Articles

Overcoming the Challenges of an Evolving Regulatory Environment

Oct 22, 2024

One of the most pressing challenges faced by healthcare providers is complying with government regulations. It’s a confusing and unpredictable landscape.

How to keep up with HIPAA regulations? What about digitizing record-keeping and reporting as required by the Health Information Technology for Economic and Clinical Health (HITECH) Act? Not to mention state-specific laws and credit-reporting mandates.

Without the right strategies in place, the risk to your healthcare organization can be significant. Staying ahead of these challenges is key to protecting both compliance and revenue integrity.

Improving Compliance Strategies

Healthcare providers should take specific steps to optimize RCM processes to keep up with changing, complex regulations. These include expanding their knowledge base, updating RCM policies, and adopting best-of-breed technological solutions.

Expanding the Knowledge Base

Empower yourself by staying up to date with regulatory changes. Ways to stay informed include:

  • Subscribing to industry newsletters that cover the regulatory landscape
  • Signing up to receive regulatory updates from the Centers for Medicare & Medicaid Services (CMS) and the American Health Information Management Association (AHIMA)
  • Exchanging information with peers by joining healthcare professional organizations and networks

Updating RCM Governance and Policies

An effective compliance-ready strategy includes the development of consistent policies and procedures. Best practices include:

  • Updating compliance policies and procedures so they address current mandates
  • Offering training programs for staff on adhering to best practices
  • Conducting regular audits of software solutions and third-party tools
  • Setting standards for third-party partners that provide compliance services

Improving Data Integrity with Technological Solutions

Healthcare organizations can improve compliance by adopting technologies designed to maximize efficiency and enable RCM teams to work with high-quality data, including:

  • Maintaining data integrity even in a fast-changing regulatory environment
  • Providing insights that empower an organization to be able to make intelligent decisions
  • Minimizing coding and billing errors so teams can focus on value-added tasks instead of resolving disputes

Fostering a Culture of Compliance

One essential aspect of compliance readiness is not just adopting a culture that values compliance but actively fostering it at all levels of the organization. Best practices include encouraging open communication and continuous education on the importance of remaining compliant. In addition, a healthcare provider should consult with third-party experts who can guide the organization toward remaining compliant over the long term through regular assessments and monitoring.

When navigating the complexities of healthcare regulations, choosing the right revenue cycle management (RCM) partner is critical. Look for a partner that not only has a deep understanding of key regulations like the HITECH Act and state-specific medical debt reporting laws but also prioritizes compliance as part of their operational framework. An effective partner should implement regular staff training, conduct thorough audits, and offer third-party assessments to identify and mitigate potential risks. Moreover, they should be proactive in monitoring regulatory changes, ensuring that their processes and your organization stay ahead of evolving compliance demands while safeguarding your reputation.

Karie Bostwick

VP of People and Compliance

As VP of People and Compliance at Revenue Enterprises, Karie Bostwick oversees People functions including recruiting, training, onboarding, engagement and satisfaction. Additionally, she is responsible for compliance training, oversight and monitoring.

Karie has a long history of working in the revenue cycle support industry. Her skills span leadership, operations start up, policies and procedures development, operations workflow, budgeting and client management.

She is passionate about the experience of our people, patients and the Healthcare clients we serve and believes that a team of diverse, talented and motivated individuals working together toward a common goal can make a difference.

Robert Sterett

VP of Information Technology

As a transformational leader Robert Sterrett has leveraged his 20 years of experience to build effective service lines and exceptional teams. In his role as VP of Information Technology at Revenue Enterprises, Robert excels at taking a unique, balanced, and strategic approach to technology leadership with people first for the best possible outcome. Using his experience from engineering, project management and service line management he takes a multi-faceted approach to ensure the right people are in the correct position coupled with the best technology to meet or exceed all expectations from security to compliance and business continuity.

Robert’s leadership style lends itself to building long term relationships and has consistently been a relied upon strength in many organizations. Over Robert’s time as an IT operational and project leader, he has spent significant time in both hands-on technology facing roles and client centric management roles to bring the best solutions that strive to meet the business and client needs.

Focusing heavily on his personal development skills and opportunities, Robert continues to foster coaching and mentorship relationships everywhere in his life, and the lives around him.

Douglas Dunbar

VP of Sales & Marketing

As VP of Sales and Marketing for Revenue Enterprises, Douglas Dunbar leads with a passion for building strategic partnerships, nurturing relationships, and upholding customer service excellence. In his role, Doug focuses on marketing and brand strategy, sales team leadership, and working closely with members of the management team to best serve company goals.

Doug has over 28 years of National sales and marketing call/contact center leadership, with 10 years of service specifically at Revenue Enterprises. Currently, Doug serves as part of Wyoming HFMA Chapter leadership and has held various roles in Colorado HFMA Chapter leadership for over 9 years.

In his spare time, Doug is very family oriented. Additionally, he loves traveling, cycling, golfing, fishing, hunting, and boating.

Kris Brumley, MBA

SVP/COO

As SVP/COO of Revenue Enterprises, Kris Brumley is a collaborative partner within the executive team and a leader for operational functions across the organization. Kris productively shares vision, drives innovation, and supports those around her in a way that elevates them and fosters continuous improvement and results. She has helped create a supportive environment for clients resulting in 98% client retention and a 65% NPS score for all clients and 75% for top clients by revenue.

Kris possesses an MBA in data analytics and has twenty-five years of experience in the healthcare industry, with 19 specifically in revenue cycle. She brings a wealth of customer service experience to her role and has worn many hats at Revenue Enterprises including Director of Business Development, EBO Division Director, and VP of Client Experience Management.

In her personal life, Kris is as busy outside of work as inside. She values spending time with her family, and enjoys fishing, hiking, traveling and interior decorating and design.

Timothy (Tim) Brainerd

CEO

As CEO of Revenue Enterprises for almost 20 years, Tim Brainerd leads by example. He promotes a shared vision and stewards a culture of Integrity, Passion, and Respect. He has assembled and empowered high-performing talent and teams to support customers, facilitate strategic planning and manage the capital of the company. Under his leadership, Revenue Enterprises has doubled in size three times over the past fifteen years while maintaining a culture of caring and gratefulness.

Tim has close to four decades of revenue cycle experience, including nineteen years with RSI
Enterprises. He has been a past president of Colorado Chapter of the HFMA and a presenting speaker on the topic of Leadership. He is a fifteen-year member of Vistage International, the world’s largest CEO coaching and peer advisory organization for small and midsize business leaders.

Raised in the Midwest, Tim values humble principles like being respectful, caring, passionate, self-reliant, and most importantly grateful. His most important lesson and the lesson he hopes to pass on in all relationships is living the Golden Rule–do unto others as you would have them do unto you. He is intentional in his choices and believes in making decisions, taking action, being accountable, and loving your neighbors.

Whenever possible, Tim spends his time with his wife of nearly forty years, his adult children, and his grandchildren. His hobbies include fishing, golfing, traveling as well as game nights and sharing great food with his family.