the importance of being able to see your entire hospital as one whole entity. As discussed, a typical traditional 3 years back cost recovery firm will find savings missed inside and outside of your system. Recovery by itself is not enough, nor is it good enough for the changing healthcare environment. Only an in-depth continuous audit with deep dynamic analytics will reveal every issue or confirm your processes’ work.

 

Deep analytics give rise to the following types of questions:

1.    Why did we have $2M in duplicates caught last month?

2.    What is the full value of our unprocessed returns?

3.    How are many duplicates payments made?

4.    Where does our return process break down?

 

The force multiplier is root cause analysis and mending.  The ability to ask why is this happening?  Where does our system come unstitched?  How do we mend this?

Recently, a hospital was able to recover a $1,000,000 duplicate payment that had evaded their internal controls.  In fact, during the process, it was revealed that the internal system had gaps in their measures.  The deep analytics and horizontal view across their enterprise discovered the issues and pointed the internal team toward the corrective measures. This is where recovery and visibility meet to deliver recovery and resolute savings.

Stop Leakage and Multiply Savings With Actionable Insights From Your Enterprise Spending

By: Michael Koory, Regional VP of Sales – Mid America

All health systems have developed and implemented internal controls designed to protect against losing money in the Procure-to-Pay Process. These include departmental controls, system controls, and process controls.

Despite all of your investment and energy toward loss prevention and controls, Financial Leakage still occurs.  Because of these leaks, hospitals spend a great deal of time, money, and effort detecting and recovering these leaks. The entire recovery audit industry was created to be the chief detective and find lost dollars.

Financial Leakage is revenue lost inside enterprise Procure-to-Pay automation, internal handoffs, keypunch errors, multiple entity spending, missed discounts, payment terms, lost opportunities, and staff reductions.

The full impact of Financial Leakage is frequently missed and out of view.  Rarely is the full spectrum viewed across your health system, due to different departments using different aspects of your system controls. Usually AP cannot access the Purchasing information or the Returns module. This is where gaps can occur because of a lack of visibility where traditional approaches don’t work as well.

The problem with this purely detective and control approach is the lost visibility into root cause analysis and the understanding of the systemic issues causing the leaks.  The reality is most businesses do not have a timely, accurate, and holistic view into their enterprise spend data and preventative measures. This void causes the enterprise to engage in a “whack-a-mole” approach to finding the leaks and yet never solving them.

Our horizontal view across your spending ecosystem will reap significant cost recovery as well as contract compliance, benchmarking, and spend optimization opportunities.

Once organizations can see the full picture of their Procure-to-Pay system, the outlier issues become visible for action to be taken. A clear view provides insight and understanding while the hidden seam breaks and leaks are identified and can be sealed. The visibility of the whole is a force multiplier. A typical cost recovery firm will find savings missed and outside of your system because recovery by itself is no longer enough. Only an in-depth continuous analysis will reveal your internal operations and the visibility to the whole issue.

 

Keep an eye out in two weeks when we discuss where recovery meets visibility.

What Scares You About An Audit?

It’s the time of the year when being scared is encouraged. Everywhere you look spiders, skeletons, and monsters are lurking… even in your finances, pharmacy, and OR. There is no reason to be part of the 51%* of surveyed healthcare executives who view a recovery audit as daunting and/or scary. The Financial Leakage monster that roams in your finances can be tamed.

The biggest concerns we hear when deciding whether or not to begin a recovery audit process, are that the process is time-consuming and they wonder if it will be valuable. A recovery project can check all these boxes if it is a full-service company matching your needs.

Overwhelmingly we hear that departments are being downsized due to budget cuts, more tasks are placed on small teams, and most people spend two hours a day on tasks outside their daily tasks*. The last thing anyone wants to do is add another task to their pile of things to do. A full-service recovery audit should not take much time.

 

  • There should be an initial setup that takes 1-2 hours
  • A download from the ERP system
  • 15-30 minutes status updates every other week
  • A final presentation of about an hour.
  • The total time commitment is less time than you spend during one week on outside tasks.
  • What do I get out of this project? No matter which portion of a recovery project you choose- whether traditional, sales and use tax, pharmacy, medical device warranty, or any other aspect the project must show you a concrete value. The value you should be receiving is visibility into your system, control gaps and areas of Financial Leakage should be pointed out, and you should learn where you are succeeding. Let’s use the example of returns to discuss the benefit of a recovery project. First, you should have the ability to see your project in real-time through a portal. Throughout the experience, a manager should meet with your team and tell you they are noticing that they are finding a higher than the normal amount found in refunds.You change the refund module and now you are saving money and getting closer to reaching your Corporate Saving Goal.

    You can then check on your returns by using a model that runs closer to the current date, so you never fall into the Financial Leakage Monster’s clutches again.

    You immediately see value in the portal, you can see control gaps and fix them, so you don’t lose any more money receiving financial value.

    If you choose to begin a recovery project don’t be scared or intimidated, do your homework and find the company that best fits your needs. Search for a company that can provide you with options to work from past to current and then continues to stay current. Find someone that has a portal for your team to have access to your project whenever your team has a moment to look at it. The final thing you should look for is a company that provides full visibility into your whole health system as well as analytics for you to take a deep dive into with your team. The check at the end of a recovery project is always nice to have, but making sure your system is efficiently operating is the real value.

     

    *all statistics come from a 2018 SpendMend Survey

 

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