From Good to Great: Optimizing the Front-End Revenue Cycle Experience

Transcription

1 From Good to Great: Optimizing the Front-End Revenue Cycle Experience Presented by: Mary Godwin, PAS Senior Manager and Shanna Bradford, PAS System Support Coordinator, Baptist Pensacola Health Care System

2 About Baptist Health System Baptist Health Care (BHC) is area s only not-for-profit, locally owned health care system whose sole purpose is to help families connect the dots between prevention, lifestyle and physician-directed care. Founded in 1951, BHC s mission is to improve the quality of life for all families throughout our service area that includes northwest Florida and south Alabama. BHC includes four hospitals, two medical parks, Andrews Institute for Orthopaedic & Sports Medicine, Lakeview Center and Baptist Medical Group and Cardiology Consultants. BHC team includes more than 6,700 employees and employed physicians and is the largest non-governmental employer the area. BHC is honored to be a member of the Mayo Clinic Care Network and is a 2003 Malcolm Baldrige recipient.

3 Optimizing the Front-End Revenue Cycle at Baptist Health Care We all dream of going from Good to Great. But how do you get there? We re here to share our journey. Where Did We Start? What Were Our Pain Points? What Solutions Best Met our Needs? What Members of the Team Made it Happen? Strategies and Steps Milestones and Success Markers

4 Where Did We Start?

5 Call Center Structure - VIBES Team 2 Team Leads 11 OP Dx/Surgery Schedulers 3 VIP Specialists 4 Verifiers Systems Coordinator Corporate Director Senior Manager Physician Staff Liaison Call Center Monthly Stats AVG Procedures Scheduled-11,000+ AVG Orders Received-12,000+ AVG Inbound Calls-10,000+ AVG Outbound-13,000+ Patient Access Specialist I (OP Scheduler or Insurance Verifier) Team Lead, Insurance Verification Patient Access Specialist II (VIP OP Scheduler / Insurance Verifier) Team Lead, Outpatient and Surgery Scheduling Patient Access Specialist III (Surgery Scheduler)

6 BHC Organization Snapshot 4 Hospitals total 679 Beds Baptist Hospital-498 Beds Gulf Breeze Hospital-77 Beds Atmore Hospital-49 Beds (AL) Jay Hospital-55 Beds 2 Medical Parks Baptist Medical Park- Navarre Baptist Medical Park-9- Mile 2 Outlying Facilities Andrews Institute Lakeview Center Baptist Medical Group 170 Owned Physician Practices 170 Employed Practitioners Facility System Users total SCI Order Facilitator 228 SCI Schedule Maximizer 340 TU MedConnect 117 TU/FHS ClearIQ Highly Competitive Regional Market Not-For-Profit Locally Owned, Local Board, Local Decisions

7 VIBES Team Schedules for Surgery (1 Location) Surgicare Outpatient Surgery (1 Location) GE Department (1 Location) Labor and Delivery (1 Location) Cardiac/EP Cath Lab (2 Locations) Interventional Radiology (1 Location) Radiology (7 Locations) Cardiology (6 Locations) Infusion (1 Location) Sleep Center (2 Locations) Wound Center (2 Locations) Pulmonary (5 Locations) VIBES Team Verifies for Radiology (2 Locations) Cardiac/EP Cath Lab (2 Location) Cardiology (2 Locations) Sleep Center (2 Locations) Wound Center (2 Location) Pulmonary (2 Locations) Infusion (2 Locations)

8 The PASS Leadership Team M*ary Godwin PASS Senior Manager A*ngie Simpson PASS Physician Office Liaison S*hanna Bradford PASS Systems Coordinator Partners and Support SCI Solutions Implementation Team TransUnion Implementation Team MedConnect Implementation Team DynaTouch Implementation Team Baptist Healthcare IT

9 Overview of Operational Implementations Cardiology Consultants Callout Campaign SM-BH Cath Lab, EP Procedures SM-GB Sleep Lab SM-BH Wound Care VIBES Team-Revamp Procedures SM-BH Cath Lab, Other Procedures SM & ORMIS-GB Cath Lab SM-Jay Hospital Surgery Scheduling-Revamp Procedures BMG-VIP1 Concierge Model

10 Overview of New Technology Implementations SCI Solutions Power Access SCI Solutions Scheduling (Provider) Portal SCI Solutions Consumer Portal TransUnion/FHS ClearIQ TransUnion MedConnect TransUnion Revenue Manager

11 Phase #1 Power Access No More Paper! Streamlined process with fewer errors Automatic correspondence Significant workflow change Cardiology Consultants Callout Campaign Follow-up to letter campaign Revamped scripting Tracked patient responses Provided feedback to Cardiology group

12 Phase #2: Scheduling thru Portals Phase #2 SM-BH Cath Lab, EP Procedures Phase I Transition from handwritten appointment book Complex rules-building Scheduling (Provider) Portal Promoted to BMG Physicians first 2 Beta sites chosen based on volume scheduled Procedures chosen based on volume & complexity BMG, 15 physicians within 8 practices Non-BMG, 16 physicians within 4 practices Ongoing rollout process

13 Phase #3 SM-GB Sleep Lab Access for additional patient population First open referral SM-BH Wound Care Initial Appointment HAPPY HOLIDAYS! Phase #4 SM-BH Cath Lab, Other Procedures Phase II, higher level of complexity

14 Phase #5 SM-GB Cath Lab Brand new Cath Lab Opened utilizing SM Consumer Portal Initial launch for BHC employees for scheduling Screening Mammograms Capability to cancel and reschedule existing appointments Available to general public HealthyLives Program Built & Live in less than a week! 30+ Locations Scheduled >3000+ appointments

15 Phase #6 Surgery Scheduling-Revamp Procedures Rewrite scripting Updated QA process Issues tracking to identify opportunities for improvement Constant communication with departments TransUnion/FHS ClearIQ Accurate patient liability estimate All facilities, Verifiers, Registrars, Financial Counselors 40,000+ Estimates created across users Shift to Pre-Service Collections

16 Phase #7 Verification Team-Revamp Procedures Team members worked in silos No depth in staffing for coverage Stepped back, tried several approaches to distribution of work Cross-trained all team members Re-worked the Verification Worklist Now work daily bucket spread evenly across team, all types of appointments TransUnion MedConnect All facilities Organization-wide Training program Verifiers, Registrars, Schedulers, Financial Counselors, BMG Schedulers, Lakeview

17 Phase #8 SM-Jay Hospital Phase #9 Rural 55-bed facility Transition from handwritten appointment book All BHC facilities schedule through SM BMG-VIP1 Concierge Model Dedicated phone line for Baptist Medical Group Dedicated team cross-trained for all VIBES functions One Call Does It All Very successful concept Physicians offices love it

18 Phase #10 Patient ID Patient ID & Address verification Self-Pay patients at time of scheduling Tested & currently analyzing workflow changes Phase #11 TransUnion Revenue Manager Patient ID & Address verification, automated alerts for ER Self-Pay Stand-alone version for ad-hoc inquiries Tested & currently analyzing workflow changes Expect significant decrease in returned mail using these tools

19 There was the flood of June 12 Flooded main hospital & Business Office Call Center absorbed Customer Service team And the Hurricane (Isaac) that wasn t BHC basically closed for 2 days Invoked Incident Command Strategy A Team deployed for Disaster Management Call Center activated Then there was the SNAKE in the Call Center January2014 Call Center flooded and center was relocated and up in running in 2 hours. Ice Storm of 2014 PENSACOLA and ICE do not mix. Call Center able to reschedule and maintain current volume. March 2014 relocated to a flood free zone location adjacent to the main campus.

20 Results Results 6.7% growth in scheduled O/P procedures $602,000 additional revenue first 7 months 17.5% improvement in Scheduler productivity AR days Collections % Net Rev Patient point of services collections improvement $324 million 103% $341 million 101% $350 million 100.5% $3.9 million $4.2 million $4.3 million $359 million 103% $4.6 million

21 How in the world did we do it? Consultants... Implementation Specialists Cart Blanche Access to IT Lots of Vacation Time Eager, Attentive Trainees Baptist Medical Group participation/ Expectations set Team Members LOVE Change RIGHT?

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23 Leveraging technology to Referral Management strategies Prevent revenue leakage Framework for population health management Efficiencies to have care coordination for specific service lines Streamline bidirectional information EMRs

24 Roadmap 2013 One Picture is Worth a THOUSAND Words!

25 Summary Collaborative effort between BHC & partners Dynamic departmental plan Engaged team Built strong relationships, internal & external Stayed agile With all you re trying to accomplish, when it feels like You re going 100 mph with your Hair on Fire, You can t take another Day, You re ready to Cry, Just Remember.How Do You Eat an Elephant???

26 One Bite At A Time!

27 Patient Access Support Services Team