TERESA LOOMIS - Corporate Director, Revenue Integrity - Orlando Health
HFMA FLORIDA CHAPTER: Chair, Data Management Committee
ORIGINALLY FROM: Sarasota CURRENTLY RESIDES: Orlando
EDUCATION: BSN from University of Central Florida & MSHA from the University of St. Francis in Illinois.
What did you like most about this area of study? Achieving my nursing degree has been the launching pad for my career. It has served as my base for every single opportunity I have ventured into.
What do you enjoy most about Healthcare Finance? Being in Healthcare Finance has allowed me to round out my view of hospital operations from the clinical to the revenue side. They are completely different in their workflows and mental process patterns, however their collaboration is essential.
How did you become involved with HFMA? I was invited to volunteer on the Education Curriculum Committee, probably 3 years ago. I then became the Chair for one year. Once you are involved, it is difficult to leave the friendships, networking and camaraderie.
How has HFMA affected you? When you are part of HFMA, you begin to see not just your area of discipline, but all business partner relationships. I also have a much stronger networking circle, which is essential as you try to navigate the healthcare revenue cycle.
What are the greatest strengths of Orlando Health? We are a large, level one trauma center. Our areas of expertise are vast, from Neo-natology to Oncology. Our Revenue Cycle Management team has strong internal collaboration. We work hard to understand each other’s business so that we can correct, rather than break processes. I like to believe that our Revenue Integrity department is state of the art. We are often visited by other hospitals so that they may understand how we:
- Are able to achieve QA for charge management with <4% error
- Have a clean charge master that is defendable and consistent from campus to campus
- Collaborate with revenue producing departments so that each department knows where and who to go to when they have questions about their revenue or charge processes.
What are some of the challenges that you have had to navigate in your leadership role? When I came to Revenue Integrity it was a relatively new department. Together, with my magnificent team, we have built a department that is able to address every style of charge management and reconciliation. We understand how we fit into the revenue cycle, and we have improved the chargemaster. From the ground up, I am proud of how we have met the challenge to identify and develop the Revenue Integrity department.
How has healthcare reform shaped or affected operations and finance at Orlando Health? From a Revenue Integrity charge management perspective, it has caused confusion for the patient when they visit our hospital based practices. As we meet regulatory guidance for hospital-based practices, it means the patient may have two E/M levels and two bills, one for practice and one for hospital. This is difficult to understand when you are a patient. Administratively is it more expensive to monitor and make functional.
How do you envision the Healthcare Industry will look in ten years? From my perspective, I think the healthcare industry will see charges for pharmacy and supplies bundled into procedures and reimbursement. These two areas are very challenging for any hospital. Although we do an incredible job at identifying, pricing and charging pharmaceuticals and supplies, these are sore spots for the consumer, and confusing. I believe there is enough data collected that the revenue cycle as a whole is going to go through much streamlining for efficiency to lessen the administrative burden of getting a charge and a bill to the patient.