Gritman Medical Center
Ben Wood
Tessa Scholl
Marc Boisvert
Mimi Sproul
Darren Schnider
Problems
Delays
Internal
Common among users of manual systems
Every time someone comes in contact with a process, there is a 5%
chance that an error will occur within the step
Unneeded queues build up
Charts are not taken by staff frequently because it reduces
productivity
Every process that has a 95% chance of success (1- 5% of error)
requires additional time in auditing to fix
Up to 10 minutes hands on time in system
Days out of system if returned by payee
External
People do not pay
Problems (continued)
Faster collections from insurance and payee
Problems:
Extended time for bill insurances
Non clean bills
Ideal scenario
Collections would take place immediately post treatment
Problems solved
Possible error processing claims
Delay before Final DRG can be sent
Improved personnel allocation
Can be done with automated coding and billing system
Scope Statement
Modeling current billing process to determine
accounts receivable days and chart processing
times
Examining possible reengineering and mistake
proofing of system
Determining NPV’s of implementing new systems
Objectives
Reducing AR time
Reducing delay of collections from insurance and self pay
account to increase TVOM
Emergency Room Coding & Record Keeping
Finding the best solution to decrease lag time
Five Day Window
Reducing it to 3 days
Additional Improvements
Institutional clean claims increased 10%*
Increased billing productivity by 70%**
Decreased error leads to less auditing time
*http://www.medassets.com/casestudies/pages/foxchasecancercenter.aspx
**http://www.medassets.com/casestudies/pages/wellmonthealthsystems.aspx
Findings
Apparent long wait times in 6.5 day window
processes
Enough errors in billing to make AR age 57.37 days
average
Industry findings that AR can be reduced
dramatically, to at most 30 days
Recommendations
Automate billing system
Add a new financial councilor
Decrease self-pay time
If the system is unable to be automated, use
improved business rules
Able to reduce queue times and improve throughput
Road map of remaining presentation
Model Description
Model Inputs
Sensitivity Analysis
Additional improvements
Emergency room
Current process and improvement
New billing program example
Accounts to concentrate on
Model Description
Gathered Information and assumptions
Inputs
Hours worked, chart processing times, staffing schedules,
average payee payment periods and 90 patient types
Information collected from actual Gritman medical staff member
Model Purpose
Accurately model current billing cycle through Gritman
medical center
Sensitivity Analysis
Individual changes made and reviewed for improvement
Sensitivity Analysis
Our purpose is to reduce Gritman’s AR by 40% to
improve costs
Changed general business rules reducing process
time while keeping old system
We are also investigating 30%, 20%, 10% and
comparing each NPV to find the break even point
Model Inputs
5 Types of Patients
Out-patient Sleep Study: OP Sleep Study
Out-patient Laboratory/Out-patient Radiology: OPL/OPR
In-patient/Out-patient Surgery/Observation: IP/OPS/Observation
Emergency Room: ER
Therapy/Series/Adult Day Health: Therapy/Series/ADH
3 Categories of Payment Amounts
>$1,500
$1,500 - $7,500
<$7,500
6 Payment Options
Medicare
Medicaid
Blue Cross
Commercial
Self-Pay
Charity
Current Emergency Room Process
Admissions
Get Demographics
Verify Insurance
Authorize
Patient
Documentation
Manual
Discharge
Wait Until
Midnight For List
Release
NICKA Coding
(2 days)
Charge Entry
Auditing
Final DRG
Bill Insurance
Proposed Emergency Room process
Admissions
Get Demographics
Verify Insurance
Authorize
Patient
Documentation
*Increase Accuracy
*Reduce Lag Time
Manual Discharge
Auditing
*Time Reduced
*Fewer mistakes to
correct
Bill Insurance
Comparison of Processes
This new process reduces
both time and error
increasing revenue
Admissions
Get Demographics Verify
Insurance Authorize
Patient
Documentation
*Increase Accuracy
*Reduce Lag Time
Manual Discharge
Auditing
*Time Reduced
*Fewer mistakes to correct
Bill Insurance
Sage Intergy EHR system
Largest AR issues
om
p
W
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St
ud
. In
s.
ed
.
ll D
Se
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ay
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8.05%
1.31%
6.17%
1.52%
10.45%
0.00%
9.97%
0.00%
2.86%
0.00%
1.61%
8.90%
1.89%
0.46%
10.68%
2.21%
1.89%
14.00% 100.00%
4.26%
7.88%
1.30%
7.52%
1.76%
10.28%
0.00%
7.68%
0.00%
2.40%
0.00%
1.94%
9.50%
2.16%
0.44%
11.29%
1.56%
1.71%
15.66% 100.00%
1-Mar-09
0.82%
6.95%
0.82%
0.00%
4.15%
8.37%
1.08%
7.50%
1.73%
8.22%
0.00%
8.57%
0.00%
1.39%
0.00%
2.09%
8.66%
2.20%
0.41%
11.55%
2.00%
2.15%
21.34% 100.00%
in
U
A/
R
3.71%
0.00%
PA
0.00%
1.11%
of
I
GM
C
Py
mt
Pl
an
s
GM
C
Se
lfp
ay
lan
s
FP
Py
mt
P
0.87%
10.28%
MC
12.54%
1.27%
Me
di c
a
FP
Pr
em
er
a
Re
pl a
ce
me
nt
Co
mm
er
c ia
l
Ot
he
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ov
Pr
og
W
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Co
un
ty
La
tah
Sh
iel
d
Bl
ue
Me
dic
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W
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Me
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a id
0.91%
HM
O
ID
He
alt
h
1-Jan-09
1-Feb-09
Gr
ou
p
Ch
am
p
us
os
s
Bl
ue
Cr
Au
to
Ins
ur
an
ce
Average % of AR
1-Apr-09
0.79%
7.57%
0.56%
0.00%
4.54%
9.67%
1.11%
4.87%
1.59%
13.24%
0.00%
7.51%
0.00%
2.54%
0.00%
2.09%
7.94%
2.35%
0.41%
11.79%
1.56%
2.39%
17.47% 100.00%
1-May-09
0.68%
6.16%
1.24%
0.00%
4.47%
6.59%
0.90%
7.30%
2.82%
8.74%
0.00%
7.15%
0.00%
2.56%
0.00%
2.44%
9.01%
2.56%
0.44%
10.82%
0.92%
1.64%
23.54% 100.00%
1-Jun-09
0.71%
10.23%
1.20%
0.00%
5.73%
7.24%
0.80%
7.02%
3.77%
9.37%
0.00%
7.39%
0.00%
2.06%
0.00%
2.72%
8.70%
2.44%
0.41%
10.31%
1.47%
0.93%
17.51% 100.00%
1-Jul-09
0.64%
7.74%
0.73%
0.00%
4.97%
5.82%
0.53%
7.30%
3.86%
8.49%
0.00%
7.26%
0.00%
2.28%
0.00%
2.68%
9.59%
2.55%
0.31%
11.74%
1.32%
1.17%
21.02% 100.00%
1-Aug-09
1.01%
6.20%
1.17%
0.00%
4.61%
4.30%
0.95%
10.13%
4.38%
7.07%
0.00%
8.37%
0.00%
1.94%
0.00%
2.21%
9.96%
2.63%
0.33%
12.30%
2.09%
1.50%
18.88% 100.00%
1-Sep-09
0.94%
8.76%
0.86%
0.00%
4.37%
4.36%
0.93%
8.14%
3.03%
7.21%
0.00%
8.05%
0.00%
1.66%
0.00%
2.37% 10.79%
2.67%
0.36%
11.24%
2.23%
1.74%
20.29% 100.00%
1-Oct-09
0.51%
7.48%
1.14%
0.00%
4.46%
4.12%
0.87%
7.49%
2.53%
8.27%
0.00%
6.79%
0.00%
1.31%
0.00%
2.12%
9.89%
2.74%
0.30%
10.95%
1.48%
2.36%
25.19% 100.00%
1-Nov-09
0.64%
7.78%
1.27%
0.00%
3.57%
6.17%
0.85%
7.31%
2.78%
8.46%
0.00%
8.43%
0.00%
1.18%
0.00%
2.14% 11.68%
2.95%
0.34%
9.60%
2.76%
1.90%
20.20% 100.00%
2-Dec-09
0.62%
12.39%
0.70%
0.00%
5.06%
3.81%
1.08%
7.28%
2.38%
12.12%
0.00%
8.31%
0.00%
0.82%
0.00%
2.05% 10.96%
2.92%
0.31%
8.97%
2.90%
2.14%
15.18% 100.00%
1-Jan-10
0.77%
8.74%
1.31%
0.00%
4.21%
4.55%
1.14%
5.58%
2.32%
6.58%
0.00%
9.44%
0.00%
1.85%
0.00%
2.30% 11.85%
3.26%
0.32%
11.27%
3.00%
2.91%
18.62% 100.00%
average % of
AR
0.79%
8.68%
1.00%
0.00%
4.47%
6.23%
0.99%
7.20%
2.65%
9.12%
0.00%
8.07%
0.00%
1.91%
0.00%
2.21%
2.56%
0.37%
10.96%
1.96%
1.88%
19.15% 100.00%
9.80%
Largest AR issues
A/
R
PA
om
p
-17.61%
0.00%
-36.14%
36.60%
47.47%
-48.85%
29.40% -66.62%
0.00%
32.47%
0.00%
14.40% -100.00% -74.43% 41.96%
-69.83%
-92.65%
70.29% -14.09%
27.87%
-86.06%
0.00%
-52.93%
-2.33%
0.00%
-32.33%
37.75%
53.69%
-33.66%
36.53% -68.42%
0.00%
1.58%
0.00%
3.40% -100.00% -69.95% 46.91%
-66.63%
-93.17%
74.73% -22.49%
21.33%
-84.34%
0.00%
1-Mar-09
6.27%
-65.19%
-26.77%
0.00%
-40.16%
23.21%
58.30%
-32.21%
39.89% -75.38%
0.00%
8.47%
0.00% -39.10% -100.00% -67.32% 35.25%
-65.67%
-93.60%
80.53%
27.14%
44.52%
-78.66%
0.00%
1-Apr-09
1.28%
-57.12%
-46.28%
0.00%
-36.44%
19.02%
62.85%
-54.69%
42.79% -60.76%
0.00%
-5.39%
0.00%
6.42% -100.00% -70.04% 13.71%
-66.30%
-94.15%
68.91%
0.42%
48.01%
-82.53%
0.00%
1-May-09
11.21%
-64.11%
4.67%
0.00%
-40.56%
-25.23%
56.45%
-34.39%
61.31% -73.83%
0.00% -10.09%
0.00%
1.31% -100.00% -62.80% 37.01%
-61.12%
-93.27%
64.67% -23.93%
6.73%
-76.45%
0.00%
1-Jun-09
-2.99%
-40.49%
-9.68%
0.00%
-30.28%
-19.37%
42.61%
-35.56%
47.71% -71.48%
0.00%
-5.99%
0.00% -20.60% -100.00% -57.57% 35.39%
-62.15%
-93.66%
60.56%
2.64%
-23.42%
-82.39%
0.00%
U
-43.49%
2.96%
FP
-13.17%
FP
1-Jan-09
1-Feb-09
MC
in
of
I
W
or
kC
St
ud
. In
s.
ed
.
ll D
Se
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ay
Pa
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GM
C
Py
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Pl
an
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GM
C
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s
Py
mt
P
Pr
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nt
Co
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er
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Ot
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ov
Pr
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W
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Me
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ty
La
tah
Bl
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Sh
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W
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Me
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Me
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He
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HM
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Gr
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Ch
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Cr
Bl
ue
Au
to
% above or
below
average AR
days
Ins
ur
an
ce
The highlighted percentages are how many more days each
of the corresponding insurances are taking over the average
1-Jul-09
1.99%
-56.55%
-50.62%
0.00%
-38.95%
-27.46%
-23.69%
-38.48%
35.99% -73.25%
0.00%
-4.78%
0.00% -10.68% -100.00% -60.40% 41.72%
-62.28%
-95.44%
73.44%
-5.13%
-3.59%
-78.98%
0.00%
1-Aug-09
-22.12%
-66.77%
-8.16%
0.00%
-40.36%
-42.45%
20.93%
-13.69%
39.26% -76.45%
0.00%
6.32%
0.00% -30.63% -100.00% -68.91% 40.35%
-62.98%
-95.40%
73.25%
4.71%
1.78%
-81.12%
0.00%
1-Sep-09
-20.08%
-54.97%
-26.10%
0.00%
-39.25%
-38.44%
-7.21%
-27.87%
33.19% -76.06%
0.00%
1.61%
0.00% -34.28% -100.00% -68.77% 42.03%
-64.79%
-95.32%
48.02%
14.50%
6.89%
-79.71%
0.00%
1-Oct-09
-23.06%
-62.13%
-14.05%
0.00%
-40.30%
-46.05%
2.91%
-31.11%
19.14% -71.72%
0.00% -13.88%
0.00% -31.86% -100.00% -74.35% 19.51%
-66.92%
-96.34%
32.34% -28.57%
49.99%
-74.81%
0.00%
1-Nov-09
-21.26%
-58.83%
4.15%
0.00%
-50.75%
-26.85%
5.99%
-33.13%
9.66% -71.89%
0.00%
7.57%
0.00% -24.39% -100.00% -74.38% 40.00%
-64.67%
-95.97%
15.06%
27.89%
42.36%
-79.80%
0.00%
2-Dec-09
28.19%
-34.04%
-46.66%
0.00%
-33.83%
-54.00%
61.74%
-32.34%
13.99% -60.15%
0.00%
-3.12%
0.00% -35.04% -100.00% -73.19% 43.42%
-61.83%
-95.94%
17.33%
21.04%
76.44%
-84.82%
0.00%
1-Jan-10
42.15%
-56.12%
-7.12%
0.00%
-47.81%
-40.83%
93.63%
-45.24%
35.74% -78.09%
0.00%
12.24%
0.00%
-54.23%
-95.52%
58.07%
26.75%
83.41%
-81.38%
0.00%
-0.66%
-54.83%
-18.97%
0.00%
-39.01%
-15.70%
36.59%
-35.48%
34.20% -71.08%
0.00%
2.08%
-63.80%
-94.65%
56.71%
2.38%
29.41%
-80.85%
0.00%
average %
of
deviation
3.72% -100.00% -67.72% 66.16%
0.00% -15.18%
0.00% -68.45% 38.72%
A/
R
70.29% -14.09%
27.87%
-86.06%
0.00%
-93.17%
74.73% -22.49%
21.33%
-84.34%
0.00%
1-Mar-09
6.27%
-65.19%
-26.77%
0.00%
-40.16%
23.21%
58.30%
-32.21%
39.89% -75.38%
0.00%
8.47%
0.00% -39.10% -100.00% -67.32% 35.25%
-65.67%
-93.60%
80.53%
44.52%
-78.66%
0.00%
1-Apr-09
1.28%
-57.12%
-46.28%
0.00%
-36.44%
19.02%
62.85%
-54.69%
42.79% -60.76%
0.00%
-5.39%
0.00%
6.42% -100.00% -70.04% 13.71%
48.01%
-82.53%
0.00%
1-May-09
11.21%
-64.11%
4.67%
0.00%
-40.56%
-25.23%
56.45%
-34.39%
61.31% -73.83%
0.00% -10.09%
0.00%
1.31% -100.00% -62.80% 37.01%
1-Jun-09
-2.99%
-40.49%
-9.68%
0.00%
-30.28%
-19.37%
42.61%
-35.56%
47.71% -71.48%
0.00%
-5.99%
1-Jul-09
1-Feb-09
1.99%
1.27%
-56.55%
10.28%
-50.62%
1.11%
0.00%
0.00% -38.95%
4.26%
-27.46%
7.88%
-23.69%
1.30%
-38.48%
7.52%
35.99%
-73.25%
1.76% 10.28%
0.00%
0.00%
1-Aug-09
1-Mar-09 -22.12%
0.82%
-66.77%
6.95%
-8.16%
0.82%
0.00%
0.00% -40.36%
4.15%
-42.45%
8.37%
20.93%
1.08%
-13.69%
7.50%
39.26%
-76.45%
1.73%
8.22%
1-Apr-09
1-Sep-09
0.79%
-20.08%
7.57%
-54.97%
0.56%
-26.10%
0.00%
0.00%
4.54%
-39.25%
9.67%
-38.44%
1.11%
-7.21%
4.87%
-27.87%
1.59%
33.19%
13.24%
-76.06%
1-May-09
0.68%
6.16%
1.24%
0.00%
4.47%
6.59%
0.90%
7.30%
2.82%
3.77%
-62.13%
-14.05%
1-Nov-09
-21.26%
1-Jul-09
0.64%
-58.83%
7.74%
2-Dec-09
1-Aug-09
28.19%
1.01%
1-Sep-09
1-Jan-10
0.94%
42.15%
1-Oct-09
1-Nov-09
average
%
2-Dec-09
of 1-Jan-10
deviation
average % of
AR
1.31%
6.17%
1.52%
64.67% -23.93%
4.71%
2.00%
1.78%
2.15%
2.35%
-64.79%
0.41%
-95.32%
11.79%
48.02%
1.56%
14.50%
2.39%
6.89%
17.47% 100.00%
-79.71%
0.00%
2.56%
0.44%
10.82%
0.92%
1.64%
0.41%
10.31%
1.47%
6.32%
8.57%
0.00%
0.00%
-30.63%
1.39% -100.00%
0.00% -68.91%
2.09% 40.35%
8.66%
0.00%
0.00%
7.51%
1.61%
0.00%
0.00%
2.54%
-34.28%
0.00%
-100.00%
2.09%
-68.77%
7.94%
42.03%
8.74%
0.00%
7.15%
0.00%
2.56%
0.00%
2.44%
9.01%
9.37%
0.00%
7.39%
0.00%
0.00% -31.86% -100.00% -74.35% 19.51%
2.06%
0.00%
2.72%
8.70%
-66.92%
-96.34%
0.46%
-46.05%
7.24%
0.80%
2.91%
-31.11%
19.14% -71.72%
4.15%
0.73%
0.00%
-50.75%
0.00% 4.97%
-26.85%
5.82%
5.99%
0.53%
-33.13%
7.30%
9.66% -71.89%
3.86%
8.49%
0.00%
0.00%
7.57%
7.26%
0.00% -24.39%
-100.00%
-74.38%
40.00%
0.00%
2.28%
0.00%
2.68%
9.59%
-64.67%
2.55%
-34.04%
6.20%
-46.66%
1.17%
0.00%
0.00% -33.83%
4.61%
-54.00%
4.30%
61.74%
0.95%
-32.34%
10.13%
13.99%
-60.15%
4.38%
7.07%
0.00%
0.00%
-3.12%
8.37%
0.00%
0.00%
-61.83%
2.63%
-95.97%
15.06%
0.31% 11.74%
-95.94%
17.33%
0.33% 12.30%
8.76%
-56.12%
0.86%
-7.12%
0.00%
0.00%
4.37%
-47.81%
4.36%
-40.83%
0.93%
93.63%
8.14%
-45.24%
3.03%
35.74%
7.21%
-78.09%
0.00%
0.00%
8.05%
12.24%
0.00%
0.00%
1.66%
3.72%
0.00%
-100.00%
2.67%
-54.23%
0.36%
-95.52%
11.24%
58.07%
0.51%
7.48%
1.14%
0.00%
4.46%
4.12%
0.87%
7.49%
2.53%
8.27%
0.00%
6.79%
0.00%
1.31%
0.00%
2.12%
9.89%
2.74%
0.30%
0.64%
7.78%
1.27%
0.00%
3.57%
6.17%
0.85%
7.31%
2.78%
8.46%
0.00%
8.43%
0.00%
1.18%
0.00%
2.14%
11.68%
2.95%
0.62%
12.39%
0.70%
0.00%
5.06%
3.81%
1.08%
7.28%
2.38%
12.12%
0.00%
8.31%
0.00%
0.82%
0.00%
2.05%
10.96%
0.77%
8.74%
1.31%
0.00%
4.21%
4.55%
1.14%
5.58%
2.32%
6.58%
0.00%
9.44%
0.00%
1.85%
0.00%
2.30%
-0.66%
-54.83%
-18.97%
0.00%
-39.01%
-15.70%
36.59%
-35.48%
0.79%
8.68%
1.00%
0.00%
4.47%
6.23%
0.99%
7.20%
10.23%
1.20%
0.00%
5.73%
7.02%
0.00% -13.88%
1.89%
42.36%
1.17%
21.04%
2.09%
76.44%
1.50%
-79.80%
0.00%
21.02% 100.00%
-84.82%
0.00%
18.88% 100.00%
2.23%
26.75%
1.74%
83.41%
20.29% 100.00%
-81.38%
0.00%
10.95%
1.48%
2.36%
25.19% 100.00%
0.34%
9.60%
2.76%
1.90%
20.20% 100.00%
2.92%
0.31%
8.97%
2.90%
2.14%
15.18% 100.00%
11.85%
3.26%
0.32%
11.27%
3.00%
2.91%
-63.80%
-94.65%
56.71%
2.38%
29.41%
2.56%
0.37%
10.96%
1.96%
1.88%
2.37% 10.79%
-67.72%
66.16%
0.00%
2.08%
0.00% -15.18%
0.00% -68.45% 38.72%
2.65%
0.00%
8.07%
0.00%
0.00%
2.21%
23.54% 100.00%
27.89%
1.32%
-35.04%
1.94% -100.00%
0.00% -73.19%
2.21% 43.42%
9.96%
1.91%
14.00% 100.00%
-74.81%
9.80%
2.44%
32.34% -28.57%
1.89%
49.99%
34.20% -71.08%
9.12%
U
G
0.00%
0.00%
0.00%
A/
R
-62.98%
2.20%
-78.98%
0.00%
15.66% 100.00%
-81.12%
0.00%
21.34% 100.00%
-62.28%
2.16%
2.86%
PA
0.00%
-3.59%
1.71%
0.00% -10.68%
0.00%
2.40% -100.00%
0.00% -60.40%
1.94% 41.72%
9.50%
W
or
k
2.21%
-5.13%
1.56%
0.00%
-4.78%
7.68%
60.56%
of
I
10.68%
-95.44%
73.44%
0.44% 11.29%
-95.40%
73.25%
0.41% 11.55%
9.97%
-93.66%
Se
lf
0.00%
-82.39%
M
C
-76.45%
M
C
8.90%
6.73%
-23.42%
-62.15%
0.00%
0.42%
2.64%
0.00% -20.60% -100.00% -57.57% 35.39%
10.45%
St
ud
.I
ns
.
-93.27%
Pa
y
-61.12%
G
1.61%
Pa
yr
ol
lD
68.91%
Se
lfp
ay
lan
s
Py
m
tP
a
Pr
em
er
Re
pl
ac
em
en
Co
t
m
m
er
c ia
l
O
th
er
Go
v
Pr
og
W
am
a
s
Un
ifo
rm
M
C
M
ed
i ca
La
ta
h
Bl
ue
W
a
ID
8.05%
FP
3.71%
-94.15%
-40.30%
0.71%
0.00%
HM
O
ro
up
Cr
-23.06%
1-Jun-09
0.00%
FP
0.87%
G
Au
to
Bl
ue
12.54%
-66.30%
in
1-Oct-09
0.91%
27.14%
Co
m
p
-92.65%
-66.63%
U
-69.83%
3.40% -100.00% -69.95% 46.91%
ed
.
14.40% -100.00% -74.43% 41.96%
0.00%
Py
m
tP
la
ns
0.00%
1.58%
FP
32.47%
0.00%
FP
0.00%
36.53% -68.42%
MC
29.40% -66.62%
-33.66%
re
-48.85%
53.69%
Co
un
ty
in
PA
W
or
kC
of
I
om
p
St
ud
. In
s.
ed
.
ll D
Se
lf P
ay
Pa
y ro
GM
C
Py
mt
Pl
an
s
GM
C
Se
lfp
ay
lan
s
Py
mt
P
Pr
em
er
a
Re
pl a
ce
me
nt
Co
mm
er
c ia
l
Ot
he
rG
ov
Pr
og
W
am
a
s
Un
ifo
rm
re
Me
di c
a
Co
un
ty
La
tah
Sh
iel
d
47.47%
37.75%
Sh
iel
d
Bl
ue
Me
dic
ai d
W
a
36.60%
-32.33%
M
ed
ic a
id
-36.14%
0.00%
M
ed
ica
id
0.00%
-2.33%
He
alt
h
-17.61%
-52.93%
Ch
am
pu
s
ID
Me
d ic
a id
He
alt
h
HM
O
Gr
ou
p
us
Ch
am
p
os
s
Cr
-43.49%
2.96%
os
s
-13.17%
In
su
ra
nc
e
1-Jan-09
1-Feb-09
1-Jan-09
Bl
ue
Au
to
% above or
below
average AR
days
Ins
ur
an
ce
Comparison
0.93%
0.00%
17.51% 100.00%
18.62% 100.00%
-80.85%
0.00%
19.15% 100.00%
Pro-Active Bill Collection Example
Different communication forms will reduce collection
time of accounts
Increase the likely-hood of collection on a Self-pay
Account
Students are less likely to receive/respond to letters
Should collect email at admissions
Send out an email on day 15 reiterating the 15% bill
reduction if paid within the 20 days
On day 18 call and remind
Ask if bill can be paid by credit/debit card
Automated Solution Example
XactiMed Revenue Cycle Solutions
MedAssets’ Solutions
Automated System
Decreased A/R Times
Medical Facility
Original
Now
Reduction
*DHMC: Medicare
27
19
30%
**JPS: third party AR
30
22
27%
**JPS: Commercial AR
Fox Chase Cancer Center
Fell an average of 90.4 days
73.1
44%
40.8
56%
Average:
Target for Gritman:
39%
40%
*DHMC: Dartmouth-Hitchcock Medical Center; NH
**JPS: John Peter Smith Hospital; Fort worth, TX
5 Day Window Reduction
Current Process for IP/OP Surgery
Admission
Patient Documentation
Manual Discharge
On Site or Off Site Coder
if Off Site: Hold
Charge Entry
.
Auditing
Final DRG
AR Queue
Billed to Payee
Steps: 10
Time: 6+ days
New Process with automated billing and coding
Admission
Patient Documentation
Manual Discharge
Billed to Payee
Steps: 4
Time: 3 days*
*This minimum time is designated by Federal regulation and is out of the scope of this project to reduce
NPV
Present Value with 40% reduction
$980,000
NPV of -$1.89 million
About $400,000 per year reduction in costs
Factors to consider
Doesn’t account for savings of reducing employee costs
Reduction of employee time for billing none value added
for other processes
Doesn’t account for additional financial counselor