Eric Rench is a revenue cycle leader with over 10 years of revenue cycle knowledge and an additional 3 years of analyst experience in diversified healthcare. He is recognized as an industry expert on identifying issues within processes and implementing solutions that reduce redundancy and save time.

His expertise at identifying opportunities and driving results to collect on unexpected situations have established him as a healthcare leader in the revenue cycle management domain. Over this interview, Eric talks to me about his attraction to the field and the leadership lessons he has learned along the way.

Getting Started in Healthcare

For Eric, being a part of the healthcare industry was not a planned career move. He began his career in a different industry and was introduced to revenue cycle management through an extended family relation. Eric initially began working with Medical Management Professionals, now called Zotec, a prominent healthcare billing company.

His background in finance helped support his new role in dealing with huge volumes of data and patient information. Additionally, Eric was responsible for managing clients and running reports. Continuing in this domain, Eric soon started achieving success in the field owing to his creative outlook and analytical mindset.

After Zotec, Eric continued to grow with reputed names in the industry such as Elite Dental Partners, RiverMend, CarePlus, and Benevis before his current role at National Health Rehabilitation Physiatry.

‘Once I got into healthcare, it was a no-brainer. I fit very well, I can communicate effectively with clients and doctors, run reports, process and present high volumes of data efficiently.’

Current Business Structure and Organization

At his current company, Eric acts as the liaison between the third-party billing company and the company. As a consultant, he does not have a team reporting directly to him but ensures that the processes conducted by both parties are structured well and flowing smoothly.

A prime responsibility for Eric is doctor payroll, a process he has managed to streamline highly effectively. From the initial period of four to five days, now the process is completed in three to four hours.

‘There’s only so much you can pick up and learn of revenue cycle without actually doing it. I ask questions, I manage the teams and produce reports because not everyone can do it at the level required without the right experience.’

Eric recalls that in his earlier roles, he was able to be a lot more hands-on when working with department heads and fixing any issue that may arise within the process. Now, in his role with his current organization, he serves more as a mentor in guiding the teams to fix the flaws in their processes.

There are slight variations that occur in the dental field. For instance, the time factor in anesthesia and behavior health cases can be different owing to their special circumstances. Additionally, at the coding level, a major difference is the fact that dental has no diagnosis code. While medical may have separate diagnosis codes for a single issue based on cause, there are no such codes in the dental world.

Standout Moments in the RCM Journey

For Eric, there have been many standout moments along the way. He recalls an instance when he was working with Benevis, where he transformed the morale of the employees by shifting certain company-standard procedures and making them employee and productivity-centric.

For instance, instead of a specified lunchtime which was often late for the workers that came into work early, Eric recommended a more flexible lunchtime, based on employee requirements.

Another thing Eric noticed is that the pay was determined based on the time at the company rather than productivity. Older hires were earning heftier pay packages owing to the standard raise even though their productivity was significantly low as compared to the newer hires who were paid a lot less.

Eric recommended introducing a pay package that reflected an employee’s productivity. This helped motivate the low-producers while rewarding the high-producers. Additionally, he even sought to introduce employee-friendly practices such as work-from-home options and revenue appreciation week which helped boost employee morale and improve the workplace culture.

‘We ended up needing fewer people and producing more and costing the company less – yet the average pay per hour was up a couple of dollars an hour. It was a win-win and everybody loved it. My philosophy is if my employee is not happy then the work is going to suffer and if their work suffers then I suffer and the company suffers, and it is cyclical.’

Another instance that Eric recalls is when he was working at the billing department in Benevis. He noticed that the doctor would put in a code and sometimes the billers would change the code. On running the reports, Eric realized that the code was being changed frequently across data that went back five to seven years.

New patients were being billed the higher code while other code changes led to the company down-coding almost USD 150,000 to 200,000 a month. These figures can be easy to miss in a huge company like Benevis. However, once Eric noticed what was happening, he instantly set in processes with IT that prevented any codes to be changed without his permission. This helped the company stop a financial loss of almost a couple of million dollars a year.

Moment of Pride and Company Achievements

At Benevis, when Eric joined the revenue cycle department, the Vice-President of the department had been brought in from Operations. As he did not have any direct experience in the field, he was often unsure of the right step to take, which was problematic since he had a team of 20-25 managers reporting to him.

At the time the collection rate was already at 97% of the expected amount which was a good place to be at. With a new VP and changes in the department, Eric stepped in restructured thongs which led him to be the team head for 6 managers. He also took on multiple departments and managed to boost collections to 98.5% which is huge for a USD 300 million company.

With improved processes, the overall efficiency of the company improved. Unbilled claims, went from a cycle of four to five days, to a day to a day-and-a-half, shifting the focus for billers to bill on production rather than an hourly average.

Seeing the efficiency of this method, the verification department also followed suit, leading to a 20% bump in productivity. The average days to collect went to 22 days from 30 days and better processes paved the way for higher-productivity people to rise and grow with the company.

Overcoming Challenges in the RCM Domain

When it comes to challenges, for Eric, the biggest challenge was dealing with company drama. At one of his earlier companies, he would travel to the office two to three times a week as the commute was very long. Even though he was the head of the department and was able to optimize important processes, initially, there was a lot of resistance.

On the days he would go to the office, Eric felt a shift in the office atmosphere. He later learned that some of the managers and department heads were not yet on board with Eric’s approach. He recalls having to face these challenges and ultimately helping the company tremendously. The department went from 10 AR people up to 25 because they were understaffed and their collections started to slow drastically because they had no visibility into reporting.

‘I pride myself on having good relationships, people trusting me going above and beyond what’s expected when they work for me because I do the same for them.’

Plans to Streamline Revenue Cycle Management Functions

At National Health Rehabilitation Physiatry, the company is 70% Medicare where the majority of the business is focused. However, at the 30% which isn’t Medicare, Eric noticed several inconsistencies with secondary insurance or the lack of payments and credentialing.

With credentialing, there is still a lack of clarity regarding the payer mix, what the doctor is seeing, is credentialing worth it, and the process required to credential.  There is no payer contract in place and this is where Eric’s primary focus is, in being proactive when doctors start by getting them credentialed with Medicare or with the other random payers. Once you have tied up with a major payer, the rest little things fall into place.

On the other hand, in nursing facilities, the demographics are largely the elderly. They have a lot of managed care plans that don’t pay, they don’t have out-of-network benefits and then it falls to the patient. The patient might be almost living in a nursing facility or not in a capacity to even get their mail and pay their bills and so collecting from patients is completely different. The challenge is getting doctors to get claims to the company quicker.

Top Philosophies and Core Values in Business

For Eric, putting the employee ahead of the company is placed at the top of the list. Another aspect he believes in is that if you can’t measure it, you can’t improve it. In a lot of companies that Eric has worked with, he realized that there was almost minimal reporting. There would be no visibility in how the AR team would work. Eric would go in and set up processes in place that improved transparency and productivity.

‘I’ve always prided myself on caring about people way more than the company because at the end of the day, happy employees produce more, stay longer and everybody wins.’

Advice for Newcomers entering the RCM Field

Eric believes there are a lot of opportunities for young people to enter the RCM domain. Being a niche community, there is always going to be the need for experts in the field. Additionally, a lot of people are connected with each other so networking can help open up doors to interesting jobs and opportunities.

Another recommendation by Eric is to learn how to report data. Learning about the latest technology and the reporting tools available can give newcomers a leg-up in the industry. However, the priority should be to understand the data and then learn how to communicate it effectively.

Best Practices Implemented over the Years

Eric states that he has put together plenty of standard operating procedures to optimize revenue cycle management, however, the biggest improvement was putting together HR material.

This means putting people ahead of outdated and stringent company policies. Small things like flexible work hours or breaks can go a long way in improving morale and boosting productivity. The focus was on getting the work done rather than being rigid about how the work is being done.

HR parameters help ensure that productivity is high while also setting up guidelines around what is and is not acceptable.

Vision for the Future of the Industry

Eric recalls at his first job, every week members from different teams would come together and discuss an hour’s worth of issues that were either client-related, payer-related, or new Medicare rules.

These days, processes are better streamlined. Additionally, the rates that third-party billing companies are charging now are extremely low versus what they used to be.  They used to be at 8 to 12% now they are at 2 to 4% because of automation.

Over the years, this trend is likely to continue. Efficiency and transparency in processes are likely to improve. However, at the end of the day, these payers make money by making it difficult for people in RCM to not pay the claim. And unless the government gets in something drastic like a one-payer solution, which would also impact millions of jobs, there will be concerns as well.

Systems and AI are becoming a lot more sophisticated. A lot of work is being done offshore while remote working also bringing in new challenges. A lot more work is going to be automated in the years to come, says Eric.

For people and organizations looking to stay successful in this arena, Eric recommends knowing the data.  Analysts that can run reports and offer a detailed analysis can be a huge asset for companies and it all starts with an in-depth understanding of the data.

Another important point to remember is that the revenue cycle is still a people business.  Everyone from the client to the doctor to the employee is a person necessitating good communication and people skills.

‘If you enjoy numbers and data, I think revenue cycle is a great spot and healthcare is not going away.  Even though COVID-19 had a massive impact on the healthcare industry, it is always going to be a huge and important sector.’

Leadership Lessons Learned over the Years

Putting the employee ahead of the company has been Eric’s leadership model from the start and it is still what he believes in. he has witnessed micromanaged leadership and the poor results that often follow such a process.

While Eric believes monitoring employees is important, it needs to be done in a productive manner that is employee-centric. It is important to show sympathy and empathy for the employee and treating employees well to boost morale and productivity.

‘I have seen how to lead just as much as I have seen how not to lead over the years.  I have a lot of candid conversations with my employees and a good rapport with everybody.  People can come to me and tell me what issues and concerns they have and what we can do to improve. I have never had an employee of mine leave because I was doing a poor job.  They stay because I am doing a good job and I have had people follow me to multiple companies because of those philosophies.’

Follow Eric Rench On: LinkedIn