Impact Insights

Lessons Learned: General Ledger Revenue Mapping

Andrew Pratt

Imagine you go grocery shopping and have 10 items on your list. What would be more efficient, making 10 separate trips to the store and getting one item each time or going to the store and getting all 10 items during one visit? It’s obvious, make one trip! At this point, you’re probably thinking to yourself, “Thanks Andrew for that lesson learned and incredible advice. I’ll be sure to ask you if I’m having trouble deciding between flying or taking a boat to Europe (flying is probably your best bet by the way).” Believe it or not, when a Revenue Cycle project involves Charging and General Ledger Revenue build/design, the two designs are often (if not always) completed at different phases of the project and often times by different teams. Why is this the status quo when these two areas are so intertwined?

Well, at my current project, we decided to shake things up a bit and instead of completing the Charging and General Ledger designs in separate stages of the project, we implemented them simultaneously. More specifically, we asked our client counterpart to provide the list of all chargeable items for a particular department and identify the cost centers that applied to that department. From there we added the identified cost centers to our General Ledger Data Collection Workbook (DCW) so those could be mapped concurrently with the charging design/build. We then repeated this process for every single department.

Let’s pause and let me explain why this has been so helpful. Early on, we afforded ourselves plenty of time to do the required due diligence to ensure all cost centers were mapped appropriately and how they’d be designed within the EHR Revenue Cycle. One of the greatest challenges faced with General Ledger Revenue design is that it is done after much of the Charge Services build/design have completed. While this isn’t necessarily a Shakespearian tragic flaw, it can (and usually will) cause issues when it comes to deciding which qualifiers are selected to route revenue correctly. By concurrently designing the General Ledger DCW alongside a department’s Charging design, we can immediately pinpoint the scenarios and attributes that will route revenue in the most efficient manner and ensure we understand how revenue is currently routed so that we can replicate that process in the future Revenue Cycle system.

Additionally, the concurrent design has allowed for the opportunity to provide our client counterparts a more in-depth explanation of the General Ledger design. As we know, change can be extremely difficult; especially when it involves a complete transformation of processes, tools, and technology that have been in place for years or even decades. However, by completing the design in an iterative and steady manner, our clients have a much better understanding of how revenue will be routed using the future Revenue Cycle system.

In conclusion, I would encourage you to consider this strategy as you plan future Revenue Cycle projects, regardless of the Revenue Cycle system being implemented. Concurrent design of Charging and Revenue Capture will improve accuracy and maximize efficiency of the General Ledger Revenue design.

All parties involved in this project were very satisfied with the method we used. Thank you for spending some of your important time listening to my thoughts and I hope you found this to be a valuable lesson learned and perhaps slightly more helpful than my travel advice I alluded to earlier. Best of luck to you all in your future endeavors and implementations.