Jeff Hollender-Healthcare Revenue Cycle
Consultant and Subject Matter Expert
Jeff is a nationally renowned Healthcare Revenue Cycle Consultant and Subject Matter Expert. With over 30 years of leadership and operational management experience, he brings valuable insights throughout the revenue cycle’s integrated healthcare delivery system.
Specializing in total operations including billing, credentialing and provider enrollment, Jeff’s expertise spans across physician groups, home health/hospice agencies, dentists, labs, and hospitals complete Revenue Cycle arena. In this interview, Jeff talks to me about some memorable experiences, the challenges he has overcome and his vision for the industry.
Starting from Accounting to RCM
Jeff began working for an accountant dealing with doctors straight out of college. During this time, he observed the relationship between the insurance companies and the individual providers as well as the billing practices.
Jeff realized that most people did not understand the billing system at a doctor’s office or a hospital. This was particularly interesting to him as the entire workflow and workload are surrounded by everything that is nonclinical.
‘I got into RCM to understand and be able to be the best to explain and help others I getting a solution which would be to bill 100% for patient services and receive 100% adjudication and reimbursement.’
Talking about his first account, Jeff recalls talking about billing practices with his doctor who was very confused with the entire system. Jeff offered to help him out and landed his first billing client. As everything was still done on paper with bills sent via mail, Jeff started streamlining the process by introducing technology. This allowed them to electronically bill patients for services making it far more efficient.
Additional referrals following this experience led to several more clients for Jeff. He continued with this practice for over 17 years with a team of 27 people reporting to him.
Jeff then moved on to PriceWaterhouse, a publicly traded accounting firm as an RCM management specialist. From there he got an opportunity to form doctors’ groups and operating doctors’ groups and help make them profitable. He also put together a large 39-doctor group with 31 offices in two counties in South Florida and did about $40-$50 million as a small ophthalmology group.
Current Scope of Work
Jeff is currently working as a Freelance Consultant in revenue cycle management while also serving as the Chief Operating Officer (COO) at Blue Ocean Healthcare Investments. While he does not have a specific vendor that he works with, he is willing to recommend companies that have done a good job.
Presently, the organization is working with medical transportation and helping home health agencies running themselves. Jeff has a team of thirteen people that report to him and handle the operational end of these aspects. They are also currently in the process of acquiring a transportation company. In most cases, after acquiring a company, the team improves the systems for better efficiency before deciding to partner with the company or sell it to another compatible company.
Talking about enhancing efficiency in operations regarding outsourcing, Jeff believes there are very talented offshore revenue cycle companies with years of experience, able to do a great job. Based on his experience with revenue cycle outsource companies work, he thinks I think it is much less expensive to outsource the whole revenue cycle department to a company than to deal with the day-to-day operations of a hospital.
‘Hospitals typically spend between 13-18% on collecting their money in billing where you could get that figure down to a flat rate of 3-4% and that’s where you’ll make your money. So I recommend outsourcing in a lot of cases.’
Standout Moments along the RCM Journey
A standout moment that Jeff recalls was when he was with Doctors Plus. As a credentialing and consulting firm in the RCM field, they were aware of the policies and procedures required to be completed by doctors to be eligible for insurance.
Jeff explains that every doctor, every provider, physical therapist, M.D., D.O., needs to be credentialed or authorized and sanctioned by not only a government agency but by the insurance companies who they bill.
For instance, when a doctor wants to accept certain insurance companies, they approach the individual insurance companies and become a provider for them. The insurance company in turn checks the doctor’s credentials and qualifications through a central database with the governmental agency called CAQH.
One day, Jeff received a call from Columbia Hospital in New York City saying that they have not been able to collect any money from any insurance companies for the past year and a half. This was massively impacting their business and raising huge financial concerns.
Jeff looked into the process of why the insurance companies were denying all the doctors for providing services and he realized it was due to lack of credentials. What had happened was, Columbia Medical Center had a whole department that dealt with credentials who were let go without realizing the importance of this process.
Once Jeff realized this, he began to internally start credentialing 1200 doctors immediately for services that they had performed in the past and were about to perform. This swift action allowed them to collect about $55 million on behalf of services that they had provided that they weren’t able to get paid for.
Another instance Jeff recalls is when he worked with Ross Perot, a Presidential candidate in the 1980s, who had a large RCM company. In his role here, he served as one of his seven advisors with Perot Systems for about seven years. He acted as a personal consultant to Ross Perot Jr. daily while flying all over the country and talking to COOs and CEOs about how they are better off with Jeff’s team being their management company, than just the doctors.
‘I have used my expertise over the last 30 years to do something that I love doing which is the operational management of the revenue cycle of hospitals and large physician practices and healthcare entities.’
Moment of Pride as an RCM Leader
For Jeff, a moment of pride was during his time with TruBridge, an RCM subsidiary of CPSI. While working here, Jeff and his team were able to bring down the account receivables days of three hospitals. The AR cycle is a great judge of how a hospital is doing. Before Jeff started work there, all three of the hospitals were sister concerns and they were all in the 120-day AR days.
After a year of working with them, Jeff was able to bring down their billing cycle to a respectable level in the 30+ days in AR. This was a huge achievement and the practices laid down by Jeff and his team are still being followed in the hospitals to this day.
That was one of the ways to turn around a hospital bill department for all of their patient methodologies, through all the doctors, hospital employees, billing team, clinicians, and non-clinicians.
‘To be able to affect change is one of the most challenging and rewarding things and we were able to do it and I love that.’
Overcoming Challenges in the Healthcare RCM Domain
The most significant challenge Jeff has encountered in an organization or as an individual is change. Often, people are set in their ways, especially if they have been working with a particular process for a long time. Change management, whether it has been the workflow or how the work has been done, often meets resistance and can pose to be challenging.
‘People understand what they need to do, but to do it and to do it well is a challenge, and that’s one of the things in the revenue cycle field I love doing is effecting change.’
Talking about significant changes that he has witnessed over his three decades of experience, Jeff lists the adoption of technology as being at the top of the list. When he first got involved with billing, Jeff remembers having to mail everything and wait seven days for a response.
Through technology, they are now able to submit bills to insurance companies for adjudication and get paid. Also, it is easier to keep medical records and databases across networks so that patients can choose doctors within a health network for easy access to patient history and doctor’s notes.
Plans for the Future
Moving forward looking Jeff is looking to shift largely to freelance and may continue with Blue Ocean Healthcare Investments on their Board of Directors. His primary focus is to go back into the consulting world where clients could just reach out with their problems. Regarding marketing, Jeff believes his growth has been largely due to word of mouth and LinkedIn.
Top Philosophies and Core Values
Jeff believes that everything requires a solid foundation along with a proper set of standards. If organizations can build a proper foundation in the RCM department, each function of the different disciplines in RCM would function properly. This could be coding, insurance verification, collections, and patient access. Technology has made a huge difference in streamlining these processes.
‘Technology has gone a long way in our world where if you go into a healthcare entity they expect to get paid ahead of time. If it’s elective you can choose either to have the procedure or not, if it’s non-elective then you know that what is the cost associated with it, and it is all because of technology.’
Advice for Newcomers entering the RCM Domain
Jeff recommends going for business administration in college as it helps develop an understanding of business management which supports entry into healthcare management.
There are many different non-clinical and clinical parts to healthcare management but healthcare as a whole is growing very quickly. Currently, dependence is high on one insurance company like Medicare/Medicaid and one commercial insurance company for many years. Jeff believes the industry is headed that way with one in eight people entering healthcare.
He recommends that people entering healthcare go into those services that support doctors, billing services, physical therapy, long-term care facility, home health agencies, lineups, those are all things that are going to make sure that they stand the test of time.
‘My advice for somebody going into healthcare would be to look at something in healthcare that you would look back and you enjoy or that you like and pursue that for a job. You may not love it or you may find something else that you like.’
Two Key Learnings from the RCM Domain
- Broad Scope
The scope of revenue cycle management is very broad. The are many steps that start from a doctor’s visit and end with an acknowledgment that insurance has paid for the services. This allows for opportunities in various departments.
- Enter at a Low-Level Position
Often, starting as a registration clerk in a hospital can allow individuals who aren’t entirely sure of their preferred domain a chance at discovering their passion. This allows people to see and discover all the jobs available and identify the avenues they feel most excited about. Ultimately, job satisfaction is very important to enjoy and succeed in your work.
Key benefits of services provided
Jeff believes the key benefits of the services come from their experience in the field and the modes they have adopted. They have various white papers, testimonials, and case studies documenting the success of numerous different types of practices and hospitals that they have helped in the past. Jeff helps clients by offering customized solutions and management support by doing what is best for them.
Vision for Future of the Industry
The vision is that the industry is going to keep growing and expanding in the years to come. Technology and interface have helped RCM become increasingly important as each component takes its own place and develops.
For instance, coding in hospitals was a one-person job. Now realizing its value in growing profit, a lot of hospitals have multiple coders that bring in the highest amount of reimbursement.
‘I think the RCM field is wide open for people, for processes, and change management, and as we get developed over the next couple of years, we are going to see how the government is going to be more involved in healthcare.’
Talking about the emerging trends in this field, Jeff expresses concern over the crowding of medical billing companies in the RCM domain. While he accepts that there are some excellent companies that do billing, he believes there are a lot of new entrants coming in because they think it is an easy job. However, not everyone may necessarily have the knowledge to run and operate a medical billing organization efficiently and stay up-to-date with the constantly changing dynamics.
Leadership Lessons Learned along the Way
Treat people the way you want to be treated. Jeff believes in giving people enough information to do a job to see how they could do it on their own. He follows a hands-off leadership approach while being accessible when reached out to for help or mentorship.
He claims his leadership style is a very learned thing based on his experiences. Over the years, Jeff reveals that he had some good bosses who gave him space to do what he needed to along with terrible bosses that micro-managed him constantly. Using his own experience, Jeff has developed a hands-off leadership style that allows his team to grow while also being available to guide them whenever needed.