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Helping a Hospital Regain Control

While patients know this general medical and surgical hospital as leading provider of compassionate, high quality care, behind the scenes the business office was struggling to keep pace with an ever-increasing volume of paperwork and regulatory requirements. They turned to Medforce to help improve processes, save time, and maximize employee productivity.

Products Used:

Challenges

This not-for-profit healthcare system includes an acute care hospital, a rehabilitation hospital, an outpatient surgery center, several kidney dialysis centers, multiple Centers for Health and Cancer Support Homes, and a network of over 20 regional clinics. The hospital embraces the use of technology to improve operations, and previously implemented several solutions which focused on improving outcomes including electronic medical records (EMR), inventory and vendor management, revenue cycle management, and a denials tracker. But when it came to the supporting documentation, remittances notices, and vital records that underpin and coordinate between the various platforms, the paperless efforts abruptly ended.  Doctors and nurses used EMRs to log patient care and many critical documents (such as ERNs) were received electronically, but the hospital’s business office had no means to easily gather the disparate supporting records in a single place to submit for payment, appeal a denial, or work collections. Subsequently, they were forced to print EOBs, create paper files, and in many cases generate multiple convenience copies so each employee had access the required information.

In addition to the physical waste and negation of the original electronic documents, the business office was saddled by inefficient processes. There was no way to sort claims to be worked by strategic priority (e.g. procedure code, dollar amount, or looming deadline).  Instead, claims were simply divvied up by the patient’s last name.  Additionally, employees needed to hand deliver files or retrieve printed documents, which meant valuable time was spent “in transit” away from their desks.  Without detailed visibility into the process, managers lack an efficient method for confirming whether critical tasks were being completed, identifying potential bottlenecks, or maximizing productivity.

Beyond the Finance office, the Human Resources department was also feeling the strain of paper-intensive and manual processes. Since the hospital is required to maintain employee records for a minimum of 10 years after their departure, the Human Resources department was literally overflowing with physical files for both past and present employees. The documentation included paperwork associated with employee onboarding, tracking employee training and performance reviews, and so on.  Additionally, all hospital employees are required to complete an annual health evaluation which coincides with their hire date. These processes and the associated documentation required intensive manual handling and intervention. As a result, human error was common and managers lacked visibility into the current and upcoming workload.

Solution

Following an extensive solution review process, the hospital selected the fully integrated ContentCenter, CommandCenter and RemitCenter platforms. We partnered with the hospital to implement electronic filing, business process management, and claims management to coordinate, standardize and automate business activities. 

Implementation highlights include:

  • ContentCenter is configured to retrieve automatic data uploads from the McKesson STAR health information system through a Cerner Open Engine HL7. As a result, billers are able to simultaneously view both the claim and supporting documentation which significantly increases their efficiency.
  • Medforce imports ERNS, parses the feed into individual EOMBs and auto-files each to the appropriate patient file without any human intervention. Additionally, this process triggers the creation of corresponding Medforce CommandCenter tasks which ensure all claims are worked in a consistent and visible manner.
  • Dynamic dashboards and reporting capabilities provide instant visibility for balancing workloads, identifying employees that may require additional training or assistance, determining bottlenecks or commonly denied claims that may require process refinement, and prioritizing work based on specific strategic directives.
  • By digitizing their employee files, the Human Resources department will be able to ensure that required information is instantly available and accessed only by the appropriate users. This creates a significant savings in both time and space while also increasing the security of employee information.
  • Medforce CommandCenter simplifies the processes associated with onboarding new employees, tracking ongoing training requirements, managing annual reviews, health evaluations, and so on.  

Results

By partnering with our implementation team, the hospital was able to design a phased implementation plan. It logically prioritized the deployment of the Medforce software according to a variety of factors including patient and employee information security and return on investment (ROI). High priority tasks which were historically time consuming and inefficient were the initial focus, and the hospital transition to a paperless, intelligent system has been easy to manage

The integrated ContentCenter, RemitCenter and CommandCenter platform provides  additional cost savings by eliminating the hospital’s antiquated denials tracking software. This freed up cash flow enabled them to take advantage of Medforce’s ZipMit esMD solution. With ZipMit, the hospital can electronically submit Medicare and Medicaid prior authorizations, audits and appeals directly to CMS and keep tabs on their progress.

Medforce helps the hospital coordinate and standardize all business activities while providing transparent, dashboard analytics to feed process improvement and maximize employee potential.

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