Transcript Document 7234280

Using Technology to improve Your
ASC
Colorado Ambulatory Surgery Center
Association
Contact Information:
MediGain Inc.
1-877-237-9539
[email protected]
www.medigain.com
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Some Technology Usage Facts
Preserving Healthcare Profits
Before
 First IBM PC is launched in 1981
 Motorola releases first mobile phone for $3,995 in 1985
• Cellular Technology Industry is formed in 1988
 The world wide web as we know it today launched in 1991
• Hotmail is launched in 1996
 HIPAA Introduced in 1996
Now
 Computer ownership in the USA – 80% of population
 Mobile phone ownership in USA – 81% of population
 Internet usage in USA – 73% of adults
• Google maps show pictures of your street and house
• YouTube used to watch movies and elections
 More than 80% of ASC’s and Physician practices still use paper
medical records
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Healthcare vs. other Industries
Preserving Healthcare Profits
 Retail Industry
• Find your favorite store, clothes and sizes
• Purchase online, and track shipping to your doorstep
• Understands customer needs and trends
 Airline Industry
•
•
•
•
Find destinations, schedules, type of airline that flies
Purchase tickets online - select seat, food etc.
Check status via internet, phone or text – notifies schedule changes
Receive promotions based on customer preference and history
 Healthcare Industry
• Minimum or if any web presence
• Most cannot schedule appointments online – no notification on delays
• Minimum knowledge and tracking of information about patient habits
• No infrastructure to share information – loads of paperwork
• Medicare takes 6 months to issue or change a new provider number
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Why Utilize Technology in the ASC
Preserving Healthcare Profits
One of the key building blocks of an ASC:
 Technology
 Processes
 Resources
Technology
ASC
Can provide the following benefits:
 Increase revenue
Processes Resources
 Decrease costs
 Improve efficiencies
 Decrease errors
 Improve visibility to operations
 Use it as a strategic advantage over competition
 Meet government and regional mandates
 Meet consumer expectations
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Preserving
Healthcare Healthcare
Profits
Preserving
Typical ASC Structure
Profits
Front Office
Back Office
Clinical
< 20% of Revenue
>80% of Revenue
From Cash
From Insurance
Patient Care
Customer Service
Transcription
Coding
Billing
Collections
Follow up
Medical Records
Scheduling
Insurance Verification
Patient Info
Electronic Claim Processing
Paper Claims and Statements
Patient Forms
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Diagnosis
Procedures
Dictation
Inventory
Management
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Reporting
Analytics
Business Intelligence
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Potential Revenue Losses in an ASC
Preserving
Healthcare Healthcare
Profits
Preserving
Revenue Lost by
Typical Facility
Profits
ASC’s Have Already Done Work
and is Owed 100%
-5%
Patient Registration/
Eligibility Verification
Lack of proper front office processes and
systems impact reimbursements
-4%
Fee Schedules/
Charge Master
Charges need to be updated and
compared with national averages
-10%
Transcription/Coding
Poor transcription and inaccurate coding
can lead to denials and lost rev.
-3%
Claim Submission
Almost 3% of claims are lost by insurers
after positive receipt by clearing house
-3%
Secondary Insurance
& Patient Portions
Many do not send or follow up on
secondary and paper statements
-5%
Payment Posting/Follow up
Inaccurate posting can result in inaccurate
statements, follow up, and collections
20% - 30%
Potentially Lost Revenue
Loss of 20% to 30% of the money
you have already worked for!
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What Processes Do You Automate?
Preserving Healthcare Profits
Process
Manual
Solutions
1. Scheduling
X
Web integration to PM System
2. Ins Verification
x
Scheduling and clearing house integration
3. Patient Confirmation
X
PM Sys and Telephone/Email integration
4. Chart Preparation
>82%
Electronic Forms and Document Mgnt Sys
5. Dictn./Transcription
>26%
Integrated Transcription and PM System
1.
editing
X
Online editing capability
2.
Signature
X
Electronic signature system
3.
Distribution
X
Web, fax and Email distribution
>82%
EMR and Electronic Forms with Bar-coding
6. Document mgmt
1.
Medical
X
Scanned or electronic health record
2.
Reports
X
Scanned or electronic health record
3.
Forms
X
Scanned and indexed
7. Coding
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EMR/Coding Engine
X
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What Processes Do You Automate?
Preserving Healthcare Profits
Process
Manual
Solutions
8.
Charge Entry
X
Integrate Registration and EMR
9.
Claim Scrubbing
X
Integrated coding engine and edits
10.
Claim Submission
X
Clearinghouse integration with PM System
11.
Claim Acknw.
X
Clearinghouse integration with PM System
12.
Payment Receipt
X
Bank lockbox with web based doc. view
13.
EOB/PMT Posting
X
ERA with integration to PM System
14.
Denial Mgmt.
X
Denial tracking, automated appeals
15.
Reporting
X
Data capture and business analytics
16.
Prescription/Labs
X
Prescription and Lab integration with PM system
17.
Materials mgt.
X
Integration of PM Sys. and Clearinghouse
18.
Patient info.
X
Web portal with Integration - Med Rec &PMS
19.
Marketing
X
Data capture through PM System/Web/Tel
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Asses Current ASC Situation
Preserving Healthcare Profits
 Technology
• Age and efficiency of current systems
• Tasks that are done manually but can be be automated
 Staff
• Knowledge of IT staff, and time allocated for technology planning
 Management
• How the organization implements and integrates technology related
decisions
 Financial
• Budget and availability of funds for technology implementation,
support and maintenance
 Conduct needs assessment by functions
• Front office – Scheduling, patient access
• Clinical – Materials management, lab/pharmacy integration
• Back office - Billing, Collections, Patient data gathering and
distribution
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Preserving Healthcare Profits
Items to Consider When Investing in Technology
 List benefits and calculate ROI
• Staff time that will be saved per month x $/hr
• Increase in revenue per month i.e. reduction in claim denial
 Set IT roadmap and priority based on highest ROI and budget
 Selecting vendors
• Ability to customize, web based
• Customer service, and customer feedback
 Other key IT considerations
• Capability to integrate to other systems and other facilities i.e. physicians,
hospitals via HL7
• Web enabled access for ease of management and maintenance
• Data exporting, mining and reporting capabilities
 Phased deployment
• Phase the deployment to ensure all stakeholders become familiar with new
systems – MD’s, staff, patients
• Set project plan and realistic timelines
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Preserving
Healthcare Healthcare
Profits
Preserving
Ideal ASC Workflow
Profits
Digital Forms
Transcription
Web
Surgery
Coding
Phone
Billing/
Collections
Posting
Insurance
Reporting
Analytics
Patient Medical
Record
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Referring MD
Inventory
Management
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Bank
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Preserving
Healthcare Healthcare
Profits
Preserving
Example of Opportunity
Profits
Assuming an average ASC
Current revenue generated
= $5,000,000/yr
Conservative estimate of improvement
= 10%-15%
Total revenue increase/yr
= $500,000 to $750,000
Total revenue increase/mo
= $41,666 to $62,500
Note:
This does not include any cost savings due to
increase in efficiencies.
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Where do you want your ASC to be?
Preserving Healthcare Profits
ASC Technology Maturity Model
Level 1
Level 2
Level 3
Level 4
Paper records
Some Scanned records
Standalone EMR
Manual entry
Min. automation of
processes
Some Automated
processes
Some delays in billing
Smooth workflow
Optimized workflow
Some electronic claims
Min delays in billing
Ave. collections
Consistent collections
and cash-flow
Automated billing and
coding
Manual processes
Paper claims
Delays in billing
Poor collections
Poor cash-flow
No reporting
Obsolete systems
Overworked staff
Reactive management
Afraid of IT
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Poor cash-flow
Minimal reporting
New but disparate
systems
IT is an afterthought
Some integration of
systems
Fully Integrated systems
Embracing IT
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Optimized cash flow
Dashboards & Buss. Intel
Some proactive
management
Reactive management
Automated processes
Basic reporting
Adequate staff levels
Overworked staff
EMR accessible to
patient/ext. entities
Optimized staffing
Leader in industry
Proactive management
Using IT as its advantage
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Questions and Answers
Preserving Healthcare Profits
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