Management Home Health

CAROLYN S. TUTTLE

REVENUE CYCLE LEADER AND CONSULTANT

Extensive management experience in performance improvement and systems implementation projects.

Proven ability to significantly increase cash collections and reduce bad debt/denials

Achieved $10M cash improvement in 6 mos, bad debt under 4% and denials under 2%

Skilled in implementing Lean Six Sigma processes resulting in reduction in A/R Days

Attained MHA Top 10 Hospital status for lowest A/R Days at 41

Specializing in compliance and customer satisfaction programs

Scored 100% compliance in HSCRC Financial Assistance/Charity audit and ranked 99% in the Jackson Patient Satisfaction Survey for Patient Access

PROFESSIONAL EXPERIENCE

KOHLER HEALTHCARE CONSULTING, Woodstock, MD

National healthcare management and consulting firm specializing in performance improvement and revenue management serving multi-hospital healthcare systems, public and private teaching institutions, academic medical centers, physician practices and community hospitals.

Associate Director/Revenue Management, 08/2011 – present

Concentration is revenue cycle improvement and redesign for improving access management, financial counseling/eligibility, payer performance, regulatory reimbursement and compliance, denial avoidance, Lean Six Sigma process improvements, cash acceleration and minimizing bad debt expense.

Specialty Engagements include:

Maryland Hospital Association facilitator for ICD-10 and 5010 preparation and implementation.

Revenue cycle assessment and performance recommendation plan for physician operations at West Virginia University Healthcare to identify and optimize billing efficiencies.

Implementation of multi-site point of service/financial counseling cash programs with positive cash results for Radiation Oncology Services of American.

Interium Executive Director for Meritus Health Centralized Billing Office assessing staffing and organizational structure to improve cash flow, best practice outcomes and recruit replacement.

MERITUS HEALTH/WASHINGTON COUNTY HOSPITAL, Hagerstown, MD

341 bed regional hospital, Level III Trauma Center offering inpatient and outpatient services including obstetrics and newborn care, comprehensive inpatient rehabilitation, radiology and diagnostic services, mental health services, a coronary care unit including a hospice and palliative care unit.

Executive Director Patient Financial Services, 2004 – 2011

Revenue cycle leader for hospital and MSO system optimizing collection of revenue by improving processes to increase lean efficiencies, productivity and collections while improving patient experience.

Facilitated cash acceleration process improvement resulting in a $10M cash improvement.

Achieved MHA Top 10 Hospital status for Days in A/R by decreasing 21 gross days in A/R.

Increased net cash collections from 86% to 105% and maintained at or above 103% of net revenue by implementing up-front collection processes.

Reduced outstanding accounts receivables over 150+ days to under 12% by implementing an in-house third-party and self-pay collection unit.

Ensured bad debt under 4.0% and charity levels maintained within targeted mission goals.

Achieved and maintain 96% accuracy of demographic data captured at time of registration.

Successful conversion of electronic billing software implementation from 68% use to 92% use with system modifications and productivity enhancements.

Facilitated the implementation of new Home Health billing and collection system.

Reduced Inpatient and Outpatient denials to less than 1% with 65% recovery rate by integrating appeal management nurse team within PFS.

Revenue Cycle Management Chair including RAC/MAC/MIC, Charge master and Coding Core Measures and Lost Charges committees to maintain strong levels of compliance standards.

Developed and implemented PFS Cross Training Programs for registration, billing and collections with training manuals, including policies, procedures, work flows and competencies.

Implemented a departmental strategic centralized business plan with a staff of 129 FTE’s, to integrate all departmental functions, reduce A/R days, increase cash collections and increase efficiencies and reduce redundant processes .

FREDERICK REGIONAL HEALTH SYSTEM, Frederick, MD

248 bed acute care hospital system offering inpatient and outpatient services including cardiology services, diabetes center, home health services, women and children, orthopedic services, wound care and hyperbaric medicine and hospice and palliative care.

Director Patient Financial Services, 1998-2004

Directed all revenue cycle activities for hospital and multi specialty outpatient center.

Increased net cash collections from 96% to 105%.

Decreased gross days to 54 days from 101 days.

Secure 12% of gross self-pay revenue for emergency and outpatient services.

Achieved a 99% national percentile rank from The Jackson Organization Patient Satisfaction Survey for Patient Access with a score of 4.39. Patient Accounts scored 4.13.

Implemented a PFS Customer Satisfaction Program, to achieve and maintain 96% accuracy of demographic and insurance information captured at time of registration.

Implemented Medicare ABN Medical Necessity for outpatient diagnostic services to become compliant with Medicare requirements.

Reduced HMO/PPO denials for ED Services from 93% to 5% by updating charge master.

Served as co-chair for hospital wide cost reduction project. Achieving departmental saving of 10% or $304K, by reducing expenses in salaries, supplies and collection fees.

Facilitated internal PFS Compliance Program, to include CDM, EMTALA, Medicare Medical Necessity, MSP requirements, EDI for HIPAA standard transactions and code sets.

Implemented a departmental strategic business plan with a staff of 78 FTE’s, to integrate all departmental functions, reduce A/R days and increase cash collections.

PSYCHIATRIC INSTITUTE OF WASHINGTON, Washington, DC

100 bed psychiatric hospital providing comprehensive behavioral healthcare for adults and children.

Director Business Office Operations, 1996-1998

Responsible for the direction of patient access, financial counseling, managed care contract negotiation, patient accounts, and information technology functions.

Increased cash collections by $1.5M or 116% of net revenue, within the first 3 months.

Decreased accounts receivable by 26 days, maintaining 4.5% bad debt.

Reduced account receivable reserve by 3.2% through monthly reserve review.

Implemented a Business Office Training program, to achieve and maintain a 98% accuracy of demographic and insurance information captured at time of registration.

MEDSTAR UNION MEMORIAL HOSPITAL, Baltimore, MD

249-bed acute care teaching hospital with a strong emphasis on orthopedics and sports medicine.

Assistant Associate Director Patient Accounts, 1995-1996

Responsible for the direction of all outpatient patient access registration, financial counseling, and patient accounts functions for a 425-bed hospital.

Gross accounts receivable decreased by over $1.2 million with a reduction of 18 days.

Successfully implemented an electronic billing system with collection workstations and telephone queues for all inpatient and outpatient units.

Trained and motivated a staff of 75 to record productivity via educational in-services and payer cross training, with regular staff meetings.

Facilitator for the planning and design of new patient accounts software and equipment.

NATIONAL MEDICAL ENTERPRISES, Leesburg, VA

120 bed psychiatric hospital with multi off-site locations providing comprehensive behavioral healthcare for adults and children.

Director Patient Financial Services, 1991-1995

Directed all patient access, financial counseling, care coordination, managed care contract negotiation, patient account, and information technology functions.

Gross accounts receivable decreased by over $1M dollars, maintaining 4.1% bad debt write-off with a denial rate of less than 1%.

Effectively reduced gross days to 52 days, having the lowest days in the region.

Cash collections average 107.3 percent of net revenue.

Increase admissions by negotiating out of network rates with managed care organizations.

Successful coordination of the clinical assessment center, case management and patient accounts via training and motivational techniques.

SHANDS AT THE UNIVERSITY OF FLORIDA, Gainsville, FL

768 bed Level I Trauma teaching hospitals plus two home health agencies.

Manager Patient Accounts, 1989 - 1991

ORLANDO REGIONAL MEDICAL CENTER, Orlando, FL

808 bed multi hospital system specializing in trauma, cardiology, orthopedics and neuroscience.

Supervisor Self-Pay, 1987 - 1989

EDUCATION AND CERTIFICATIONS

CPAM, will sit for April 2012

Certificate, Lean Six Sigma, 2011, Villanova University, Tampa, Fl

Business Administration, Broward Community College, Davie, Fl

AFFILIATIONS

Member of Healthcare Financial Management Association

Member of American Association of Healthcare Management

*Bi-lingual, English and Spanish

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