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Revenue Cycle Operations

diagram of Revenue Cycle Operations
Funding the Mission
to Fullfill the Mission

Revenue Cycle Operations

UTMB Health Revenue Cycle Operations creates a culture of excellence built by providing outstanding service. We do this through accurate verification of patient eligibility and timely billing of services. Our objective is to secure optimal reimbursement while maintaining excellent customer service. As a world-class revenue cycle organization, we will continue to be proactive and innovative through the integration of our diverse departments. Unified, yet independent, our teams collectively maintain the momentum which moves the mission of  the UTMB system.

Our Mission

To optimize revenue and reimbursement through strategically driven initiatives contributing to the organization’s financial health and patient satisfaction. 

Our Promise

Based on our extensive experience, we will cultivate a culture of trust, perpetuate patient care, analyze revenue, encourage efficiency, identify performance trends, communicate objectives with clarity and develop customized solutions across the entire revenue cycle.
This site addresses a number of common financial and billing questions under the billing team’s department home page. If you do not find the information you need, please contact one of our Customer Service Account Specialists at (409) 747-1099 or (800) 435-1871.

Our History:

Historically known as separate entities: Physicians’ Billing Services, Hospital Patient Financial Services and Admitting, have integrated into oneRevenue Cycle department, with the welcome addition of the innovation and support from the Solutions and Strategy Teams. Together, these areas leverage processes, technologies, relationships, and business structures to heighten the financial performance of UTMB Health. Through our proficiency in the Epic billing system, we are gaining efficiencies in our collection and billing processes while maintaining compassionate customer service with our patients. The amalgamation of these separate entities under one, unified department has ensured cohesion in mission and action toward achieving our goals and endowed us with innovation and adaptability through our diversity.



Revenue Cycle Operations Departments

Patient Access Team


Commitment


The Revenue Cycle Patient Access team has the most contact with the patient out of any of the RCO departments, as they are most involved with the pre-care patient treatment. Patient Access is responsible for patient registration, surgery planning and eligibility. Spread over two locations and with a staff of over 75 employees, this team, with the guidance of Director Gretchen Hall, successfully establishes a positive point of contact for the patient to receive care and begin the revenue cycle process. This team is also engages the patient in financial counseling in order to maximize not only their quality of care, but their quality of life after medical treatment has been received.


Contact


Director Gretchen Hall
Phone: (409) 772-6991
E-mail: ghall@UTMB.EDU

Coding Team


Commitment


The Revenue Cycle Coding team of over 80 individuals supports UTMB Health and UTMB clinics in encounter documentation and data interpretation. Through our innovative information systems and our diligent coding specialists, with the management of their Director Melody Dowler, we are able to ensure quality assurance in the capture of all healthcare encounters throughout the fiscal year. Our coders operate both in house at Shearn Moody Plaza and remotely, in order to encourage accessibility, productivity, quality and ease for our valued team. During training periods, our coding team will also visit campus and clinics to assist in clinical documentation training.


Contact


Director Melody Dowler
Phone: (409) 266-8929
E-mail: mrrogers@UTMB.EDU


Billing Team


Commitment


The Revenue Cycle Billing team is responsible for timely billing and processing of denials for all of our hospital and professional claims, as well as the fiscal mitigation of our special contract relationships, the financial management of our UTMB research accounts and provider enrollment to all payors. Our Billing team, understands the time sensitive nature of processing reimbursement for the UTMB enterprise and executes their contribution to RCO with prompt diligence; however, they do not lose sight of customer service or patient sensitivity. Our billing department works as much for our patients as for our providers, and assists with all payment options and queries, redirecting potential candidates for financial assistance to our esteemed customer service specialists or eligibility team in order to ensure quality care without compromising quality of life.


Contact


Director Kara Campbell
Phone: (409) 772-0861
E-mail: kgcampbe@UTMB.EDU


Denials Team


Commitment


The Revenue Cycle Denials Management team, led by Director Sharon Richter, is responsible correcting denials of reimbursement for medical care in order to optimize revenue. After the patient has received care and that claim for care will be sent out to a payor to receive payment. Sometimes, the payor finds that documented claim insufficient. It is the Denials team's responsibility to mitigate the denial and attempt to root cause correct the error in order to prevent any unnecessary loss of reimbursement to our facility or faculty.


Contact


Director Sharon Richter
Phone: (409) 747-1038
E-mail: sjrichte@UTMB.EDU


Patient Accounts Team


Commitment

The Patient Accounts team has our most interaction with patients outside of the hospital or clinics, as they are responsible for all customer service post care. This team concludes all "back-end" Revenue Cycle responsibilities in payment posting and patient payments.



Contact


Director Patricia Ojeda
Phone:(409) 772-0865
E-mail: pojeda@UTMB.EDU

 

Project Management Office


Commitment

The Project Management Office (PMO), led by AVP Blake Sollenberger, is RCO's answer to the opportunities for efficiency discovered in our diverse billing processes. As our billing systems become more sophisticated and notation becomes more specific and critical to claim success, our technological solutions increase in demand. In order to guide these process driven initiaitives, we have asked our PMO to guide our projects to success.

 

Contact


Administrative Assistant: Sherlyn Dyda
Phone:(409) 747-1130
E-mail: sdyd@UTMB.EDU


Strategy Team


Commitment

The Strategy team drives innovative tactics to improve process flow and gain efficiencies to simplify and hone RCO operations. In response to the growing complexity of the healthcare revenue cycle, this versatile team maintains the stability and effectiveness of internal operations and encourages external relationships with our vendors, stakeholders, community and clients. Our areas of responsibility include strategic planning, executive and operational support, budget management, employee excellence and strengthening relationships with our customers.

 

Contact


Director: Michelle Cantrell
Phone:(409) 772-7791
E-mail: mdcantre.EDU

 

The Road Ahead for Revenue Cycle:

As we further develop greater cohesion between our diverse departments, our teams are inundated with increased innovation, progressive process enhancement and creativity in effective communication across all specializations in this department. It is with diligence in our daily accomplishments and compassion for our patients that Revenue Cycle excels in its efforts to encourage the function and vitality of UTMB.
Our Project Management team is congruously in perpetual development and training mode, building a smarter way to work better. Our Strategy team is guiding our mission through to fruition, as they work to encourage daily decision making in closer alignment with future focus. Our Patient Access and Patient Account teams execute our day to day action plans through the full arc of patient care, as they motivate quality and sustain success across the organization. Our Coding team persists in precision as they assure accountability through accurately captured healthcare encounters. Our Denials Management team is our champion of maintaining efficiency while our Billing team strives toward enabling excellence in reimbursement efforts. All teams work in tandem and tenacity with our Administration, driving greatnessat the forefront of our united efforts.
We understand at RCO that excellence is an achievement to be maintained, while greatness must be ever strived after. This department is the embodiment of the guiding principle of UTMB: Working together to work wonders.