Inseparable: Strategies for Integrating EHR & Revenue Cycle for Financial Success Carmen Sessoms, FHFMA AVP of Product Management
EHR + RCM = Inseparable For patients, the clinical and financial experiences are one and the same Consider how your Revenue Cycle Management (RCM) solution will function within the new EHR workflow Prepared organizations can maintain positive financial performance 2
Make Sure RCM Has a Seat at the Table Clinical focus on EHR often means RCM is not prioritized When choosing an EHR vendor, ensure RCM leaders have input Consider best-of-breed RCM solutions RCM leaders must stay engaged throughout 3
RevCycle Planning Plan with the end result in mind a positive clinical and financial patient experience Determine how the RevCycle will be impacted Help ensure an uninterrupted RevCycle with integration points and workflows for: Eligibility Verification Registration Data Quality Assurance Pre-authorization & Medical Necessity Management Pre-Claim Editing Medicare Claims Processing Secondary Claims Claim Workflow Remittance Management 4
Implementation is Key to Success Work with RCM partners to establish regular communication touch points Identify a project manager for the revenue cycle portion of the EHR transition As a coordinated team, determine which technology will be used to manage each part of the revenue cycle process 5
Closely Monitor Performance Four Strong Indicators of Performance to Watch Closely During Disruptive Change: Service-to-payment velocity Days not final billed Charge trends Denial rate 6
Service-to-Payment Velocity 2015 U.S. Median Service to Payment Days Bottom Performers 49.10 Average Performers 42.93 Top Performers 37.86 Source: RelayHealth Financial Data, 2015 7
Service-to-Payment Velocity Services & Discharge Claim Generation Claim Transmission Payment Resolution Service to Payment 42.9 Days Service to Release 16.0 Days Service to Submit 15.0 Days Submit to Release 0.7 Days Release to Payment 24.4 Days Service Submit Release Payment Source: RelayHealth Financial Data, 2015 8
Lean on Your RCM Partner for Best Practices Ask your RCM partner for best practices for integrating systems with minimal disruption to your cash flow Consult RCM partner about new RevCycle capabilities that may be possible as you move forward with a new EHR 9
Revenue Cycle Solution Leadership RelayClearance RelayAccount RelayAssurance RelayAnalytics Clears the path with patient financial visibility to help: Efficiently manage patient accounts and make payments to help: Assure the fastest route to remittance to help: Analyze opportunities to determine action to help: Increase registration data accuracy Increase self-pay collections and reduce bad debt Improve work flow efficiency and staff productivity Manage authorizations and medical necessity processes Increase revenue and reduce bad debt Increase patient satisfaction Decrease patient phone calls Reduce postage expense by 20-30% Improve patient experience Reduce collection time and cost Reduce A/R days Maximize claim and remittance processing efficiency Reduce claim errors and denials Improve staff productivity Improve claim lifecycle visibility Assess operational and financial performance Increase visibility across the revenue cycle Isolate root cause of issues Inform strategic decision making Accelerate positive organizational change Compare performance to peers End-to-End Revenue Cycle Solutions 10
Thank You For Your Time & Attention! For Further Information, Contact RelayHealth Financial 800-752-4143 www.inseparablerevcycle.com 11