Episode 72 - Revenue Cycle Management for Tribal Health Centers

Joe: On this episode of "Putting Possibility Into Practice," we're talking about tribal health community centers. We're discussing incorporating revenue cycle management and talking about some of the other solutions that are available for tribal health centers, and how the story of one tribal health center could help your tribal health center succeed in continuing to give excellent patient care each and every day. This is "Putting Possibility Into Practice," and it starts right now. 

I'm Joe Agostinelli, social media manager at Greenway Health, and I welcome you to this episode of our podcast, "Putting Possibility Into Practice." If you are a returning listener, thanks once again for tuning in. And if you are a new listener, we are glad you found us, and we invite you to subscribe on your favorite podcast platform of choice and get notifications each week when new episodes are published. We'll go into those podcast platforms a little later on in today's episode. And on this episode, I am joined by Marlene Smallwood. She is the health clinic director for Yerington Paiute Tribe Health Clinic. And, Marlene, I wanna thank you for taking time out of your busy day to join us on this episode. 

Marlene: Thank you. I enjoy being here. 

Joe: And, Marlene, talk to us a little bit about your location, the tribe, your providers, the services that you offer patients at the health center. 

Marlene: Okay, we are located on the Yerington Paiute Tribe reservation, and we're like five minutes from the town of Yerington. We're located in Nevada. We're kind of West Central Nevada, 80 miles from Reno. Our clinic here provides services to tribal community members, and we also serve non-native patients, which makes us stand out a little bit more than your regular tribal clinic. We are a multi-specialty clinic. We offer podiatry, optometry, behavioral health, and then your general practice providers. 

Joe: And it was interesting that you mentioned that point. So you also see patients...you see non-tribal patients, correct? Is what you mentioned?

Marlene: Correct, yes. 

Joe: And how does that differ from many of the other tribal health centers that we may partner with? 

Marlene: Some of them may only see tribal patients. Our tribe, in particular, is compacted. We accumulated our own funding from IHS and have a funding agreement where the other tribal health clinics may still fall under the IHS umbrella. 

Joe: And for those Greenway followers on our social media networks, who may be familiar with our possibilities and partnerships in our Greenway Go-Live campaign, we recently highlighted the practice on our social media platforms, a great photo of you guys, Greenway Go-Live. Talk a little bit about the platform that you guys went live on and how you partner with Greenway. 

Marlene: Our social media, we really don't have like a tribal webpage. It is actually under construction, but we do have a Facebook page and our go-live was featured there. We also have a community newsletter which we distribute out to our tribal community members. And they also go out of state, those tribal newsletters to wherever the community member lives, that's where the newsletters go. So it's kinda small, but it's a start. 

Joe: And what product solution did you go live on and incorporate into the practice from Greenway? 

Marlene: Okay, we went with pretty much an entire big package from the billing to the EHR. Let's see, we have like the clinical services with the lab portal because we do...oh, yeah, that was another thing. We do have a lab here.

Joe: Oh, interesting. 

Marlene: Yeah, and so we did the lab portal with the clinic services, the Greenway clearinghouse, the direct messaging, pretty much everything that Greenway has to offer we went with, only it just made sense to have it so you don't have different companies trying to configure the revenue for one clinic. 

Joe: And as somebody who recently went through implementation, how has the process been and what have your thoughts been so far in integrating Greenway Health solutions into your practice and getting your staff up to speed? 

Marlene: It's been really good. I mean, it was a lot of hard work only because I scheduled our training sessions back-to-back because I wanted to jump right in and get it going. It was something that it's been a long time coming. The meetings were very informative. There's lots of training available. If you need help, they're there. I have nothing but good things to say for Greenway and the training and the people that are in particular assigned to our clinic to help us. 

Joe: And it's, I mean, it seems like a lot of responsibility, advice for other clinics who may be heading towards that implementation process. What did you learn through the process that may help somebody else who is just getting ready to implement product solutions from Greenway? 

Marlene: I would say to...if you're looking for something, to look for transparency, a company that will show you where and how the process works, to remember the partner is working with you for your practice and handling your revenue, they should be educating you on things that are questionable to help you understand the process. The most important is communication, the emails, the meetings, the telephone calls to keep it going. You know, always touch bases to stay involved and don't make it just the billing department's duty and responsibility. Everyone should be on the same page with the staff and the management altogether. 

Joe: And in regards to the revenue cycle management and Greenway Revenue Services, how would you characterize your relationship with the GRS team? 

Marlene: The team itself is very friendly, knowledgeable about tribal health, and communication is excellent. I was impressed that they were already working with other tribal health centers. And as a tribal health clinic, our staff has learned so much from their team. I believe it's a great relationship. And with our clinic staff understanding and learning about clinic billing workflow, I think it will be even better. The GRS team has seemed to close a big gap when it comes to billing and revenue services, and they have filled a big need in our clinic. 

Joe: And what challenges face tribal health centers today that may make them a candidate for revenue cycle management? 

Marlene: Well, for us, our biggest challenge was working with a billing company that was everything that Greenway is not. It was like night and day with Greenway at the top. Most tribal health centers work with an outdated resource patient management system, and it lacks updates and support. I think the more tribal clinic staff and upper management is educated on the billing processes within the clinic, the more efficient the clinic will run. The understanding and the knowledge of billing processes can sometimes be limited within tribal clinics, which later can lead to miss revenue and costs that could have been avoided. Those seem to be the biggest challenges. 

Joe: And for those practices who may be looking for revenue cycle management partners, what advice would you give them on the, you know, on the process that maybe you went through in ending up choosing Greenway to go with your solutions? 

Marlene: I would say do your homework, invite the different companies in, compare them, make sure that they fit your needs, and whatever your gaps and needs are, to really pay attention to that. And if it takes, you know, 10 meetings with the same company to figure out if that's what you really want and what you really wanna go with, then I would, in the end, choose the one that you feel in your gut is the most comfortable. 

Joe: And aside from the revenue cycle management, what are some of the other challenges that face tribal health members today that may not be something private practices may face? 

Marlene: Well, with Indian Health Services, or I would say, you know, tribal clinics, funding is always a big one. Another is because we are rural, and most tribal clinics are on reservations, it's really hard to find providers that are willing to work as permanent staff. There is not a whole lot for providers to do in their off-time when they're way out here on the reservation. We are an hour and a half away from Reno Tahoe area. So activities that are going on all year round seem to attract potential providers, and we don't have that out here where we are 

Joe: And what's in store for Yerington as we enter...every time I say, it's hard to believe that we are entering the second half of 2019 already, but what's in store for Yerington as we enter the second half of 2019, any goals that the center may have in regard to health care and the services that it provides to the tribe? 

Marlene: Yes, well, being that I been with the tribe now as the director for a year, one of my biggest goals for us was to start with the infrastructure. Since we are in our third month of going live, I wanna continue to learn more about the Greenway EHR because every day we find something cool within the system, you know, whether it's a little shortcut key or something the system does for us, we do not have to manually input it anymore when we find those little shortcuts. So it's kinda Nice. It's been a long time coming for us to get this far, and I believe the second half of 2019 will be to fine-tune the infrastructure within the clinic to make a solid foundation. 

Joe: And aside from the relationship with Greenway, only because you're in Nevada, I have to ask how hot does it really get during the summer there because our headquarters are in Tampa, and a lot of folks think the 90-degree days are hot, humid, hazy? But how hot does it get out there? Does it not get into the triple digits? 

Marlene: Usually, in July, we'll get triple digits, but it's usually under 105. The hottest I've been in is probably 108. And we get dry heat, there's no humidity. So it's nice when you get that cold breeze toward the evening, it cools down, but the average temperature is higher 80s, lower 90s. 

Joe: Great. Well, I wanna thank you for taking the time out of your day to join us on our podcast. Really enjoyed our conversation. We look forward to partnering with Yerington in the months and years ahead to help you continue to meet and exceed your goals. 

Marlene: Okay, well, great. Thank you. I enjoy Greenway and the health solutions community. And we look forward to working with them for a really long time, and I cannot stop telling you about the wonderful things we have found with Greenway. 

Joe: in that case, we may have to have you on for another podcast episode sometime. You've been great today, Marlene. 

Marlene: Okay, well, thank you. I appreciate. 

Joe: And once again, that was Marlene Smallwood. She is the health clinic director, Yerington Paiute Tribe Health Clinic out in Nevada. We thank you for tuning into this episode of our podcast, "Putting Possibility Into Practice." Reminder that you can subscribe to our podcast on your platform of choice. And we are on a number of the platforms now. You can find us on Apple iTunes, Google Play Podcasts, Stitcher, fm.player, SoundCloud, Lipson, Spotify, TuneIn Radio, and iHeartRadio. I'm Joe Agostinelli, the social media manager at Greenway Health. And for more information on the products and services that we talked about on this episode of our podcast, you can visit our website at www.greenwayhealth.com. Thanks for listening.