Palms Home Health Care


Based in Tampa, Florida, Palms Home Health Care (Palms) is a Medicare-certified home health agency with a mission of empowering people toward proactive, holistic and comprehensive health care in the comfort of their own home. The agency partners with the patient, the physician and the community to encompass all aspects of the care continuum for the common goal of restoring and maintaining patient outcomes.



The Challenge

Palms identified numerous significant outstanding balances in its accounts receivable (AR). They initially reached out to Richter to help address these balances. Yet, after a discovery call, Richter’s performance advisors concluded that many of these balances were uncollectible. Moreover, it was apparent that Palms lacked the proper revenue cycle structure to minimize outstanding balances and lost revenue. Identifying the root causes of these issues was essential, so Palms instead engaged Richter to perform a thorough process review.

The Solution

Richter’s financial process review for Palms was extensive and included interviewing staff from intake through billing and follow-up; reviewing the configuration and utilization of revenue cycle management software; examining the organization’s policies, procedures, job titles and job descriptions; and analyzing all aging receivables. Some questions we asked included:

  • How do you get your incoming referrals
  • What are your referral sources?
  • When you get that referral, what’s the first thing you do?
  • Who does the verification on the payer?
  • Once you get the verification, who follows up on it, and how is it documented? Is it in the system, or is it something that you write down on a piece of paper? If it’s paper, who has it? How do we know it’s correct?

Overall, our review dove deep to review inherent processes throughout the organization and identify bottlenecks and other issues.

The Results

Through our process review, we concluded that Palms’ financial staff were assigned overlapping duties that led to process gaps and procedural missteps. Financials weren’t being managed properly, and important deadlines and milestones were missed—either because no one was assigned to handle them, or people weren’t sure of their roles and hesitated to step on other colleagues’ feet. Other than the CFO, Palms lacked specific revenue cycle leadership. Therefore, we recommended assigning a current and qualified staff member the title of Director of Revenue Cycle and provided a full list of duties and responsibilities.

Furthermore, while internal revenue cycle processes were in place, they lacked an adequate structure around them. Therefore, we provided recommendations on establishing a structure to bind those processes in logical ways; we also advised Palms on strategies for adjusting certain balances and utilizing their EHR system more effectively.

In the end, Palms successfully integrated the new Director of Revenue Cycle into their role and implemented corrective measures we recommended to manage aging receivables.

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