First Illinois HFMA Client Panel Discussion: Cash Reconciliation INSERT LOGO

First Illinois HFMA Client Panel Discussion: Cash Reconciliation INSERT LOGO 11/4/2013

Learning Objectives Understand what banking and revenue cycle tools are available for reconciliation automation projects. Learn techniques for uniquely identifying cash transactions of all types, to facilitate automated reconciliation. Leave the session with a list of do s and don ts related to structuring reconcilement automation projects, selling related changes to internal business partners, and implementing new technology. 2 Copyright PNC Bank, N.A. All rights reserved.

Introducing the Panelists Dawne Clark: Jefferson University Physicians (JUP) Manager of Lockbox, Payments, and Reconciliation Dawne.Clark@jefferson.edu Steven Honeywell: Penn Medicine Senior Director of Patient Accounting, Professional Fee Billing Steven.Honeywell@uphs.upenn.edu Stephen Saathoff: OSF Healthcare Senior Accountant and Project Manager, Hospitals Stephen.E.Saathoff@osfhealthcare.org 3 Copyright PNC Bank, N.A. All rights reserved.

How Other Industries Reconcile A/R and G/L integration Less information with payment Payment/remit often travel together Fewer timing differences between bank credit and A/R update Fewer $0 payments Enterprise systems facilitate data automation 4 Copyright PNC Bank, N.A. All rights reserved.

Issues for Healthcare Providers System Timing Process Technology A/R and G/L may not be fully integrated Payments/ remits may travel separately Posting delays Fewer automated tools 5 Copyright PNC Bank, N.A. All rights reserved.

The Cash Reconciliation Process Bank Control Totals" Patient Records = Bank "control totals" Patient EOB/payment records = totals Posting exceptions Totals and non-patient cash The big spreadsheet Posting Exceptions and Non- Patient Cash The Big Spreadsheet 6 Copyright PNC Bank, N.A. All rights reserved.

Automation Tools OTC transaction identifiers Lockbox check files NACHA files BAI bank transaction files Reassociation data Data extracts from revenue cycle system 7 Copyright PNC Bank, N.A. All rights reserved.

OSF Healthcare Reconciliation project: Auto-matching check and ACH payments with Direct 835s Automating reconciliation of patient cash via exports from EPIC and bank information systems Automated reconciliation spreadsheets Complete accounting reconciliation for 8 hospitals by the 10 th day of each month 8 Copyright PNC Bank, N.A. All rights reserved.

Penn Medicine Reconciliation project: Automating reconciliation of patient cash Early adopter of EPIC Cash Management Module (CMM) Checks and ACH payments are identified with EPIC payer codes during lockbox processing Lockbox check/ach files create automatic EPIC batches for individual checks and ACH payments, which can then be assigned to cash posting team EPIC CMM compares check and ACH batch totals with patient amounts posted for each payment and flags variances EPIC CMM tracks total bank deposits for patient cash to amounts posted 12 Copyright PNC Bank, N.A. All rights reserved.

Jefferson University Physicians (JUP) Reconciliation project: Automating reconciliation of over-the-counter physician practice deposits Tools: Enhancements to IDX patient accounting system, Microsoft Excel Deposit tickets are identified uniquely with a practice ID and sequential number Credit card terminals are mapped to practice IDs Patient account numbers are entered when credit cards are swiped Deposit ticket numbers are entered into IDX and associated with patient encounters Customized bank reports by practice enable daily and monthly reconciliation of over-the-counter deposits to IDX 16 Copyright PNC Bank, N.A. All rights reserved.

Planning Automated Cash Reconciliation: Factors to Consider Revenue cycle (A/R) and G/L system integration Sources of data Same entity ID map and data elements on all systems Treasury/Accounting/IT in-house talent Leverage bank and other external resources for advice 20 Copyright PNC Bank, N.A. All rights reserved.