Communication Is The Key

Sometimes interim staffing doesn’t work out. As we said in our last post on building relationships, communications can go a long way in making sure that each party gets what they’re hoping for when interim staff, both regular staff and management staff, is placed.

For instance, one story we heard was that a staffing company placed someone at a facility who was there to help out with billing. That person was immediately put into doing another job that wasn’t her specialty. Within a week, the contract was being terminated, and no one was happy with the relationship. The client had asked for a billing person, believing that billing people should be skilled in all areas of the revenue cycle system, but that’s just not the case at all time.

Another situation we heard about was when a person was sent to a facility to work as a supervisor. Once they were there, the person in charge decided to change that person’s job duties, which were now more comprehensive than what they had asked for up front. When the staffing company learned about the change, they attempted to renegotiate the rate, since the job was of a higher status. The client felt that they had hired a body with particular skills, and that the position shouldn’t matter. The staffing company felt they had no choice, pulled the person, and ended the contract. Once again, no one was happy with the outcome.

Good communications between all parties is always the key to trying to get things right. If the client is able to express their expectations, then staffing companies are better prepared to give them what they want. If staffing companies are able to better intrepret what clients may actually need, rather than always sending exactly what was asked for, even when they know better, things will go smoother and no one will be upset about anything.

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Building Business Relationships

Like every other company, we consider ourselves as a business about relationships.

Some of our clients have been with us for years, and keep coming back to request more bodies, in different capacities, as needed. Some of our clients are one-time hits, meaning they have an issue, we help them address that issue, then they move on from there and we never hear from them again.

Still, it’s all about relationships. We treat each client as though they’re the most important client we have. Customer service is a big deal, especially for a staffing company. The truth is that we’re not on site with the people we place or the client. Things don’t always go exactly as planned; no one has any control over everything.

Sometimes it’s our fault for placing the wrong person. Sometimes it’s the client’s fault for not telling us their exact needs. Sometimes it’s the person’s fault we place, who one day suddenly does something out of character that no one could have anticipated. And sometimes it’s no one’s fault; circumstances are just that, and a contract might have to be altered or canceled.

No matter what, customer service will determine how that business relationship fosters itself. Clients usually know that no one is perfect. Good customer service can go a long way towards solving any issues that either are, or aren’t, under a staffing company’s control. All of us, either in the health care field or outside of it, work hard to give the best customer experience possible.

We don’t win them all, but we win the overwhelming majority of them. It’s a good feeling when clients rave about people we’ve sent to them. It’s gut wrenching when there are problems. Luckily, we don’t have to keep a supply of antacids around because of worries about the people we place. We’re not perfect, but we’ll always strive to get there.

Interim Staffing In Tough Financial Times

Many employers feel that, when financial times are tough, they need to start cutting back on spending and expenses, which often means employees as well. Truthfully, that’s an understandable position across the board, as companies need to be fiscally responsible to their organizations.

Health care is no different. Whether it’s physician’s offices, hospitals or clinics, everyone needs to keep their eye on the bottom line. One really can’t go around spending money on things that aren’t bringing in the proper return on their financial investment.

The problem with that is when hospitals start looking at departments that aren’t revenue generating and determining that they should be a big part of the cuts. It doesn’t get more problematic than looking at the accounts receivables area. Sure, it doesn’t generate any new revenue, but it’s responsible for bringing in your money, which is your facility’s life’s blood. Without cash, nothing runs. No doctors, no staff, no hospital. That’s not a good scenario.

A quick review should give you an indication of how you might use interim staffing, along with your own, for at least short term projects. First, determine how many bodies you actually have working on billing. Divide that number into your monthly cash. That gives you a quick down and dirty figure of what each billing person is worth to you at that moment.

Next, take that same amount and divide it into your previous 3 months worth of revenue. That tells you how much they’re worth to you in new outstanding receivables.

Then look at your receivables over 90 days. If it’s under 30%, you’re doing pretty well. If it’s more than 50% of your entire receivable, you could use some staffing help. At that point, it depends on how fast you want to get out of distress in determining how many people you need. Start with half of your staff for 3 months as a guide and proceed from there.

That should get you caught up, but remember that old receivables don’t always equate to the equivalent in cash. But the interim staff will bring your receivables down, and you will see your cash go up. And at that point, you’ll have a better idea of where your facility lies financially.

Know Your Financial Position Better

When the economy gets tough, hospitals sometimes start cutting and slashing in an attempt to protect the money that they have coming in. What is sometimes missed are regulatory issues and making sure the facility stays profitability.

By regulatory issues, we mean things such as making sure certain staff isn’t working too many hours, making sure patients aren’t being made to wait an extraordinary amount of time before having services performed, and even things like making sure all patient maintenance areas are being cleaned as much as they’re supposed to be. It’s a tough world, and hospitals have as tough a time as anyone else, sometimes more, and the powers that be are trying to do the best they can with what they have.

However, one thing they certainly need is better cash flow. For better cash flow, there might be a host of positions that need to be filled on an interim basis to help see just how things are going.

For instance, bringing in extra billing personnel to bring days in receivables as low as possible is never a bad thing. It’s been calculated that every hospital billing person is responsible for upward of $250,000 to $400,000 in new cash for a small to medium sized hospital, with “new” being defined as less than 90 days. Older receivables are much harder to define, but if you have enough billing personnel to begin with you have less worry about receivables older than 90 days.

Bringing in someone to help a facility learn how to track denials is important because denials are what drains a hospital’s cash in the first place. It’s not just having people working denials; it’s learning what they are and trying to address the issue based on that information. One can’t fix what one doesn’t know is broken.

Things like that help hospitals know exactly where they stand when it comes to cash. Bringing in interim personnel can help hospitals determine what moves they need to make for long term success.

Specific Computer System Knowledge Isn’t Overly Important

Often we get requests for interim personnel who have knowledge on specific computer systems. The feeling is that the ramp up time for people who come in with the knowledge of a computer system will be less than bringing in someone without that comfort with a particular computer system.

Although the idea seems sound, truthfully, the type of billing system a hospital has doesn’t have much impact on the qualifications of a billing person. Many people who Expeditive brings in have worked on a number of systems, but the reality is that there are literally a couple hundred different systems for hospitals across the country, and even more for physician’s offices. Though there are differences here and there, almost all billing systems are the same in some fashion.

CFO’s possibly think there are great variations in systems because, once you leave registration and billing, things can drastically change. We’ve seen how there can be dramatic differences in how general ledgers are created, and we’ve seen how materials management systems can be different also. The processes involved can take a long time to teach people who may be used to one standard of how to do things.

But when it comes to billing, systems are fairly standard. Sure, there may be slight differences in screens, but the information is the same. And, these days most hospitals drop their bills into another electronic billing system where bills actually get cleaned up and sent out, and many of our billing personnel are quite familiar with those systems.

For this reason, it’s always better to look for people who are qualified in working the insurance your facility needs help with, rather than their competency on specific hospital computer systems.

What To Look For In Interim Leadership

Sometimes health care entities have a need to replace management level positions. Someone may have left, or administration might feel the need for another high level body to come in and offer something they don’t already have.

One of the best reasons for bringing in an independent consultant, which is how most management level interim employees consider themselves to be, is that they are usually skilled in stepping into a situation, doing quick evaluations, then taking action steps to help fix problems as necessary.

Interim leadership offers many things. One, they know they’re not going to be permanent employees, so most of the time they don’t come in trying to make too many friends, although they will try to find employees who will work well with them. They don’t get caught up in a lot of the drama of living in a particular area, which makes them dispassionate about the job that needs to be done. It’s not that they don’t care what happens, because they obviously do. What they do want to make sure of is that they can make decisions that affect positive outcomes, yet not get caught up in office politics that can often restrict current employees from trying something different, or revisiting something that may have been tried before in some fashion.

Expeditive works with a lot of these independent consultants, of all management levels, in making sure we place the proper person with the proper client. Some of our consultants are specialists, which may cost a little bit more, but you can bet that, if we’re recommending them, that they’re at the top of their game.

Deciding When You Need Interim Management Staff

Management level staff leaves companies every day. Some companies can easily fill management level positions because they have a lot of candidates from within they can choose from.

However, it’s a different story for hospitals. Often, they tend to hire only one person with the experience and skills to handle a particular job, and when those employees leave, they have to do some extensive outreach to try to find another body. Sometimes, that can take a long time, especially in areas that aren’t near large cities. That, plus most hospitals aren’t all that close to each other, so they have to try to convince candidates that either moving to their area or driving long distances is a good thing.

What happens is that, during this time period, departments might be leaderless. If you’re a relatively small facility, you might not have had an assistant director, manager, or supervisor already named to lead things. Probably if you had confidence in someone you’d have already thought about promoting them to the position. You can sometimes get by with putting someone in charge for a few weeks, but anything longer than that and you could be compromising your facility’s abilities to provide quality.

Interim management staff provides instant leadership and stability. Every interim leader who steps into either a leadership position or an independent position within your facility has already proven themselves in a number of other situations, either in your area or somewhere else around the country. More often that not, staff immediately recognizes their proficiency and accepts them in their role as a temporary leader. And we usually find that interim managers can easily affect positive changes that, strangely enough, the full time leaders you’ll bring in afterwards are often happy about.

This is why Expeditive is always happy to recommend interim management staff to hospitals. We recognize their proficiency and professionalism, and know that they will do the best job possible for you, our clients.