About the client
Lake Health Physician Group (LHPG) is a physician network composed of family practitioners, internists, obstetricians, gynecologists, pediatricians, orthopedists, sports medicine specialists, an ophthalmology practice, general surgeons and a vascular access surgeon. The group is part of Lake Health, a private, nonprofit leader in community health care in Northeast Ohio. Founded in 1902, Lake Health includes 600 physicians, 2,900 health care professionals, almost 1,000 volunteers and multiple facilities.
Background and approach
RSM US LLP consultants began working with LHPG when it was determined the physician network wanted to evaluate the performance of its existing provider-based billing methodology. LHPG had worked with RSM previously on another engagement; this time, the organization turned to the firm’s dedicated health care industry professionals to complete an initial assessment of its billing processes and revenue cycle. Given the size and practice diversity, as well as the current regulatory climate affecting the revenue cycle, it was a precautionary move to assess LHPG’s systems and processes. According to Cathy Jefferson, manager of LHPG’s revenue cycle operations, while the group was eager to see what RSM might uncover, there were some initial doubts there would be much to improve upon.
“When RSM began working with us, we were skeptical. We thought there would not be many ‘aha’ moments about our billing process,” Cathy said. “However, through the course of the assessment and engagement, we discovered our processes needed to be updated, our edits needed to be increased in the billing system, our claims could be automated and uniform billing claims could be released sooner.” In addition, she said it was determined that LHPG’s staffing model needed revamping; this involved creating two new team lead positions and adding two new coders. According to Cathy, the entire update provided key transparency into the physicians’ practices.
