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Case Study: Implementing Charge Capture and Optimizing Cash Flow

Aug 17, 2007
Most doctors enter the health care profession because they want to care for people. But it doesn't take long for many to realize that they are spending just as much time running the business as caring for patients. Providing outstanding health care, while keeping the revenue cycle running smoothly, is a big challenge. But today's technologies can make it easier and, as one physician practice has learned, it can be as easy as using a mobile phone or PDA.

Room for Improvement:

As pay-for-performance programs become the norm, terms such as efficiency, effectiveness,patient satisfaction and ease of doing business are becoming an integral part of the language of running a practice. These terms have become the watch-words of businesses around the world as they institute change to improve customer service and management of the financial side of the business.

At the same time, we have seen a shift toward a more consumer-driven healthcare system and demands for higher quality healthcare. Patients expect a comfortable office with efficient service, accurate billing, and a reasonable response time when they have an urgent question. In this environment, the business side of the practice has a bigger impact on the patient experience than ever before.

It's time for the healthcare industry to take a page from general business management and gain the performance improvements that come from optimizing practice management. Several areas within a typical practice provide an opportunity for increased accuracy and optimization. Three of the most prevalent are coding, billing and collections, since they represent a significant opportunity for managing cash flow, with a high potential for solid financial returns.

Going Mobile: One Case Study

In one five-physician nephrology practice, an investment of $2,679 in coding, billing and collections generated an annual increase in revenue of $37,473.

The improvement process began with a thorough analysis of the practice's existing processes and procedures, as well as the tools used during rounds and for billing and collections. Interviews of key personnel revealed issues in the following areas:

* Down-coding too frequently when code selection was not clear
* Reduced charges due to coding errors
* Lost charges due to misplaced forms
* Lower collection rates when records were incorrect
* Increased insurance denials due to late submissions
* High denied-charge write-off rates that seemed to track insurance denials

The physicians had been capturing patient information, diagnoses and codes using paper forms, which were collected throughout the day and returned to the office for processing at the next available opportunity. Frequently, the forms were misplaced, illegible or incorrectly coded, requiring the doctors to take extra time away from their patients to get them right.

Over the course of an entire year, the total revenue impact of this lost time alone totaled $12,558. The lengthy process also often exceeded the allowed processing time, and insurance companies were refusing to pay.

To overcome these challenges, this practice implemented a Web-based mobile software tool to capture patient information, procedures and diagnoses. Because these physicians spend the majority of their time away from the practice, working at patients bedsides in local hospitals, they needed a solution that would allow each doctor to capture data while on the go.

This charge capture solution can run on PDAs as well as other mobile devices, such as mobile phones. Data can be sorted by patient or by doctor, the software handles scheduling for rounds, and allows the transfer of patients between providers. It also provides a customized set of codes, so the doctors don't have to page through codes that don't apply to their specialty. It even has text recognition so a description can be automatically completed by the software after typing three to four initial characters.

These mobile devices synch with a central Web-based database, so all patient data resides in a central location accessible by authorized staff members, with no special technical expertise required. The mobile devices can synch utilizing multiple technologies such as cellular, blue tooth, wireless, IRDA or cradle. When synchronization occurs any new data on the mobile device is sent to the central servers and new data on the central servers is sent to mobile device. In fact, when one of the doctors devices was accidentally damaged he feared that he'd lost many records. But because the data had been synched with the central servers within minutes of finishing his rounds, all the data was intact on the central servers.

Best of all, the solution can be uploaded to a mobile device and operational in less than an hour.

Because the new system dramatically reduced errors and re-work time, the practice recaptured its $2,679 hardware and software investment in less than two months. Over one year, the practice increased revenue more than $37,400.

An Investment that Pays Off

By investing a small amount of time and money in implementing and learning a new technology, practices can dramatically simplify billing, coding and collections processes; increase charge capture and revenue collection; decrease denials and write-offs; and free up more time to spend with patients. And isn't that why you became a physician?
About the Author
James Casey is a certified six sigma black belt and project management professional (PMP). He has 15 years experience as a leader in the healthcare and technology industries implementing technology solutions.
To learn more about charge capture technology please visit MediMobile. http://www.medimobile.com
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