Boosting Productivity, Improving Patient Satisfaction, Increasing Revenue by: Combining Lean Methods with New Informatics Tools to Collect Accurate Patient Information at Time of Service Connie Bratton Manager, Patient Services and Specimen Processing Executive War College May 3, 2017
Who is The Medical Foundation? Over 100 Years of Service in the Community Formerly South Bend Medical Foundation until 2013 Serves Hospitals, Physicians and Patients Provides quality and cost effective: Pathology Laboratory Blood bank services Over 750 employees; 20 pathologists 24/7 Laboratory Operations 90 million net revenue Over 6,000,000 tests/year
Who is Connie Bratton Worked for TMF for 20 years Manager, Patient Services and Specimen Processing Manages 23 Patient Service Centers, Physician Office sites and full service Charged with working directly with Billing department to ensure insurance claims are submitted completely and accurately Develops strategies to grow business
Connie s Service Site Locations Connie manages 23 Patient Service Centers Bittersweet Medical Associates Granger, Indiana Bristol Family Practice Bristol, Indiana Central Lab Patient Reception South Bend, Indiana Central Lab Phlebotomy South Bend, Indiana Crossroads Healing Arts Elkhart, Indiana Elm Road Medical Campus Mishawaka, Indiana Fairhaven Fairhaven, Indiana Family Practice Associates Elkhart, Indiana Goshen North Goshen, Indiana Mishawaka Medical Arts Mishawaka, Indiana BMG Nappanee- Nappanee, Indiana NIMA-Kendallville (Northeast Internal Medicine Assoc.) Kendallville, Indiana NIMA-Lagrange Lagrange Indiana River Oaks OBGYN- Elkhart, Indiana University Commons Mishawaka, Indiana Wakarusa Medical Clinic Wakarusa, Indiana Green Castle Greencastle, Indiana Terre Houte- Terre Houte, Indiana Greenwood- Greenwood, Indiana Indianapolis Nursing Homes- Indianapolis, Indiana Greencroft- Goshen, Indiana Specimen Processing- South Bend Main Campus
Medical Foundation Challenges Data Coming from PSC s had a Negative Impact on Billing Operations! Unacceptable denial rates Delays in submitting claims High rates of return mail Environment has had negative impact on DSO Patient Responsibility increasing dramatically What Can We Do To Improve Quality of Data without Affecting patient wait times? Average Patient Deductible is nearly $5K and increasing
Medical Foundation Challenges Items that Negatively Impact Billing: Missing, Incomplete or Inaccurate in the following areas: Patient Data Insurance Data Subscriber Data Name Insurance ID Name Address Address of Insurance Company Address Contact Plan Information Contact DOB DOB DOB SS # SS # SS #
Medical Foundation Challenges Items slowing claims processing Incorrect or missing patient information Insurance claims must be edited and re-filed Name misspelled Incorrect DOB Incorrect insurance information Selecting the correct Insurance payer Government challenges Medicare Challenge HMO Medicaid Challenge HMO
Medical Foundation Key Reasons for Poor Patient Data MANUAL PROCESS CAUSING Typographical Errors Errors recognized after patient gone Slow process of patient registration Mistakes when choosing the correct payor/plan type Patient and Insurance Data Not Validated Hand Written Forms Name Changes Outdated information
Medical Foundation Challenges and Strategies Considered Challenge Strategy Eliminate Data Entry Errors Eliminate Typographical Errors Speed Up Process Validate Patient and Insurance Information at Time of Service Automate Data Entry into Atlas Drivers License Scanning
Why The Medical Foundation Chose tevixmd The Medical Foundation had been using traditional solutions that were not optimal. The tevixmd system was the only one that could address all the problems, meet our budget and not impact other departments.
The New Registration Process The Drivers License Patient Admissions Process The New Registration Process Returning patients are automatically re-validated in about 8 seconds! Any changes are easily transferred to SB OnLine. Patient provides drivers license. The PDF-417 image on back is scanned.
The New Registration Process Alternate Search Process The New Registration Process Search is completed. Next step, select the correct patient, address, and insurance company. This process takes about 15 seconds to complete. Patients with no drivers license are validated using a simple Last Name, First Name and Zip code.
The New Registration with Documents Pre-filled documents for each patient The New Registration Process Patient does not have to fill in their information each time which speeds processing.
The Medical Foundation Integration Simple fast integration using the tevixmd Transfer Agent The Transfer Agent was customized to move data into SB OnLine (Atlas) System used at our PSC. This process took less than 30 days and did not involve a third party vendor. Once patient has been validated, we click one button to transfer all of the patient s information.
The Medical Foundation Results As a result of limited data entry by our front line staff we experienced: Fast patient registrations No incorrect patient information Identity and Insurance No out of date patient information No typos No missing information No lost information
The Medical Foundation Implementation Deployment is cloud based very simple and requires limited I.T. Step one: Determine type of integration 1 day Target vendor or vendors Define what to integrate Define current process and rules Step two: Test integration 10 days (No IT involvement) Check to see if process matches current manual process Make sure data mapping is acceptable Step three: Deploy via web 1 day Provide users with login information Provide sites with scanners Train users
The Medical Foundation Training and Implementation Initial training Train the trainer Initial install at 2 of our busiest sites Optimal to spend whole day at each site Vendor spent 2 days supporting the Train the trainer On first day many top management were on-site observing and supporting implementation Follow-up Training Additional sites conducted virtually Trainers follow-up as needed Customer Support team available by phone
The Medical Foundation Implementation and Training What went right Top management support Got front line employees engaged and excited about rollout Showed how this makes their job better Managers received feedback and made changes to workflow without delay What went wrong Had a difficult time getting enough scanners Delayed implementation
Medical Foundation Improvement Metrics Current results: Reduced Errors in Patient Information by 50% Reduced Errors in Insurance Information by 50% Expected results: Reduce Initial Denial Rates by 50% Reduce Claim Rework by 50% Reduce Claim Process Time by 50% Reduce DSO by 30% Increase Cash Collections by 30% Reduce Patient Processing Times by 25% tevixmd Solution was installed on March 15, 2017
How Are We Doing? New Solution installed in 5 PSC sites All 19 PSC sites will be installed by Summer 2017 TMF Billing Staff now using tevixpas Using the tevixmd solution on every claim Staff is comfortable with new workflow and system tools
THANK YOU Connie Bratton Manager, Patient Services and Specimen Processing The Medical Foundation Ph: 574-204-4727 Cbratton@sbmf.org