Latest / Becker’s Healthcare Podcast / Stacey Benson on Using AI and Analytics to Strengthen Revenue Cycle Operations

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Stacey Benson on Using AI and Analytics to Strengthen Revenue Cycle Operations · Becker’s Healthcare Podcast

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  - Register on our events page at beckershospitalreview.com
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  - This is Laura Dierda with the Becker's Healthcare
• 1:00
  - podcast.
• 1:01
  - I'm thrilled today to be joined by Stacy
• 1:03
  - Benson, director of revenue cycle operations at Houston
• 1:05
  - Methodist Physician Organization.
• 1:07
  - Stacy, it's a pleasure to have you on
• 1:09
  - the podcast today. Awesome. Thanks for having me.
• 1:12
  - Absolutely. Now I'm excited for our conversation. I
• 1:14
  - know we're gonna talk through some of the
• 1:15
  - things you're doing at Houston Methodist as well
• 1:17
  - as how you're looking at the next couple
• 1:19
  - years. But before we do, can you tell
• 1:21
  - us a little bit more about yourself and
• 1:22
  - your background?
• 1:24
  - Sure. Sure.
• 1:25
  - I actually fell into health care when I
• 1:27
  - was in college.
• 1:28
  - I needed a part time job,
• 1:30
  - and my then, boyfriend, who's now my husband,
• 1:33
  - his mom had a friend that worked in
• 1:35
  - an ophthalmology practice. So, I just kinda fell
• 1:37
  - into the role of working the front desk
• 1:39
  - at this ophthalmology practice. Never dreamed I'd be
• 1:42
  - in health care,
• 1:43
  - but really liked it. And so then
• 1:46
  - after I graduated, I just stayed in health
• 1:47
  - care, kinda climbed that ladder, did everything within
• 1:50
  - a physician office that's nonclinical,
• 1:53
  - and loved it. So,
• 1:55
  - yeah. And then I eventually made it to
• 1:56
  - Houston Methodist,
• 1:58
  - but I had previously been in private practice.
• 2:00
  - And what I learned when I got into
• 2:02
  - a big system is that it's more siloed,
• 2:04
  - unlike private practice where everything is
• 2:07
  - you know, you just do it all. No
• 2:08
  - matter what there is, you do it. But
• 2:10
  - then when you move to a bigger system,
• 2:11
  - I was an operations manager, so I was
• 2:13
  - strictly focusing on operations, but I realized how
• 2:16
  - much I enjoyed revenue cycle being in private
• 2:18
  - practice, but I didn't have that. But we
• 2:20
  - have, obviously, have a CBO at Houston Methodist
• 2:23
  - and a position opened up over on the
• 2:24
  - CBO side and I was able to move
• 2:26
  - over. Been on the CBO side now for
• 2:28
  - about eight years with Houston Methodists
• 2:30
  - for eleven years,
• 2:31
  - and love it. I just
• 2:33
  - I love all things revenue cycle. I know
• 2:35
  - it's getting tougher and tougher out there, but,
• 2:38
  - I just the the challenge of it, the
• 2:40
  - numbers, the, you know, when you can get
• 2:42
  - that claim paid that you thought, you know,
• 2:43
  - you couldn't,
• 2:44
  - you know, the wins, we just, you know,
• 2:46
  - celebrate them all. So, that's kind of me,
• 2:48
  - short and sweet.
• 2:50
  - Well, I love it. And, you know, definitely
• 2:52
  - being able to see those wins, have those
• 2:53
  - wins, and then a
• 2:55
  - transformational
• 2:56
  - department for sure, and the revenue cycle side
• 2:58
  - is so critical to any organization.
• 3:00
  - So from your perspective, could you give us
• 3:02
  - a quick state of the union? What's going
• 3:04
  - well this year, and then what are you
• 3:05
  - focused on for the rest of 2026?
• 3:08
  - Mhmm. So we are a little I'm sure
• 3:10
  - people listening to this probably will shake their
• 3:12
  - head. We're a little behind in that our
• 3:14
  - teams,
• 3:15
  - accounts receivable, cash applications, and analytics roles to
• 3:18
  - me. And we've been on a hybrid schedule
• 3:20
  - with our employees,
• 3:22
  - with two days remote, three days in the
• 3:24
  - office. And we were finding that
• 3:26
  - we were struggling to recruit as well because
• 3:29
  - revenue cycle tends to be a 100% remote.
• 3:31
  - Our coding team, for example, has been a
• 3:33
  - 100% remote for quite some time.
• 3:35
  - So we were toying with the idea for
• 3:36
  - a couple years of how can we offer
• 3:38
  - more,
• 3:40
  - more time at home, you know, successfully,
• 3:42
  - make sure we have all of our systems
• 3:44
  - set up. So this year, we were able
• 3:45
  - to, give them four days at home. We
• 3:47
  - do still have them come in one day
• 3:49
  - a week just because
• 3:51
  - we feel that there's still times where you
• 3:52
  - need to print or,
• 3:54
  - you know, just have that office time. So
• 3:56
  - we do still have a rotating, but, plan
• 3:59
  - of them coming in. But four days a
• 4:01
  - week at home has been a huge success
• 4:02
  - for us this year. So we've been super
• 4:04
  - happy that we were able to roll that
• 4:05
  - out.
• 4:06
  - And then for the rest of the year,
• 4:08
  - really focusing on the team though, because what
• 4:10
  - we're finding is, you know, revenue cycle is
• 4:12
  - becoming more and more difficult. We're getting more
• 4:14
  - and more, you know, accounts in our work
• 4:17
  - queues and it's hard to keep up. So
• 4:19
  - focusing on how can we
• 4:21
  - really utilize
• 4:22
  - the tools in the system to get some
• 4:24
  - big wins, to get some high impact,
• 4:28
  - efficiencies out there, and what how can we
• 4:30
  - use the system to really target,
• 4:32
  - hey. You know, this payer is denying for
• 4:35
  - this diagnosis code or this procedure code every
• 4:37
  - single time. So what can we do to
• 4:38
  - get these big wins, fast wins, to then
• 4:40
  - really get our team members focusing on the
• 4:42
  - areas where we really need them to focus?
• 4:44
  - So, a a lot of focus on how
• 4:46
  - to utilize
• 4:48
  - AI analytics technology
• 4:50
  - to really help the team. We've got them
• 4:52
  - happy now. We've got them home more, but
• 4:54
  - we wanna keep them happy and not jumping
• 4:56
  - up their work shoes. You know?
• 4:58
  - Yeah. I think that makes a lot of
• 4:59
  - sense. You know? Something that takes a lot
• 5:01
  - of intentional time, effort, and planning,
• 5:04
  - as you're trying to figure out what that
• 5:06
  - remote in office balance is and how the
• 5:08
  - team can work effectively
• 5:09
  - in a hybrid space. And so I think
• 5:12
  - that makes a lot of sense, and it's
• 5:13
  - helpful to understand how you're thinking about it
• 5:15
  - and the technology that, helps power it as
• 5:18
  - well. And then from a cultural standpoint,
• 5:20
  - how do you keep everybody focused on the
• 5:22
  - right things? And especially,
• 5:24
  - as you're, you know, doing,
• 5:27
  - additional remote work? What does it look like
• 5:29
  - for you as you're building out your teams
• 5:30
  - and thinking about the next few years,
• 5:32
  - you know, to to try to make sure
• 5:34
  - that culture is in place?
• 5:36
  - We actually have daily huddles. This is a
• 5:39
  - a Houston Methodist
• 5:40
  - workflow. I guess it's a Houston Methodist initiative
• 5:42
  - that, there's daily huddles throughout the whole system,
• 5:45
  - not just revenue cycle. The clinics have it.
• 5:47
  - I believe, they do on the floors as
• 5:49
  - well.
• 5:50
  - And the daily huddles really just bring everybody
• 5:52
  - together. And I'm gonna be honest, when we
• 5:54
  - first heard that we were rolling out these
• 5:56
  - daily huddles,
• 5:57
  - it was like, okay. We get it for
• 5:58
  - the clinic because you're trying to figure out,
• 6:00
  - okay. You know, maybe somebody's out who's covering
• 6:02
  - this position, you know, and that kind of
• 6:03
  - stuff. But we thought for rep cycle, what
• 6:06
  - why what what's the usefulness of the daily
• 6:08
  - huddle. Right?
• 6:09
  - But I have to tell you, it has
• 6:10
  - been wonderful.
• 6:12
  - Every day at 9AM,
• 6:13
  - our accounts receivable team, for example, they hop
• 6:16
  - on a team's call, and they just talk
• 6:18
  - about, you know, how are we pacing? What's
• 6:19
  - going on? Did you have any issues in
• 6:21
  - your work queues yesterday? Did anything pop? What
• 6:23
  - kind of trends are you seeing? And it
• 6:25
  - really just brings everybody together. Everybody's on the
• 6:27
  - call. They only last, you know, five, ten,
• 6:29
  - fifteen minutes,
• 6:30
  - sometimes longer depending on what's going on out
• 6:32
  - there. But it really just brings everybody together
• 6:34
  - and it keeps the focus. You know, here's
• 6:36
  - why we're here, here's where we're going, here's
• 6:39
  - what's going on.
• 6:40
  - There's different
• 6:41
  - tabs on our worksheet for our huddles where
• 6:43
  - we discuss, like, supplies and methods and equipment.
• 6:47
  - So, you know, if there's
• 6:48
  - a printer issue, well, we put it on
• 6:50
  - there because, historically, if there was a printer
• 6:52
  - issue, it would just kinda fall into no
• 6:53
  - man's land and somebody was tracking it, but
• 6:55
  - nobody knew who was tracking it and you
• 6:57
  - just kinda waited for stuff to be fixed.
• 6:58
  - Well, now it's in your face every day
• 7:00
  - and you need to speak to it and
• 7:01
  - you have to track it and you need
• 7:02
  - to solve these problems.
• 7:04
  - So it's really helping with the morale of,
• 7:07
  - hey, we hear you, we're working on it,
• 7:09
  - but also the culture to your point of
• 7:11
  - we're all together. You know, people are out
• 7:12
  - there sending happy birthdays to somebody or, you
• 7:15
  - know, good morning, happy Friday, or you know
• 7:17
  - what I mean? So it just it really
• 7:19
  - it helps. It helps keep them engaged and
• 7:20
  - together even though they're not together.
• 7:23
  - That's great to hear it and really useful
• 7:25
  - to understand how how you've continued to make
• 7:27
  - those connection points and and keep things
• 7:29
  - accelerated and and top of mind. Now when
• 7:32
  - you look into the future, what are some
• 7:33
  - of the big headwinds that you're keeping your
• 7:35
  - eye on and preparing for?
• 7:37
  - So we're dealing a lot with, and I'm
• 7:39
  - sure a lot of people are with professional
• 7:40
  - billing, payer downcoding.
• 7:42
  - They are just downcoding our,
• 7:44
  - E and M codes a lot, and it's
• 7:47
  - happening, you know, on
• 7:49
  - hundreds of accounts each day. Some payers are,
• 7:52
  - they'll send in a code with it so
• 7:54
  - we can track it and understand, hey. Okay.
• 7:56
  - You know, this payer, for example,
• 7:59
  - we see that they're using this denial code
• 8:01
  - and they're paying less, and we can track
• 8:03
  - it. But then others are just paying less.
• 8:05
  - Like, there's no code that comes with it.
• 8:07
  - So
• 8:08
  - trying to figure out how we can
• 8:10
  - really
• 8:12
  - track it, trend it, and fight it in
• 8:14
  - its high, high volume,
• 8:16
  - is really been a problem for us. But
• 8:18
  - we're we're doing the best that we can
• 8:20
  - to try to, you know, run reports to
• 8:22
  - figure it out. We have teams that will
• 8:24
  - review it. And if they disagree, we will
• 8:26
  - appeal it. And then and then our hope
• 8:27
  - with that is that then we can then
• 8:29
  - show, hey, you know, 95% of the time,
• 8:31
  - you know, just throwing out a number.
• 8:34
  - We're right, and we want you to stop
• 8:36
  - doing this, you know. So that really is
• 8:38
  - a big, big initiative for us to try
• 8:39
  - to figure out how to fight it and
• 8:41
  - prove that we're doing the right thing.
• 8:44
  - I can imagine that, you know, it can
• 8:45
  - be very frustrating at times and definitely
• 8:48
  - a lot, to work on. And so when
• 8:50
  - you think of, you know, the last couple
• 8:52
  - years and into today,
• 8:54
  - have you seen more of the the billing
• 8:57
  - issues coming up? Or or, how have you
• 8:59
  - seen those trend lines coming, and what do
• 9:01
  - you expect in the next couple years?
• 9:04
  - Yeah. I mean, it just seems like as
• 9:06
  - soon as we figure out how to fight
• 9:08
  - one issue, another issue comes up. Right? I
• 9:10
  - mean, it's just kind of the name of
• 9:11
  - the game in revenue cycle.
• 9:13
  - I really think that it's interesting because we
• 9:16
  - hear a lot that the payers don't like
• 9:18
  - us using AI, but it seems that they're
• 9:20
  - using AI to automatically deny.
• 9:22
  - So it's trying to find that balance of
• 9:25
  - how do we use AI effectively,
• 9:28
  - to really combat what's going on out there,
• 9:31
  - and not have any issues with, you know,
• 9:33
  - with the payers with that. So,
• 9:35
  - I mean, really, I think moving forward, what
• 9:37
  - we have to focus on is number one,
• 9:40
  - analytics. How can we really track and trend
• 9:42
  - what's going on out there?
• 9:44
  - And then what kind of tools can we
• 9:46
  - put in place within our system
• 9:48
  - to help hit these big bangs, you know,
• 9:51
  - additional documentation, for example.
• 9:53
  - We always had our heavy payers. We knew
• 9:55
  - who was gonna ask for additional documentation. But
• 9:56
  - then this year, it seems like we have
• 9:58
  - some just kinda coming out of the weeds
• 9:59
  - and all of a sudden asking for more.
• 10:01
  - So really trying to stay ahead of it,
• 10:03
  - track it, and figure out how we can
• 10:06
  - really work it because we're not
• 10:08
  - hiring more people, but we're getting more invoices
• 10:11
  - in our work queues. And so what can
• 10:12
  - we do within the system? And if we
• 10:14
  - can't do it within the system, then what
• 10:16
  - kind of AI is there,
• 10:18
  - that can really help us? And then also,
• 10:20
  - speaking of team and morale, we always whenever
• 10:22
  - we talk AI with our team, we we
• 10:24
  - let them know
• 10:25
  - that we need you. We're just trying to
• 10:27
  - help you. AI is a tool. It's not
• 10:29
  - a replacement. So really just, you know, taking
• 10:32
  - that theory and helping people understand and then
• 10:34
  - helping us see, you know, they're in the
• 10:36
  - work queues every day. Where can we get
• 10:38
  - some big wins possibly with AI that maybe
• 10:40
  - you don't have to touch so you can
• 10:41
  - touch this other stuff that really does need,
• 10:43
  - you know, the human touch?
• 10:45
  - So I think that's just gonna be a
• 10:47
  - huge initiative,
• 10:48
  - not just now, but several years into the
• 10:50
  - future, I would say.
• 10:51
  - That makes a lot of sense, you know,
• 10:53
  - and and really is something to plan around.
• 10:55
  - And it sounds like, you know, you have
• 10:57
  - a a resilient team you're building that keeps
• 10:59
  - their eye on the right things and can
• 11:00
  - certainly meet the challenges, whatever they are that
• 11:03
  - come ahead. Now where do you see some
• 11:05
  - of the best opportunities to grow as well?
• 11:08
  - So I was thinking about this. You know,
• 11:11
  - I have this love hate relationship with AI,
• 11:13
  - but I think growth for everyone. I think
• 11:15
  - a lot of people probably are there. But
• 11:17
  - I think really growth is
• 11:19
  - really embracing AI and understand it.
• 11:22
  - I tend I've noticed that I tend to
• 11:24
  - focus on AI for for workflow efficiency. Right?
• 11:27
  - How can it help us? But I know
• 11:29
  - a lot of other people use AI for
• 11:31
  - analytics and research, and I have not really
• 11:34
  - taken myself there yet. So I think growth
• 11:37
  - for myself would be really understanding
• 11:40
  - how AI can help us on the analytics
• 11:43
  - side,
• 11:44
  - because knowing what's going on is is huge.
• 11:47
  - If we can figure out what's going on
• 11:49
  - out there and how to combat it,
• 11:50
  - then really putting that piece of AI ahead
• 11:53
  - of the workflow efficiency makes sense. So,
• 11:56
  - personally and for my team, I want to
• 11:59
  - see us grow
• 12:00
  - in
• 12:01
  - thinking of AI differently of not just workflow,
• 12:05
  - but
• 12:06
  - analytics, thought processes, tracking, trending.
• 12:09
  - And I think if we can if we
• 12:10
  - can, you know, climb that hurdle, I think
• 12:12
  - that we'll be we're setting ourselves up pretty
• 12:14
  - nicely.
• 12:16
  - I love that. And, you know, definitely thinking
• 12:18
  - it through what AI means and how quickly
• 12:20
  - it's evolved and changed and then, you know,
• 12:22
  - where it can be most beneficial.
• 12:25
  - I know it's a huge focus. So it's
• 12:27
  - great to see that your teams are finding
• 12:29
  - it useful and and how,
• 12:31
  - it can impact workflows, analytics, and more. And,
• 12:34
  - you know, for for your people and teams
• 12:36
  - too, how are you making sure that they're,
• 12:38
  - embracing the technology, adopting it, and and, you
• 12:41
  - know, for for some folks,
• 12:44
  - understanding how it works to to really make
• 12:46
  - sure you're getting the most out of it?
• 12:49
  - Well, a lot of research.
• 12:50
  - And then we also have a really great,
• 12:53
  - training team. We have a training team specific
• 12:55
  - to our, revenue cycle physician organization, and they
• 12:58
  - do a phenomenal job in,
• 13:00
  - making sure everyone understands it, how to use
• 13:03
  - it, its purpose.
• 13:04
  - Great relationship with our IT team too as
• 13:06
  - we roll items out.
• 13:08
  - So we're just really I I think just
• 13:10
  - the understanding is what people need to understand
• 13:12
  - what is it doing
• 13:14
  - for me so that there's not this misconception
• 13:16
  - that it's going to
• 13:18
  - you know, for example, we do,
• 13:19
  - AI appeal letters. Well, there's a there's a
• 13:22
  - place for that. It's not gonna take care
• 13:24
  - of all of your appeal letters. It's more
• 13:26
  - on the medical necessity side. So really making
• 13:28
  - sure the team understands when to use it
• 13:30
  - and what's its benefit.
• 13:32
  - And then from there, they'll learn from it
• 13:34
  - and can you then incorporate it somewhere else.
• 13:36
  - So just really making sure that we're talking
• 13:38
  - to the team, training is involved,
• 13:40
  - and we're moving in the direction together.
• 13:43
  - Absolutely. That that is great to hear. Now,
• 13:46
  - before we wrap up here, I wanted to
• 13:48
  - ask you about leadership too. Who do you
• 13:50
  - admire as a leader really from any industry
• 13:52
  - and why?
• 13:54
  - So
• 13:55
  - this question, I thought about it. You know,
• 13:56
  - you said it my way and I thought
• 13:57
  - about it. And I kept coming back to
• 13:59
  - the same leader, but I I I struggled
• 14:00
  - with it because in all honesty, it's it's
• 14:02
  - our CEO, Doctor. Mark Boom, who's the CEO
• 14:04
  - of Houston Methodist. I didn't wanna come out
• 14:06
  - here and say, oh, you know, I admire
• 14:08
  - our CEO and sound like, you know, I'm
• 14:09
  - just like this suck up for lack of
• 14:11
  - a better term. But I honestly I can
• 14:14
  - honestly tell you that I
• 14:16
  - fully admire him. When I was, going through
• 14:19
  - my master's program, I actually did my master's
• 14:21
  - after I had been in the field and
• 14:23
  - went back, you know, later.
• 14:24
  - And so I feel like since I went
• 14:26
  - back to it later as an adult,
• 14:28
  - I remember some classes. And a class that
• 14:30
  - stood out to me within that program was
• 14:32
  - servant leadership. And I really it really struck
• 14:34
  - me. I really
• 14:36
  - appreciate that form of leadership.
• 14:39
  - I I just
• 14:40
  - strive to be that way. I wanna make
• 14:42
  - sure we put people first,
• 14:44
  - because, you know, if you put people first
• 14:45
  - and that, you know, you're gonna get the
• 14:46
  - best out of them. And when I joined
• 14:48
  - Houston Methodist,
• 14:49
  - eleven years ago, we did a leadership orientation
• 14:52
  - and doctor Mark Boone came in and I
• 14:54
  - thought, oh my goodness, this CEO of a
• 14:57
  - huge health system is in this leadership orientation.
• 15:00
  - I just thought that was amazing. And and
• 15:02
  - I can tell you honestly through the years,
• 15:03
  - you know, I've been to Houston Methodist for
• 15:04
  - eleven years.
• 15:06
  - He has just the same person, you that
• 15:09
  - I saw in that leadership orientation is the
• 15:10
  - same person we see today. He's just truly
• 15:13
  - embraces servant leadership. He
• 15:15
  - pushes systemness.
• 15:18
  - He wants to make sure he understands what's
• 15:20
  - going on. He's got a people first, patient
• 15:22
  - first
• 15:23
  - attitude and just really rallies the troops and
• 15:26
  - keeps us all marching in the same direction.
• 15:29
  - I just really appreciate his knowledge,
• 15:32
  - his empathy, his compassion, his integrity. So,
• 15:36
  - yeah, I
• 15:37
  - I I stand strongly behind that. I I
• 15:39
  - admire doctor Mark Boone for sure.
• 15:41
  - Absolutely. He's definitely an inspirational leader. Somebody that
• 15:45
  - we here at Beggars have really enjoyed,
• 15:47
  - speaking with and,
• 15:48
  - hearing from on the stage at our events
• 15:50
  - as well as in the interviews we've done
• 15:52
  - for articles
• 15:53
  - too. Such a a great person and leader
• 15:56
  - as well. Thank you so much for joining
• 15:58
  - us on the podcast today, Stacy. This has
• 16:00
  - been a really fun conversation.
• 16:02
  - Fascinating to hear all the things you're doing
• 16:03
  - at Houston Methodist, and I look forward to
• 16:06
  - seeing you as well at our
• 16:08
  - conference this fall. I know you'll be speaking
• 16:10
  - on a panel, and it'll be great to
• 16:11
  - explore some additional themes during that time. So
• 16:14
  - looking forward to seeing you in a few
• 16:15
  - weeks at our IT and RCM event.
• 16:17
  - Awesome. I'm looking forward as well. Thank you.