Advanced Forms Automation and the Link to Revenue Cycle Management

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1 Advanced Forms Automation and the Link to Revenue Cycle Management Chris Joyce Director of Healthcare Solutions Engineering

2 Today s healthcare providers are facing growing financial pressures that can affect the delivery of quality patient care. As a result, hospitals and ambulatory facilities are continuously seeking innovative new solutions to improve revenue. Advanced forms automation can play a vital role in helping hospitals optimize the revenue cycle and cut costs. Introduction There is significant financial pressure facing hospitals today. A recent report said that 54% of hospitals had a negative total margin during the first quarter of 2009, including 80% of hospitals with 500 or more beds. 1 In light of this disturbing trend, hospitals need to find creative solutions that can improve revenue and cut costs. Studies have shown that the quality of data entered into hospital systems is an important factor in whether a claim is paid or denied. In fact, published statistics suggest that healthcare providers lose $60 billion dollars each year due to registration errors alone. 2 In addition, a Rand Corporation report states that correcting the patient records database can cost large hospitals more than a million dollars per year. 3 Healthcare providers need to take advantage of the latest tools and technologies to improve the accuracy and timeliness of data, thereby optimizing revenues. Healthcare forms automation (or e-forms ) can play an important role in enhancing the revenue cycle. Implementing the right forms automation solution can result in faster time to revenue. E-forms technology can help ensure data integrity in clinical, financial and administrative systems. Data can be validated at the point of care or capture, ensuring that all forms, consents and required information are correct, complete and immediately available. This produces cleaner claims downstream in patient billing. The results: Faster claims processing Fewer denied claims Less time in accounts receivable The Expanded Role of Advanced Forms Management Forms management has undergone a revolutionary transformation in recent years. Rather than being a primarily paper-based function, advanced forms management technology now offers users the flexibility to originate, interact with, maintain and distribute documents in the format that is best for their facility, their business applications and their key constituents, whether on the Web, via a mobile device, in print or some combination thereof. Through Health Level 7 (HL7) interfaces and other interoperability techniques, today s forms management solutions can automatically exchange data with other systems or applications, including hospital information systems (HIS), electronic medical records (EMR) and clinical data repositories. This dramatically improves efficiency and ensures that all data is consistent and accurate throughout the organization. Advanced forms management solutions also incorporate a host of other capabilities such as workflow management, automated data validation and electronic signatures that help eliminate paper, increase productivity, improve data quality and completeness, and ultimately enhance the revenue cycle. Advanced forms automation fills the gaps between systems to make processes completely electronic. By providing a link between disparate financial, clinical and administrative systems, hospitals can further leverage their existing technology investment. And, unlike most HIS and EMR systems, advanced forms management offers robust data-capture capabilities that can be adjusted quickly and easily to meet fast-changing requirements.

3 Asante Health Applies Workflow to Improve Efficiency and Safety Asante Health, based in Medford, Oregon, depends on Bottomline Technologies advanced forms automation capabilities to provide the forms delivery and workflow management needed to improve performance, productivity and patient care. Users throughout Asante Health including registration, clinical care, pharmacy, human resources, business office and finance depend on the Bottomline solution to drive important patient care, patient safety and business processes. The Bottomline advanced forms automation solution, which has been delivering benefits to Asante Health s two hospitals since 2003, interfaces with Epic to capture key information, eliminating the need for manual data entry and scanning. The system: Automatically uses captured data to format and distribute documents and safety alerts Applies business rules to deliver critical document output and mobile text messages to the right hospital destination at the right time Generates patient forms and notifications to meet CDC Core Measures and other compliance requirements Speeds the registration process and automatically routes correct forms to the correct location Reduces manual data entry and improves workflow Better Data Means Faster, Cleaner Claims Studies show that obtaining better data up-front is crucial to producing cleaner claims downstream. The cleaner the claim, the faster the reimbursement. Forms automation helps drive the data collection process and at the point of collection can validate that required information is complete and correct. As a result, better data is immediately available to coding and patient billing systems. This means that billing personnel now have the exact information needed to substantiate a claim. They no longer waste time revalidating data or recollecting information. Furthermore, coders receive better, more complete information from clinicians. This accelerates reliable and accurate coding of inpatient records, which translates into improved cash flow and more accurate reimbursement. Automating Admissions and Registration Processes New regulations and changing requirements have added layers of complexity to the admission process. From advance beneficiary notices to patient privacy documents to Medicare and insurance forms, an inpatient admission can now require as many as ten documents and consent forms. Advanced forms automation can provide the workflow management, e-forms and electronic signature capabilities needed to control this increasingly unwieldy process. Here is how it works: Interfaces to hospital systems automatically populate all forms and documents with the correct demographic information. Workflow built into the advanced forms automation system then drives the process automatically. Registration clerks are presented with the correct sequence of tasks and the appropriate forms and barcoded armband/labels based on the type of admission and other key data. Business rules make workflow easy to set up and adjust. Patients and witnesses review documents and electronically sign on a tablet or other portable computing device. The system validates that all required admission and registration information and steps (such as eligibility checks, insurance/health plan information, signatures, etc.) are complete. The correct information is then submitted in real time to the proper hospital system, document management or repository, with no need for scanning, copying or manual intervention. By providing clean data in a timely fashion to the billing office, hospitals can better manage claims to different commercial and government payers, including Medicare, Medicaid and Blue Cross Blue Shield.

4 In addition to the revenue-enhancement opportunities, admission/registration forms automation offers other benefits: Speeds the admission/registration process Gets patients to clinical care faster Removes the amount of manual and repetitive effort for patients Improves patient satisfaction Requires less training for admission/registration personnel Alamance Regional Medical Center Automates Consent Forms Alamance Regional Medical Center, a 238-bed community hospital in North Carolina, has implemented an electronic consent solution using Bottomline Technologies Logical Ink. As a result, the hospital has eliminated nine paper consent forms and replaced them with a mobile electronic solution that includes electronic signature and workflow. The Logical Ink solution features an HL7 interface that accepts an ADT feed from the hospital HIS to generate electronic forms prepopulated with the correct demographic information. Workflow rules then create an electronic packet for the patient based on insurance type, service and the patient s primary language. The patient uses a smart tablet, with a natural pen and paper interface, to complete all required consent forms. Color highlights on screen walk the patient through the required signatures and fields on each form, providing an improved customer experience. In addition, validation rules prevent the registrar from saving an incomplete form. Benefits include: Faster, cleaner claims processing Elimination of costs associated with preprinted forms, scanning and indexing Improved patient satisfaction Supporting Clinical Documentation Forms automation can support a variety of clinical documentation applications as well. Using mobile devices or a Web interface, clinicians can capture necessary information in an efficient manner at the point of care. As a result, coders can code at the appropriate level, which can mean additional revenue and reduced risk of audit. Clinical forms automation solutions can include advanced features that help improve efficiency and accuracy. For example: Context aware document creation can help manage the documentation process by presenting required fields based on the procedure and situation. This can play a big role in improving the consistency and completeness of physician and nursing documentation. Advanced forms management solutions even have the potential to collect data for billing and coding with no manual intervention. Discrete data can be acquired from other systems through an interface to populate a specially designed form, which then becomes the source to populate fields in a billing or coding system. The biller or coder then simply needs to validate the information before submission.

5 Forms automation can support clinical point-of-care procedures in a variety of areas, including: Progress notes Flow sheets Rehabilitation document support Radiology screening Anesthesia records Surgical and lab informed consents Consolidated Billing Improves Customer Satisfaction Bottomline Technologies supports the patient billing office by creating a consolidated patient bill. This proven solution combines separate encounters and procedures on a single invoice for each patient, eliminating the need to generate a separate invoice for each procedure. How? Bottomline s software receives individual encounters electronically from a single system or multiple databases and batches them. The system then performs the required calculations and produces a single invoice in a format customized for each institution. The benefits: Better patient satisfaction Less billing labor and lower cost to the facility Faster revenue collection Unlocking Data from the Trap of Paper Advanced forms automation moves documents away from paper and its limitations. Information becomes a reusable, workflow-ready asset for multiple clinical, financial and administrative systems. This reduces the amount of time it takes to access information by making the data immediately available to multiple people at the same time. In addition, organizations can more quickly respond to compliance mandates and other healthcare reform initiatives that require data portability and security. Advanced forms management helps hospitals quickly react to new requirements by offering: Easy-to-use design tools that enable facilities to rapidly change forms Version control that eliminates the need to collect old paper forms and makes updated forms immediately available to the next user Prevention of revenue loss caused by using outdated forms Elimination of paper waste Furthermore, by replacing paper with an advanced forms automation system and business rules, hospitals ensure that required steps and documents digitally feed downstream systems such as coding and billing that impact revenue, patient care and patient safety. Conclusion Advanced forms automation can play a vital role in revenue enhancement. By transforming paper processes into electronic processes, hospitals improve workflow and speed secure data accessibility. In addition, healthcare forms automation provides the tailored tools and technologies needed to capture relevant information for billing and coding applications. It also ensures that all required information is validated at the point of entry, which leads to better data integrity. In short, paperless processing helps create financial clearance that results in faster time to revenue.

6 Healthcare forms automation also helps balance financial objectives with mandates for improved patient care and safety. Increased efficiency and less process waste mean more time to concentrate on patients. Improved processes increase patient satisfaction, which supports patient-retention goals. Finally, cost savings that result from removing paper and repurposing staff allow a greater focus on patient care. In summary, by adopting advanced forms automation, hospitals have the opportunity to simultaneously improve both their fiscal health and the quality of care they provide to their patients. References 1. AHA News Now, April 15, Cincom, New Approaches to Revenue-Cycle Management Are Helping Healthcare Administrators Sleep Better 3. Rand Corporation Report, Identity Crisis, 2008 About Bottomline Technologies Bottomline Technologies (NASDAQ: EPAY) provides collaborative payment, invoice and document automation solutions to corporations, financial institutions and banks around the world. The company s solutions are used to streamline, automate and manage processes involving payments, global cash management, transactional documents and invoice approval. Organizations trust these solutions to meet their needs for cost reduction, competitive differentiation and optimization of working capital. Headquartered in the United States, Bottomline also maintains offices in Europe and Asia-Pacific. For more information, visit

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