Chris Johnson, with more than thirty-five years revenue cycle experience, has spent the past twenty-one years of his career at Atrium Health leading various components of revenue cycle operations for the Atrium Health owned facilities and affiliated or regional facilities.
Johnson’s most recent project began in 2015 and involved a multiyear implementation plan to migrate Atrium Health’s owned facilities to a new accounts receivable software platform that combines patient balance billing from both the hospital and physicians into a single platform. In order to capture maximum efficiency from this new software, Johnson led the formation of the Unified Business Office, combining patient facing activities from the legacy hospital and professional billing systems.
While the combination of separate and distinct customer service call centers, cash posters, credit processors, and correspondence teams proved to be difficult in the short term, it was well worth it in the long run. During the transition, customer service representatives had to use three different systems: the new unified Epic platform, as well as two legacy billing systems. Though the system was cumbersome and inefficient, it was a necessary bridge to a more effective solution.
“We didn’t adequately anticipate the complexities for our internal team with three different billing systems,” admits Johnson, who is vice president of revenue cycle management, regional facilities/UBO at Atrium. When patients phoned in to ask questions about bills, customer service representatives needed extra time to scour the data from the multiple systems with different user interfaces and process flows. Even with additional training, migrating between multiple systems in a fast-paced call center proved to be difficult. As a result, Johnson says, wait times, length of calls, and abandonment rates all increased.
Now that the migration to the new system is complete, all those metrics have improved—not only from their spike during the adjustment period but even from where they were originally, prior to the new billing platform. Most importantly, patients can resolve their billing issues by viewing one bill and by calling just one phone number, making for enhanced customer service and better cash flow. Moreover, these improvements have also saved Atrium Health $700,000 annually in statement and postage fees by reducing the number of bills sent to patients.
Now that the system implementation is complete the organization has solidified its footing—and the results speak for themselves. Atrium’s revenue cycle team has enjoyed record cash years in 2017, 2018, and are on track for similar results in 2019.
Much of this improvement is due to teamwork between clinical and financial groups, Johnson says. A multidisciplinary committee focused on reducing revenue lost to third-party denials includes members from patient access, patient accounting, health information management (HIM), case management, radiology, surgery, and other clinical areas.
Members of the patient accounting team shadowed leaders in several clinical areas to gain insight into their daily operational processes, which better prepared them to jump through necessary bureaucratic hoops to turn payment denials into approvals. As a result, Atrium decreased its final denial percentage from 0.76 in 2016 to 0.39 in 2019, representing additional reimbursement of $29.2 million.
“I truly believe I and other revenue cycle leaders play a role in patient care. The clinical operation is not going to work without a sound financial standing.”
Atrium is an organization on the move and if a multiyear computer system implementation wasn’t enough to keep the revenue cycle team busy, in January 2019 the organization, which serves a large area of the Carolinas, combined with Georgia-based Navicent Health, allowing Atrium to expand into new territory. For Navicent, the transaction would boost its ability to improve services such as telehealth offerings and save money through the increased buying power of the larger partner.
While mutually beneficial, the transaction still posed significant challenges for the revenue cycle teams of both organizations. Systems and operations needed to be reexamined to determine how to manage revenue cycle operations as a combined organization. Johnson, with insights gleaned from leadership positions for the Healthcare Financial Management Association, was tasked by Atrium’s senior vice president of patient financial services, to lead the operational team that would execute these plans.
As the organizations combined, the goal was to ensure that both benefitted from processes that allowed for optimal reimbursement. This included taking a careful look at where financial teams spent their time. “We realized that having our internal staff focused on denial insurance appeals, as opposed to other parts of revenue collection was most effective in our revenue cycle performance,” Johnson explains.
It is this type of operational analysis that has enhanced Atrium’s revenue cycle success. During the past three years, Atrium has optimized internal resources in areas of expertise such as insurance billing and follow-up with the help of external revenue cycle partners specializing in areas such as motor vehicle accidents, worker’s comp, insurance discovery, estate claims, and zero balance account review. As a result, these partnerships uncovered more than $41 million in additional reimbursement to the system,
This continual improvement of the process, through innovation and sometimes basic blocking and tackling, is what drives Johnson’s passion for his job, as it enables the organization to continue its mission. “I was not called to be a clinician which is good for me and the patient,” Johnson says. “However, I truly believe I and other revenue cycle leaders play a role in patient care. The clinical operation is not going to work without a sound financial standing. Even the most dedicated clinicians expect to be paid.”
On Becoming a Better Leader
In addition to having great mentors, Chris Johnson credits his involvement with industry groups as a key to his success. “By nature, I am a relatively introverted person,” Johnson says. Participating in activities of the Healthcare Financial Management Association (HFMA), and later taking on leadership roles in that organization helped him come out of his shell.
Johnson joined HFMA to broaden his industry education. After a while, HFMA acquaintances asked him to join leadership committees. Taking on the role of program council director for the North Carolina Chapter was a daunting step.
One of his duties in that role was to open and close multiday meetings. “For the first time in my life, I was close to having a panic attack,” he recalls. He not only survived the experience but also gained great confidence in his leadership ability while quickly learning that any leader is only as good as the team that surrounds him.
That knowledge has served him well and prepared him for a multitude of challenges throughout his career. Johnson freely acknowledges any level of success he has achieved throughout his career is a direct result of the many talented individuals on his respective teams.
DCM Services shares in the excitement of Chris Johnson’s continued success and contagious passion. As the industry leader in specialty revenue cycle management solutions we drive higher performance at crucial stages in the recoveries process, having recovered millions in partnership with the Revenue Cycle Management team at Atrium Health.
“Meduit congratulates Chris Johnson for this well-deserved honor. As vice president of revenue cycle management for Atrium Health, Chris makes a substantial and tangible difference for Atrium and is a valued executive partner for the entire Meduit team.”
–Rhonda Silver, Sr. Vice President of Insurance Operations