Electronic Registration Improves Wait Times, Billing Accuracy

A RelayHealth Case Study Electronic Registration Improves Wait Times, Billing Accuracy The Bellevue

2 The Bellevue had relocated to a modern building three years earlier, but was still using paper-based registration in the emergency department and main hospital waiting areas. The use of paper-based forms made tracking wait times difficult and did not allow staff visibility into the identities or numbers of patients waiting for various tests or procedures. Auditing of registration processes was also done manually, with one staff member charged with auditing more than 61,000 registrations annually. As a result, only 50 percent of registrations were being audited, and those that faced additional scrutiny were checked for only a handful of common errors. The desire to increase registration accuracy and billing accuracy while providing staff insight into wait times convinced leaders at The Bellevue to purchase AhiQa and Ahi Lobby, now part of RelayHealth. We wanted an automated system to prevent errors on the front end, rather than fixing them on the back end, Nicholas Courtright, patient access leader, said of AhiQa. The hospital also purchased Ahi Lobby to help track wait times, especially in the ED. AhiQa has helped The Bellevue maintain a 99.5 percent registration accuracy rate over the past several years without the need for a staff person to monitor and audit registrations. Accounts receivable days have continued to drop and now stand at 43 days. Wait times throughout the hospital average 10 minutes, and just five minutes in the ED.

3 A group of visionary Bellevue, Ohio residents came together in 1914 to imagine the future of healthcare in their community. The result culminated three years later in the opening of The Bellevue (www.bellevuehospital.com). That visionary leadership has endured for nearly a century at the locally owned, non-profit hospital system. Following expansions and renovations over the intervening eight decades, hospital leadership realized a new facility would position the facility for future generations. The Bellevue relocated in 2005 to a prairie-style, 129,000-square-foot facility that allowed the system to expand its range of services, including Occupational Health and a Specialty Care Clinic that offers full-time cardiology services and many other medical specialists. The Bellevue is the only hospital in Ohio to be awarded the HealthGrades TM Outstanding Patient Experience Award for the past five consecutive years. It is a Designated 2012-2013 from NICHE (Nurses Improving Care for Healthsystem Elders) and has scored in the top 5 percent nationally on the Consumer Assessment of Healthcare Providers. The hospital s home health agency is ranked in the top 25 percent by HomeCare Elite. : The Bellevue, Bellevue, Ohio Solutions: AhiQa, Ahi Lobby Beds: 50 Employees: More than 400 Medical Staff: More than 100 active and affiliated physicians

4 Before adopting AhiQa, The Bellevue employed one person to audit about half of the hospital s more than 61,000 annual patient registrations. The employee was only able to check for about 10 common errors. This meant about half of annual patient registrations weren t audited at all, and errors other than the 10 key errors that the auditor could look for were missed in those that were. The result was a large number of errors on filed claims that required additional staff to answer payer questions, correct erroneous information, and refile claims. Not only are we saving an FTE who formerly conducted audits, it s an Internet-based program that our IT staff doesn t have to deal with, Courtright said. I m able to handle user questions, reset passwords and other administrative functions. AhiQa has 260-plus rules built into the system, throwing up flags that the registrar can follow up on while the patient is still in the waiting area, Courtright said. If it s a policy number, for example, we can go in and fix it that day, which prevents the claim from kicking out or getting a denial and having to work it later. The automated system also allows 100 percent of claims to be audited, helping to reduce denials and days in accounts receivable. The Bellevue accounts receivable days have dropped to 43 days from 51, which Courtright attributes to AhiQa and to a push to reduce A/R days ahead of an electronic medical records installation at the hospital. Registration auditing a manual process Only 50 percent of registrations checked Could only check for 10 error types Manual processes a drain on hospital resources 100 percent registration checks More than 260 error types checked 99.5 percent accuracy rate 16% decrease in accounts receivable days No FTE neededl

5 In conjunction with AhiQa, The Bellevue also adopted Ahi Lobby, which helps support electronic patient registrations. Before Ahi Lobby, staff had no effective method for measuring wait times in the hospital or the emergency department. Without looking over paper records, they also did not know whether patients had checked in, or who had been scheduled for a test or procedure. Ahi Lobby is critical for the ED, Courtright said, because anything can happen between registration and the time a patient is assigned a bed. When a patient checks in, a triage nurse is notified so there is no wasted time. Shortly after implementation, the hospital s wait time averaged 11 minutes. That figure has dropped 55 percent to just five minutes from registration to bed, Courtright said. In the main part of the hospital, Ahi Lobby helps keep track of patients from the time they arrive. Shorter wait times can help a hospital increase its patient satisfaction scores, and if a patient shows up late for a procedure, for example, staff can note that fact in case questions about scheduling arise later. Current wait times for The Bellevue average 10 minutes. The two products work really well together, Courtright said. The accuracy of the registration definitely helps with wait times. The service has also been superior. When there is a problem, I send an email, get an email right back, and the issue is fixed within the hour. Paper registrations in main hospital and ED department No way to track patient wait times No visibility into patient scheduling Electronic registrations more efficient, secure Patient wait times easily tracked VISIBILITY Provides staff visibility into wait times 55% decrease in patient wait times