• Boston US-NY
Gregory Kanetis, MPA

Gregory Kanetis, MPA

Revenue Cycle Management Subject Matter Expert

Summary

A Healthcare Revenue Cycle Management professional with 20+ years experience in: revenue cycle management, productivity improvement, administration, management, strategic planning, development of strategic alliances, budget preparation and management, credentialing, IT system conversions and implementations, negotiations, practice management systems, and customer relationship development. Proven success streamlining business office functions, and processes within healthcare facilities and group practices while greatly increasing profitability and revenue growth. A visionary known for an ability to see the “big picture,” understanding consequences of actions/inactions, and keeping an eye toward fiscal responsibility and employee empowerment. Holds a Masters Degree in Healthcare Administration.

Outstanding Accomplishments

  • Successfully improved end to end revenue cycle functions resulting in 97% registration accuracy, copay collections increase by over 800%, denials reductions by over 50%, cash collections increase by 10%, days in AR in the mid 40’s, bad debt reduction of 20%, and reduced credit balances by 84%.
  • Redesigned the entire revenue cycle function for a facility operating a nursing home, hospital, and outpatient clinic. At the inception of the project all billing was done on paper, no automated insurance eligibility verification, and no automated follow up functions existed. A/R days were reduced from 63 to 51days with full revenue cycle automation and a clean claim rate of 99.35% achieved.
  • Developed annual budget forecasts and successfully managed budgets in excess of $35M dollars.·     Planned and coordinated revenue cycle functions for a $100M healthcare facility resulting in 20% reduction in A/R days.
  • Collaborated with executive leadership to pursue new business office operations resulting in significant cost reductions in excess of $350K annually.
  • Negotiated with executive level leadership to invest in computer programming services; reducing accounts receivable by $3.8M over 3 months.

Work History

Work History

Director, Patient Financial Services

2013 - Present
Lawrence General Hospital - Director, Patient Financial Services

Directing all revenue cycle management/operational functions related to $550 million in billing and collections for a 189 bed community hospital with 75, 000 ER visits and 330, 000 outpatient Article 28 visits. Over one hundred direct reports ranging from scheduling, pre-registration, financial clearance, registration, billing, cash control, follow up, collections, self-pay billing management, bad debt, and vendor management. 

  • Reduced accounts receivable from a high post implementation of $100 million in 2012-2013 to mid $50 million and AR days at mid 40’s in 2016.
  • Implemented tools, technology and processes at the front end resulting in reduced patient access denials by 50%.
  • Collaborated with team to created individual work queues for each biller depending upon certain criteria to drive efficient billing and follow-up.
  • Engaged a full ChargeMaster review resulting in findings yielding $2,000,000 in potential revenue lift.
  • Orchestrated the onboarding of all previously outsourced physician billing and integrated such to the HIS system, which was previously thought not possible resulting in a savings in excess of $350,000.
  • Collaborated with team and vendor to create split billing functionality within HIS system resulting in the improvement of claims processing by over15%. This was previously though not possible.
  • Created sets of dashboards and metrics monitoring tools in business intelligence application to manage accounts receivable on a daily detailed basis.
  • Collaborated with consultants to redesign the financial counselors program effectively transforming the role from benefit specialists to true financial counseling resulting in better co pay collections and insurance application process.
  • Implemented the HFMA Certified Patient Communications Program and required all financial counselors to take the program. We were the first hospital in the northeast and second hospital nationally to implement such a program.
  • Collaborated with a nationally recognized consulting firm to redesign the patient access process of the front end revenue cycle resulting in improved registration quality from an accuracy rate of low 80% to 97%, increased copay collection by 800%, and denials reductions of 50%.
  • Researched, negotiated, and implemented a revenue cycle training curriculum for entire staff.
  • Exceptional vendor management relationships resulting in new ideas to reduce AR balances and improve collections.
  • Continuously improving operations resulting in reduction of staff by 8 FTE’s.
  • Redesigned cash control processes resulting in increased efficiency and a 40 % reduction in staff.
  • Exceptional technical expertise, team builder, and collaborator.

Consultant

2012 - 2013
Masonicare Healthcare Center Independent Meditech Revenue

Brought in initially to resolve aged claims attributing to increasing A/R. Upon initial review of systems and practices the project expanded to a complete revenue cycle redesign. Areas under review and redesign include patient access, billing, collections(internal and external), billing system set-up, HIM, ChargeMaster, and Policies and procedures.

  • Performed complete analysis of the Meditech billing system and all sub-systems. This review included all dictionaries and master files set-up. Re-designed and rebuilt all RUGS, DRG, and APC billing functions within the billing system. The redesign included building or rebuilding insurance dictionaries in the MIS module, B/AR module, and claim format files.
  • Created Meditech biller, collector, and denial management desktops to route rejected, and denied claims to appropriate staff for follow-up resulting in a more efficient workflow and reducing the need for paper report compilation.
  • Reviewed all managed care contracts and worked with the contracting manager and IT to build appropriate dictionaries and reports to effectuate electronic billing to all carriers and monitor contract performance.
  • Re-designed, built, and streamlined the collector desktop for all self-pay collection practices complete with referral to outside agencies.
  • Brought Emdeon in as clearinghouse scrubber and insurance eligibility verifier. Managed implementation of such. At the start of the project there were no electronic claims being produced. Currently the clean claim rate stands at 99. 35%.
  • Collaborated with all levels of staff to facilitate a more efficient, productive workflow solution regarding unbilled claims. At the start of the project the level of unbilled claims exceed $3,000, 000. Currently the level of unbilled is $1,200, 000.
  • At the inception of the project the A/R days were at 63 throughout the redesign process the A/R days were reduced to 51.
  • Collaborated with all levels of revenue cycle staff, CFO, IT, and consultants to create a detailed work plan which contains in excess of 300 tasks to be completed.
  • Re-wrote all business office policies and procedures relating to revenue cycle functions.
  • Reduced the amount of time it takes to complete month end closing from 3 days 8-10 hrs
  • Improved revenue cycle process by accelerating billing cycle from mid-month and monthly to weekly.
  • Implemented insurance verification module through Emdeon for all patient access areas.

Director Revenue Cycle

2009 - 2012
Patient Access Solutions, Inc.

Developing National team dedicated to driving top line revenue growth. Leading revenue cycle consulting engagements related to: EMR/EHR/PHR systems, billing systems for hospitals, SNF's, medical and dental providers, digital pen solutions for home health providers, payment processing solutions, practice management, and full revenue cycle consulting engagements from patient access to collections.

  • Created and maintained successful relationships with vendor partners, clients, and new customers; consistently bringing in new business. Presented Patient Access Solutions as a“ full solutions” provider; conducting meetings, presentations, and demonstrations on products and services.
  • Developed Revenue Cycle Management Departments, and participated in design and analysis of Electronic Medical Record software.
  • Developed end to end revenue cycle policies and procedures for clients resulting in more efficient processes leading to significant reductions in A/R days.
  • Conduct and manage gap analysis with respect to breaks in revenue cycle. Recommend and implement new processes thereby eliminating the breaks and closing the gaps.
  • Developed tools to monitor client analytics and performance; pro-actively engaging clients to discuss analytics, performance, operations improvement, and overall relationship management.

Operations Director

2005 - 2009
Imagine Healthcare Financial Services, Inc.

Provided short and long-term operational and administrative management services for a variety of health care and local organizations in need of re-organization, streamlining, and restructuring of services.

  • Handled full evaluations of income and expenses for a variety of healthcare organizations; making recommendations on restructuring, improving systems and services, reducing staff, and closing non-performing operations while increasing revenue.
  • Took over operations for a Nuclear Cardiac Imaging division of a health care organization; working collaboratively with corporate departments and improving credentialing access to managed care plans. Efforts resulted in increased revenue production, and improvements in the account receivable process through an aggressive restructuring plan resulting in a 20% increase in collections.
  • Brought in to manage all business, strategic planning, and customer service functions for an Ambulatory Surgery Center with 6, 150 cases and $6.5M in net revenue annually. Reviewed all operations, contracts, vendor agreements, and made staff changes to turn around a 5-year unprofitable venture that had been outside managed and owned by a group of physicians.
  • Brought in to turn around chronically mismanaged dialysis center with 24 stations, 4 shifts, and 29, 000 treatments. Reorganized staff, reinforced and reinstated company policy, procedures, and state department of health regulations; resulting in net revenue of $4. 7 annually, building to successful acquisition by DaVita.

Administrator

2004 - 2005
Western Queens Dialysis Center

Responsible for the set-up of a new billing system and overall management of a dialysis center with 11, 000 treatments and $1.8M in net annual revenue.

  • Strategically planned, implemented, and managed billing system and collections functions; saving the organization over $200K annually.
  • Developed and implemented new billing system from scratch; setting up computer and software systems, negotiating contract for practice management system, hardware, and support services. Worked with clearing-house to establish submitter ID numbers, and set up all master files and patient files. Achieved full set-up within 45 days.

Administrator

2003 - 2004
Beth Israel Medical Center

Managed 3 chronic dialysis centers with over 142, 000 treatments annually, as well as a peritoneal dialysis program with 56, 000 treatments, and 5 acute dialysis hospital programs generating $35M annually.

  • Led all program services for multiple site administration including: budget process, forecasting, managing vendor and union relations, managing accounts receivables and payables, and payroll.
  • Successfully developed customer relationships with executive level leadership, 140 staff, union leadership, and 500+ patients. Established“ dashboard” with metrics, allowing easy and effective management of each business aspect.

Administrator

2001 - 2003
Atlantic Dialysis Management Services, Inc.

Administrator of multiple sites including: an 8 physician owned $3M Nephrology practice, and a 24 station 12, 000 treatment Newton Dialysis center with $2M in annual revenue.

  • Strategically planned and implemented a billing and practice management system, recommended process improvements, and saved the partnership $110K.
  • Created a new network for the organization through IT management; reviewing payment processing, streamlining the A/R and A/P processes, and utilizing the Medical Manager system to actively mange patient registration, insurance verification, charge entry, billing, payment posting, bank reconciliation, and to follow-up to unpaid claims processes.

Administrator, Ambulatory Care

1998 - 2001
Terence Cardinal Cooke Health Care Center

Administrator, Financial Services

1997 - 1998
Terence Cardinal Cooke Health Care Center

Director, Patient Accounts

1996 - 1996
Terence Cardinal Cooke Health Care Center

Responsible for Administration management and streamlining business processes to gain efficiencies resulting in higher revenue collections and lower expenses for the organization.

  • Managed Revenue Cycle department, Admissions, and Credit and Collections departments with total revenues in excess of $100M.
  • Developed strategic plans, goals, and objectives, and managed 2 separate $3M outpatient programs.
  • Implemented process improvements and monitored positive results in the patient scheduling functions; translating into reductions in no-shows and increases in billable revenue. Led and managed cross-functional project teams and external consultants ensuring timely implementation of practice management systems.
  • Served on quality Improvement Committee; acting as facilitator of Quality Improvement for the organization.
  • Partnered with multiple departments and vendor management to create effective utilization of Practice Management System by interfacing with clinical documentation, lab, and inventory systems.

Education

Education

M.P.A

2000 - 2002
Long Island University - New York

Masters Degree in Public Administration with a concentration in Healthcare. Graduated with Honors Pi Alpha Alpha Honors Society.

B.S.

1979 - 1984
St. John's University - New York

Bachelors of Science Degree in Healthcare Administration

Skills

Skills

McKesson Paragon

Hospital and Long Term Care Software

Merchant Services Processing

Business Intelligence Software

McKesson Business Intelligence

Denials Management Software

Healthcare Revenue Services

ClearingHouse Software

Emdeon (Change Management), RelayHealth

Contract Evaluation/Management

Acquired skill set

Microsoft Office

Excel, Word, Outlook, Powerpoint, Notes

Meditech B/AR

Hospital and Long Term Care Software

Credentialing Software

Source Medical

Ambulatory Surgery Software

American Healthcare Software

Long Term Care Software

Keane Systems

Hospital Systems Software

Medical Manager

Physician Billing Software

Azzly EMR

Physicians EMR