Yolanda is an experienced healthcare leader in implementing operational processes that boost efficiency. Her prime focus is on process improvement, redesign, operational training, and employee development to re-engineer full stream revenue cycle workflow.

These strategies help result in a positive financial performance, trusted professional relationships with stakeholders, executive leadership, physicians, managed care payers, and external vendors. In this interview, Yolanda talks to me about her journey in becoming a thought leader in revenue cycle management and her learnings along the way.

Making the Shift from Medicine to Healthcare Administration

Yolanda has always been passionate about working in the healthcare industry. Having worked as a teenager in hospitals across different roles, Yolanda was excited about becoming a nurse and working in healthcare full-time.

In college, she enrolled in a medical course to become a nurse, but soon realized that the medical aspect of the job didn’t appeal to her. At this time a college advisor was able to direct Yolanda’s passion for healthcare towards administration and public health allowing her to match her interests to her passion.

Yolanda started her career working for Prudential Insurance Company. She was responsible for queries by medical providers regarding unpaid patient claims. Those days, the work used to be referred to as simply billing or coding-there was no clear understanding of a specialized revenue cycle management system.

After marriage, Yolanda shifted locations and landed a job at the other end of the field. She started working in a revenue cycle management job at Thomas Jefferson University Hospital although it was largely referred to as billing at the time.

Yolanda recalls that hospital systems had started adopting technology and shifting towards electronic billing. Since everything was submitted online, if there was an error of any kind, the insurance payer would not accept it. She would then work with the team to fast-track the updated claim and get it processed.

For Yolanda, this was a major learning period as she worked with multiple people across departments including coders and clinical staff.

‘Back then you could cross over to one area like look up a coding book or just pick up the phone and call the insurance company if needed.  You did not even have to be certified in every aspect those days.’

 Current Business Structure and Organization

At her current organization, Yolanda works with two other experts-a coder and a financial analyst. Regarding the number of people directly reporting to her, Yolanda says it varies based on the client or project. Her client in LA has about 75 to 80 people reporting to her while in some of the smaller projects the team size is much smaller at 15 or 30 people. Currently, Yolanda has three active clients.

She is an interim VP of revenue cycle management for a major multispecialty group in LA along with two smaller clients. Her focus is on helping them with their payer enrollment and credentialing to help streamline that process to increase their cash flow and reduce their denials.

‘I have had 300 people reporting to me in the past.  When I was with individual organizations, I have had as few as 10 people working for me depending on what I was working with, what the client needs.’

Before her current role as a consultant, Yolanda worked with Florida County. However, with the pandemic impacting every industry, she realized that it was time to make a change. As she had prior experience as a revenue cycle consultant before her advisory position, the shift was familiar.

‘As a consultant, my role depends on the needs of my current customer or client. What are they looking for, what is the outcome and what is the time span that they are looking at to get their return on investment?’

Even as a consultant, Yolanda is directly involved in the work itself. She works on building structures, workflows and development, while scaling up the staff for greater efficiency. She also interacts on behalf of the client with payers or vendors.

Yolanda ensures she is available for her clients for whatever they need during the entire timeline of the project.

‘I work with a leader or manager heading the revenue cycle team and help them streamline and work through any hurdles they may be facing.  I ensure they are equipped to remain successful even after my departure.’

Standout Moments in the Revenue Cycle Management Domain

‘I like to say my best standout moments are the people that I have seen evolve. I like to see how people have blossomed or found their niche within revenue cycle management.’ 

As a leader in revenue cycle management, Yolanda has worked with numerous individuals, with different compatibility dynamics. She states that she loves watching how people evolve over time. Often people enter the field with a particular mindset or knowledge base and grow over the years to cultivate their skill-set.

Recalling moments of pride, Yolanda talks about significant progress in cashless revenue cycle management. It is always wonderful when their work is able to successfully meet or exceed the goals set towards any cash goal.

 Overcoming Challenges along the way

One of the challenges Yolanda talks about in this industry is that a lot of people are afraid of the unknown and are not willing to always take the risk. At this point, it is important not to take things personally.

With her years of experience, Yolanda has a lot of confidence in her suggestions and the work she does. However, often, even after a lot of hard work, people may be unsure of the path they want to continue with. Sometimes they prefer going in another direction and it’s important to realize that sometimes is nothing particular but maybe it was not the right time or place.

‘My experiences taught me how to look at the message, understand it, but also learn not to take it personally when people say no.’ 

 Business Plans for the Future

Presently, Yolanda is focused on her current commitments and dedicated to completing achieving their goals within the approved timelines. She is debating whether to expand her company as being a team of one in the revenue cycle domain, the workload can be enormous.

Most of her current reach is through word-of-mouth, referrals and repeat customers. She is currently accessible on LinkedIn and before COVID, Yolanda was also an active participant in industry seminars and publications.

 Top Philosophies and Core Values in Business

Yolanda’s top philosophy or core value in business is that people need to understand that revenue cycle management may have started off as one particular thing decades ago but it has evolved significantly as an important aspect of healthcare.

Revenue cycle management has emerged as a key role in addressing industry practices.  The three major trends here are real time processing, customer-driven healthcare and changes in regulations and reimbursement structures.  Anyone who accepts a government payer reimbursement or interacts with that patient population understands there are always changes that are required of the medical provider.

It is important to understand there are different components of revenue cycle management which consist of a front-end revenue cycle which is the pre-revenue cycle, the main revenue cycle, and the backend revenue cycle. Earlier, people didn’t think of it as such.

 Advice for Newcomers looking to enter the Revenue Cycle Domain

First, be open to change because change is always happening. Next, understand that while a degree can offer an academic understanding, without practical work experience it won’t be easy to understand the need or concerns of people.

‘I have worked with individuals who have been very well educated in healthcare management but never actually did any of the functions in revenue cycle before. I don’t believe those individuals can relate to some of the issues that the individual user may or may not be experiencing.’

Key Learnings from this Journey

1. Work with different organizations to experience and learn various facets of the industry. Regardless of whether one is on the physician side or hospital side or both, it is important to stay involved and updated about the multiple changes that are happening and how it can affect one’s organization and clients.
2. Network. Reach out to individuals and learn from their experiences. Not everyone enters the field equipped with all the relevant knowledge. Mistakes may happen. It is important to work with seniors in the field and peers to learn new ideas.

Key Benefits of the Services at Southern California IPA Group

Yolanda considers her ability to stay informed of the latest trends and changes in the industry as one of the most crucial benefits she brings to her clients. She stays on top of regulatory requirements while knowing exactly what is trending and happening, what the payer’s expectations are of the medical provider, etc. Additionally, she communicates with people in a way that is easy for them to understand whether they have a clinical or non-clinical background.

‘I can always translate information to a VP of Finance or a CFO who is looking at the financials but I can also pivot and deliver the same message to a medical provider in a way that he or she understands and need to know what the next steps to be followed.’

Talking about the best practices implemented in her practice, Yolanda keeps the focus on important aspects such as revenue cash leaves, late charge, the collection rates, and debt, among others.

Bad debt is absolutely important to monitor, especially at this time. Patient responsibility and pre-collections have become even more important to monitor with price transparency on the rise.

Vision for Future of Revenue Cycle Management

According to Yolanda, chances are that things get even more complicated for the medical provider.  A lot of rules and regulations are being introduced which are needed but can put a lot of pressure on medical providers.

A future challenge will be working on collections given the current state of the world and economy. Several individuals have been out of work for a period of time, some may have lost their healthcare coverage or the financial bandwidth to pay their deductibles or any coinsurance.

People in revenue cycle management will have to be open to change, be prepared for change to continue educating the teams about the new upcoming changes and what is required.

For organizations looking to stay successful in the field, Yolanda believes employee recognition is important. While financial compensation is important, employees need to feel valued and respected to work hard and help an organization achieve its goals.

‘Employee recognition to me is number one because you cannot be a successful business without your employees doing the functions or duties to make the business successful.’ 

Another important aspect is building authentic relationships whether it is with customers or clients and identifying acutely their concern or need.

Leadership Lessons over the Course of Life

The best leaders, according to Yolanda, are the ones that have always tried to pull some of their skills out of other people. Those who were willing to be honest and truthful even when it was not pleasant to hear at the time, but who could be truthful and deliver the message well.

There is a big difference between critiquing and criticizing. Critiquing can offer valuable feedback on what needs to be done to improve whereas criticizing brings down the individual and their performance. Communication is an important quality for a good leader.

‘To be an efficient leader admitting that you may not know everything and that you are open to ideas and recommendations is valuable.’ 

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