FTE Model 101: Balancing Resource Capacity And Demand

FTE MODEL 101: BALANCING RESOURCE CAPACITY AND DEMAND

UNDOUBTEDLY, DOCTORS AND NURSES ARE YOUR HOSPITAL’S MOST VALUABLE ASSET, AND SO ARE THE MEDICAL BILLERS AND CODERS. WITH THEM, YOU COULD BILL YOUR SERVICES

ACCURATELY AND TIMELY AND GENERATE REVENUE. HOWEVER, THEY ARE ALSO YOUR HOSPITAL’S MOST EXPENSIVE COST. IF YOU DON’T KEEP THEM BUSY AND REAP MAXIMUM BENEFITS, THEY’LL EAT AWAY AT YOUR PROFITS. YOU NEED ENOUGH MEDICAL BILLERS AND CODERS TO CAPITALIZE ON YOUR OPPORTUNITIES, BUT ONLY A FEW OF THEM TO SIT ON THE BENCH. THE CONFLICT BETWEEN HIRING AND FIRING IS ONE OF THE MOST SUBSTANTIAL AND UNRESOLVED IN RUNNING A SUCCESSFUL HEALTHCARE ORGANIZATION. THE RESOURCE CAPACITY VS. DEMAND EQUATION MUST BE SOLVED TO STAY PROFITABLE AND SUBMIT CLAIMS TIMELY. THE BEST WAY IS TO UTILIZE THE FULL-TIME EQUIVALENT MODEL, I.E., THE FTE MODEL.

How to maintain a balance between resource capacity and demand:

• RESOURCE CAPACITY

ANY EMPLOYEE’S (MEDICAL BILLERS AND CODERS) CAPACITY IS THE TOTAL NUMBER OF STANDARD HOURS AN INDIVIDUAL IS AVAILABLE TO WORK UNDER THE TERMS OF THE AGREEMENT. HOURS, FTE (FULL TIME EQUIVALENT), PERSON DAYS, PEOPLE, AND OTHER UNITS OF RESOURCE CAPACITY CAN BE USED.

• RESOURCE DEMAND

THE PROCESS OF CALCULATING THE RESOURCES NEEDED TO MEET THE DEMAND FOR VARIOUS BILLING AND CODING TASKS IS KNOWN AS RESOURCE DEMAND. THE UNIT OF DEMAND FOR RESOURCES IS MEASURED IN HOURS, FTE, PERSON DAYS, AND SO ON.

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THE BALANCE BETWEEN RESOURCE CAPACITY & DEMAND

IT IS THE PROCEDURE OF BALANCING THE EFFORT AND TIME OF THE BILLING TEAM WITH THE REQUIREMENTS OF THE SERVICES TO BE BILLED FOR GETTING REIMBURSEMENT FROM THE INSURANCE COMPANIES. IN OTHER WORDS, IT FORECASTS WORKFORCE RESOURCE (MEDICAL BILLERS AND CODERS) SHORTAGES OR EXCESSES IN THE SHORT OR LONG TERM. IT IS COMPUTED BY ANALYZING THE GAPS BETWEEN RESOURCE CAPACITY AND RESOURCE DEMAND. THIS DIFFERENCE CAN BE MEASURED IN HOURS, FTES, OR PERSONAL DAYS. THERE IS A SHORTAGE WHEN RESOURCE DEMAND EXCEEDS CAPACITY OR SUPPLY. EXCESSIVE RESOURCE DEMAND EXISTS WHEN THE RESOURCE DEMAND EXCEEDS THE CAPACITY OR SUPPLY.

Why is balancing important?

A LACK OF PROPER RESOURCE PLANNING CAN ERODE YOUR DOCTOR’S AND PHYSICIAN’S EFFORTS AND EVENTUALLY LEAD TO ZERO OR NO REIMBURSEMENTS. HERE IS A STEP-BY-STEP BREAKDOWN OF HOW IT CAN DERAIL REIMBURSEMENTS:

● POOR PLANNING WILL RESULT IN OVERWORKING AND OVERSCHEDULING THE IN-HOUSE BILLERS AND CODERS WITH CONFLICTING PRIORITIES, EVENTUALLY LEADING TO EXHAUSTION AND BURNOUT.

● WHEN IN-HOUSE TEAM MEMBERS ARE OVERWORKED AND OVERSCHEDULED, THEIR MORALE SUFFERS.

● WITH LOW MORALE, SUCH TEAM MEMBERS CANNOT GIVE THEIR 100% IN BILLING AND CODING WORK, LEADING TO AN ENDLESS REWORK CYCLE ON CLAIMS SUBMISSION.

● ALL THIS WILL ENHANCE THE TIME AND COST FOR HEALTHCARE ORGANIZATIONS, WITH A HIGH RISK OF DENIALS OR REJECTIONS OF CLAIMS.

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