Practice Pulse RCM Analysis and E.H.R. HealthCheck Angela Jarrett, CPC, CMPA Senior Professional Services Consultant

RCM Analysis Overview Increase productivity, increase staff knowledge, increase revenue, modify workflows, increase staff measurements and outcomes Analysis Professional Consulting Living RCM

RCM Analysis Agenda Overview Revenue Cycle Management Analysis Report System Work Flow Analysis and Design Professional Consulting and Support Goal

Revenue Cycle Management Analysis This information is intended to provide the staff with an analysis of overall system status as well as a review of system usage and overall performance. Administration – Exclusive Review of specific Admin Tables Financial Performance System Maintenance Management Goals and Outcomes, Measurements and Expectations

A Peek Behind The Curtain

$ Squeezing the Sponge $

Stay In the Bell Curve HRSA Top 5 Financial Classes: Medicare, Medicaid, Slide Fee, Self Pay and Commercial. Are the providers coding ALL patients the SAME way? With the RCM ANALYSIS Report… you will know!

Workflow, workflow, workflow! A workflow consists of an orchestrated and repeatable pattern of business activity enabled by the systematic organization of resources into processes that transform materials, provide services, or process information.

System Workflow Analysis and Design Identify workflow, system functional weaknesses and staff competency Front Desk Staff Observation Billing Department Staff Observation EDI Database Review Development of Optimized Workflows Plan

Professional Services Consulting and Support Identify required maintenance, staff re-training and overall optimization RCM to “Living RCM Standards’ Administration Training System Training Billing/Patient Financial Services Training Payment Entry - Insurance/Patient Reports Training Closing Date Procedures Training

RCM ANALYSIS Tier 1, 2, 3 and beyond

NamePlan DurationAssignedTotal Hours Revenue Cycle Management Analysis Day 1 Financial Performance - Report and Dashboards Created 2hrs Online 2 Administration – Exclusive Review of specific Admin Tables 4hrs Onsite 4 System Maintenance 4hrs Onsite 4 Management Goals and Outcomes, Measurements and Expectations 2hrs Onsite 2 System Work Flow Analysis and Design Day 2 Observation Front Desk 4hrs Onsite 4 Observation Billing/Patient Financial Services 4hrs Onsite 4 Day 3 EDI Database Review 4hrs Onsite 4 Development Optimized Workflows Plan 4hrs Onsite 4 Implementation and Post implementation Support Beyond Admin Follow Up Training 2 Days Onsite Training 16 System Training (Super/End User Training) 2 DaysOnsite Training16 Billing Training 16hrs Onsite Training 16 Payment Entry - Insurance/Patient 4hrs Remote Training 4 Reports Training 4hrs Remote Training 4 Reports Training Follow Up/Scoping 2hrs Remote Training 2 Closing Date Procedures Training 2hrs Remote Training 2 Collections Training 4hrs Remote Training 4

Our Goal

W HAT I S … The E.H.R. HealthCheck The objective of this program is to assist customers that find themselves still struggling with how to implement the changes required by CMS, Government etc… The overall goal is to help practices change their concept and thought process regarding the software by accepting change in their workflow. The key initiatives for this service are: Analyze our customers’ workflow Fabricate a systematic workflow process Create benchmarks for each process Ultimately generate revenue

P ROCESS F OCUS 1. Evaluation – Evaluate the overall office processes to include the current roles of the staff and utilization of EHR system during the day- today operations. 2. Analysis – Analyze the efficiency of the tools within the EHR system as it relates to the client's EHR vendors best practices. 3. Recommendations – Consultation on the discoveries found during the analysis as to find mitigation on broken processes. 4. Implementation – Based on the recommendations agreed upon, we will incorporate the needed workflows as well as introduce new products and functionalities to move towards Meaningful Use compliance. (i.e. Patient portal, HL7 interfaces, etc...) 5. Evaluation – Perform a post-evaluation of the overall office processes to include the current roles of the staff and utilization of the EHR system during daily operations as comparison to your initial evaluation.

Benchmarking Examples Check-In Process Has check in lag time improved? Is the end user capturing all necessary MU Information at Registration? Are demographics being updated? Decrease in No Show Rate? Clinical Process IIs the Clinical Support Staff managing the encounter types, scheduled visit and LOC correctly? Did the clinical staff capture the Meaningful Use data? Is tasking/orders tracking used correctly? Lag Time Improvement Services and referral follow-up lag time improvement. Provider Process Are providers documenting HPI and CPOE thoroughly for ICD-10 standards. Are providers completing note during the visit, after the patient leaves or later? % of On Hold, In Progress, Completed Orders. Are all charges captured. Are the providers creating an Append and documenting this correctly? Are providers completing prescriptions, ordering labs and x-rays procedures? Are providers scheduling the patient’s next appointment?

What to Expect When We Arrive 1st We will examine and analyze your front office, clinical staff, and provider processes. 2nd Based on our findings, we will deliver a strategy that will allow your agency to employ Best Practices based to assure your success. 3rd We will help you modify your workflows, as needed, and introduce you to any new product functionality that has been evolved since your implementation. 4th We will conduct an Exit Interview to discuss finding and recommendations. 5 th A writte n evalua tion and recom mend ations will be provid ed for future impro veme nts. We would like to keep track of your progr ess with a follow up call 30 to 60 days from the Check -up visit.

C RITICAL CLINICAL ASSESSMENT AREAS : EHR Implementation Team Workflow Design Appointment Scheduling Patient Check In Clinical Check In Provider Process Orders/E-Rx /Referral/Pt Education Clinical Check Out Office Check Out Billing

Investment There’s an investment on the client’s part for this to be successful: Time – The practice has to invest in the time to learn. Adjustment – To the changing times and regulations of CMS Attitude – How you react will affect your staff Concepts – We need to be open to new ideas Workflow – A re-training or new workflows and concepts

Who is our target audience? Our Customers Our clinical support staff Our providers YOU!

DECIDE….. COMMITT…. ACHIEVE!

Questions and Answers

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