Dartmouth-Hitchcock Heath Realizes 12.6% Increase in Cash Collected Over Baseline Through Improved Revenue Cycle Operations

2018-08-22T11:13:28+00:00 May 22nd, 2018|

Dartmouth-Hitchcock Health Realizes 12.6% Increase in Cash Collected Over Baseline Through Improved Revenue Cycle Operations


Dartmouth-Hitchcock (D-H) is a nonprofit academic health system serving communities in northern New England. D-H provides access to more than 1,000 primary care doctors and specialists in almost every area of medicine at Dartmouth-Hitchcock Medical Center (the state’s only academic medical center); the Norris Cotton Cancer Center, one of only 49 Comprehensive Cancer Centers in the nation; the Children’s Hospital at Dartmouth-Hitchcock; four affiliate hospitals; 24 ambulatory clinics across New Hampshire and Vermont; and through the Visiting Nurse and Hospice for Vermont and New Hampshire.


D-H had two primary areas of focus to drive business outcomes for their health system. First, they wanted to maintain and enhance their day-to-day revenue cycle performance. This meant better managing the Single Business Office (SBO), improving cash collections and patient satisfaction, as well as creating a more robust financial assistance program to help uninsured or under insured patients. Additionally, D-H had several high-priority strategic initiatives that required strong integration expertise and significant Epic knowledge and experience.


D-H partnered with Conifer Health Solutions to assume operational management of the revenue cycle for the entire health system, including physicians, outpatient surgery centers and imaging centers. As D-H’s service provider, we supported key strategic initiatives including a “OneTouch” Customer Service approach, Epic revene cycle applications implementation, as well as ICD-10 conversion support.

D-H is achieving sustainable long-term financial performance, while focusing in on key health system strategic initiatives.

Dartmouth-Hitchcock localized their customer service model, improved performance in their SBO and successfully operationalized strategic business projects across the health system.

Implemented ‘One Touch’ Customer Service Approach

Resolved patient billing issues during the initial call, improving overall patient satisfaction with the billing process. By improving operational efficiency, we helped the customer service team be more effective and produce significant results.

Improved Performance in the Single Business Office

Focused on implementing Conifer’s revenue cycle operational best practices, including automation and workflow and a team of Revenue Cycle expertise to help improve D-H’s performance with a previous vendor.

Completed High-Priority Strategic Initiatives

Focused on improving revenue capture opportunities and facilitating transparent access to data for the Epic ADT implementation. Worked closely with the client using a cross-walk approach and ensured all issues were addressed timely during the ICD-10 conversion.


By collaborating closely with D-H on the best revenue cycle operational approach and flexible ‘one-touch’ customer service methodology, D-H improved financial outcomes and satisfaction with patients in the tight-knit community.

Chief Financial Officer Dan Jantzen says “Conifer Health has helped D-H achieve significant improvement in patient satisfaction with billing-related issues and key revenue cycle financial metrics.” Some of these improvements include:

  • Reduced inbound customer service calls by 13.7%
  • Reduced abandonment rate by 50%
  • Decreased the number of executive/administrative escalations
  • Improved every customer service survey response category
  • Improved Point-Of-Service (POS) collections by 40%
  • Reduced Initial Denial Rates by 23%
  • Decreased ‘Aged A/R > 90 days’ by 20%

Now, the SBO Net Days in A/R are at a historic low for the system and D-H has exceeded their cash collection goal by 101% in 2017. In addition, D-H was recognized as an Epic Top Performer – Ranking in the Top Quartile in DNFB, Candidate for Bill (CFB), Coding Days, and Billed Lag Days.


Revenue cycle performance

65% Growth

in average monthly cash collections from 2013 -17

13 Day

in A/R days resulting in an additional $70 million in balance sheet cash as of June ‘18

“Conifer Health outperformed in FY2017, reducing A/R days from 60 to 47 days and achieving 104% of the cash collections goal. Thanks for your responsiveness and thanks for producing these results. It is greatly appreciated!”

— Dan Jantzen, CFO,

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