Michael McGhee of HGS EBOS LLC, a solution provider at the marcus evans National Healthcare CFO Summit Fall 2013, on better healthcare revenue cycle management. Interview with: Michael McGhee, Vice President - Practice Leader, HGS EBOS LLC

1. Interview with: Michael McGhee,
Vice President - Practice Leader,
HGS EBOS LLC
“We see significant revenue leakage
across the revenue cycle, from the front
end to the back end,” says Michael
McGhee, Vice President - Practice
Leader, HGS EBOS LLC. “With the
Affordable Care Act, healthcare
organizations should prepare for an
influx of volume and further strains on
their cash flow. They must seek ways to
automate business processes to create
more cost-effective organizations,” he
advises.
From a solution provider company
attending the marcus evans National
Healthcare CFO Summit Fall 2013,
in Los Angeles, California, October
20-22, McGhee delivers his thoughts
on healthcare revenue cycle
management and how to take
advantage of opportunities to boost the
bottom line.
How could hospitals prepare for the
future from a revenue cycle
perspective?
Accountable or affordable care will bring
tens of millions of new customers to our
provider clients. This could overwhelm
their financial systems and put a strain
on claim generation and timely
payment. Organizations must prepare
for what could be a very challenging
business environment.
According to your website, your
organization can bring 10-12
percent returns from value-adds
and process improvements. How?
Payers are very aggressive in
challenging the validity of claims,
leading to denials and delays in
reimbursement. We see revenue
leakage across the continuum, from
patient registration, making sure a
patient is eligible, proper authorization
for service, pre-authorization referral,
all the way to the back end with the
quality and timeliness of billing and
follow-up.
A focus on prevention could mitigate
extra work on the back end, which is
where revenue loss occurs. Revenue
loss occurs in the business office, but it
is typically generated by something that
did not happen correctly initially,
upfront.
The challenge for most healthcare CFOs
is headcount. Do they have the number
of staff needed to stay with a claim
throughout its lifecycle?
Hospitals can recover significant
amounts of lost revenue if they leverage
automation and supplemental work
force opportunities. Our proprietary
technology allows us to take data feeds
from clients and automate resolution
steps, thereby minimizing human
intervention while reducing costs.
What insights could organizations
gain from this technology?
Our powerful analytics engine looks at
the root cause of payment delays and
denials across the revenue cycle. If we
then take that root cause and
reengineer the business process, we can
eliminate or greatly reduce that delay
going forward.
Most organizations do not have a
business intelligence capability for this
kind of deep-dive analysis.
What trends could healthcare CFOs
capitalize on today?
The biggest trend we are seeing is a
significant commitment to revenue cycle
technology. As an industry, healthcare
has been slow in upgrading technology
beyond their clinical systems. Now the
expectation is that new financial
systems will solve all the problems. I
believe there will always be a need for
additional wrap-around technologies to
address some of the shortcomings of
even the best systems that are being
implemented today.
Digitization of healthcare records is
another important trend with its own
challenges. It is creating inconsistencies
and difficulties integrating with other
systems but the opportunity is there for
us as consumers to have control over
our own health information.
The move to ICD-10 in October 2014 is
a major milestone that many providers
are preparing for, but we are unsure
how well that conversion will work.
Because of the complexity of the code
set, coder productivity may be reduced
by as much as two thirds placing
greater demands on our clients’ ability
to bill claims timely.
A focus on
prevention
could mitigate
extra work on
the back end
Preventing Leakages across the
Healthcare Revenue Cycle

2. About HGS EBOS LLC
HGS EBOS has been providing revenue cycle management services for the US health care Provider industry for over 12 years. HGS
EBOS supports hospital systems, multi- specialty physician groups, laboratory services and DME providers in their efforts at
improving their financial health. HGS EBOS has a hands on partnership approach to managing all its clients and as a part of the
engagement, we bring over 10-12% returns in terms of value-adds and process improvements to our clients.
www.teamhgs.com
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