Revenue Cycle Automation Helps Regional Health Center Maximize Resources

Transcription

1 A RelayHealth Case Study Revenue Cycle Automation Helps Regional Health Center Maximize Resources Sky Lakes Medical Center

2 2 Sky Lakes Medical Center is the definition of rural, the only hospital in a 10,000-square-mile area in south-central Oregon and northeastern California. The facility in Klamath Falls, Oregon, serves more than 100,000 residents of Klamath and Lake counties in Oregon, and Modoc and Siskiyou counties in California. But don t confuse rural with behind the times. To save on labor, reduce reliance on institutional knowledge and automate formerly manual processes, Sky Lakes has greatly increased its revenue cycle automation through a partnership with RelayHealth. Using a variety of revenue cycle management products from RelayHealth, Sky Lakes has seen a dramatic drop in A/R days, consolidated billing for 15 different physician offices, and gained new insight into its billing processes. A/R days reduced by 25 Cash/net revenue increased by 4 percent Efficient billing practices include analytics When it s all said and done, we have hospitals much bigger than us asking how we do things, said Andrew Molatore, director of Patient Financial Services. At HFMA meetings, I talk to people who are working now on issues we solved three to five years ago. I talked to one woman recently who was hiring three people for a process that we ve already automated. High level of integration among disparate EMRs

3 3 About Sky Lakes Medical Center Sky Lakes Medical Center is a not-for-profit, Program, where 24 standalone, community-benefit regional healthcare center that combines small town charm with big city medical expertise in its 176 beds. At the base of the Cascade Mountain Range s eastern slope, Sky Lakes Medical Center was built by the community in 1965 with a combination of money generated through community fundraisers and federal grants. The hospital achieved national accreditation just three physicians in the threeyear Family Medicine residency program help meet the medical needs of people throughout the region. Many of the graduates now practice in Klamath Falls or in rural settings throughout the United States. years after it opened, and maintained full Joint Commission accreditation until it earned international accreditation from Det Norske Veritas (DNV) in Sky Lakes Medical Center, its employees, volunteers and medical staff are partners with the community in social and economic issues as well as healthcare matters, participating in many outreach activities that include cancer and diabetes The Sky Lakes family includes the Sky Lakes Cancer Treatment awareness and fitness. Sky Lakes Medical Center partners Center, which opened in 1990 and has since doubled in size with the Providence Telestroke Network, giving patients 24/7 twice; the Sky Lakes Family Birth Center, which opened in access to top stroke 1998 and features 12 specialists and care private rooms; Sky that exceeds the Lakes Home Health; Hospital: Sky Lakes Medical Center, Klamath Falls, Oregon American Stroke a variety of physician Solutions: RelayAssurance, RelayClearance Plus, RelayClearance Association s quality clinics; and the Professional Services, RelayAnalytics Acuity, RelayAnalytics Pulse, guidelines for care. Cascades East Family RelayAccount Statements, RelayAccount Online Practice Residency Beds: 176 Employees: More than 1,000

4 4 Molatore joined Sky Lakes after the hospital had upgraded to epremis (now RelayAssurance Plus) and quickly discovered the product was not being used to its full potential. I knew that it was going to take time, money and other resources to make sure we received the full benefits the product has to offer, Molatore said. The hospital turned to RelayHealth Account Executive Debbie Garrett and Professional Services Consultant Blake Henderson to help optimize the product setup and business processes and get the Sky Lakes staff fully trained on how to use the system. High A/R days due to manual processes Lack of insight into billing processes Lack of automation among departments Also, some of the issues we were having originated in our host system, said Molatore, adding that the professional services consultant also is knowledgeable about the various products that interact with the RelayHealth software. The hospital currently uses Meditech as its EHR, with RelayAssurance serving as the intermediary for claims data. Claims and notes flow back and forth from Meditech with few issues. Claims Management Done Right Regardless of the software issue, we know who to call when there is a problem, Molatore said. In the first 18 months following implementation under Molatore s direction and RelayHealth s assistance, days in A/R dropped by 25. Cash/net revenue increased by 4 percent. In terms of Medicare and Medicaid denials, Molatore says the hospital is outperforming its peers in that measurement by sending claims correctly the first time.

5 5 At the same time, the hospital adopted the revenue cycle management tool RelayClearance Plus to make improvements in the patient access areas of the revenue cycle. Financial estimates are important, Molatore said. The hospital was looking for one vendor to handle the entire process, rather than several vendors to handle just one piece each. Connectivity is the main reason we went with RelayClearance. There were more payers on the RelayHealth platform, including two large commercial payers in our market that the other vendors didn t have. Improving Financial Decisions at Within the last year, the hospital has either bought or contracted with 15 physician offices that use a half-dozen EHRs and Practice Management systems. As a stop-gap measure while the hospital contemplates buying one system, registrations are uploaded to RelayClearance one day after the patient is seen. The dashboard feature allows Molatore to oversee patient flow and billings in those remote offices, with a red/yellow/green monitoring system that allows staff to zero in on potential problem areas. YOUR ESTIMATE

6 6 During his tenure at Sky Lakes Medical Center, Molatore has learned to work smarter, relying on experts where it makes sense and benefits overall operations. Blake Henderson has been an integral part of that, helping the hospital further optimize the performance of its claims and revenue cycle products. He also helps Molatore think strategically about the hospital s IT systems, including Meditech. All pieces run as smoothly as possible, Molatore said. With Blake s help, we ve been able to let the system carry as much work as possible while reducing labor costs. The migration from PREMIS to epremis (RelayAssurance Plus) is one example of how technology trumps people. Only one employee knew the system well enough to make the tweaks that were needed. When that employee was let go, however, that knowledge went with her. Professional Services Increases True optimization we couldn t maintain that knowledge here, Molatore said. Actually, we ve tried to lessen our dependency on Blake by hiring and training internal talent. But as soon as we train, they get promoted or go somewhere else.

7 7 Sky Lakes Medical Center recently added RelayAnalytics Acuity and RelayAnalytics Pulse so executives could get increased visibility into the hospital s financial operations and see how its performance compares to peers. Molatore says the hospital is now using both products on a limited basis, but they already are proving their worth. The trending ability of RelayAnalytics Pulse, which analyzes financial performance in comparison to peer groups, has been particularly beneficial. Sometimes cash doesn t come in, and I waste time looking for a problem that doesn t exist, Molatore said. Now, I can log in and see the collection rates of my peers and see that it s more of an industry problem. RelayAnalytics Acuity parses financial information by department, allowing leaders in those areas to monitor departmental performance while Molatore monitors overall performance. The product lets me see patterns and peer deeper into processes, Molatore said. I m aware of problem areas earlier.

8 8 RelayAccount Statements and RelayAccount Online work in concert to reduce costs through automated statement processing and simplify the patient billing experience at Sky Lakes. With RelayAccount Statements, we can build a bill using as many as 80 data points that we can customize in a way that works for our patients, Molatore said. Other statement automation systems the hospital looked at did not have this level of detail. The director noted that RelayAccount requires a good deal of attention on the front end to set it up properly, but that diligence pays off in the long run through a reduction of manual processes and returned mail. I ve been most impressed with RelayAccount, Molatore said. We re not getting as much web payment traffic as we want because we have a large elderly population. But the system is very versatile and has met our needs. It s not often that patients compliment a hospital s bills, but that is the case for Sky Lakes. Molatore said a critical access hospital in northern California visited Sky Lakes after hearing from patients who use both facilities. Patients said our statements were better than theirs and that the other hospital should copy us, Molatore said. Statements, Electronic Payments Complete the Picture Because of Sky Lake s disparate systems, the hospital uses RelayAccount WebPay as a common payment system, a central repository for both cash and credit transactions. It even uses WebPay to reconcile payments in the hospital cafeteria.

9 9 Sky Lakes Medical Center has enjoyed a long, mutually beneficial relationship with RelayHealth as the hospital seeks to bring a high level of accountability to the claims and revenue cycle processes. Molatore said the hospital appreciates the robustness of the RelayHealth products that Sky Lakes uses, and the ability of those products to work with other software the hospital uses. We automate as much as possible so that the system is dependent on IT not people, Molatore said. RelayHealth has been and continues to be a critical partner in that process.

10 Health Connections Brought to Life RelayHealth and/or its affiliates. All rights reserved. C