Practice Manager Town Hall Epic Implementation Details

Practice Manager Town Hall Epic Implementation Details
February 5, 2016

Meeting Objectives Provide high level information about the project
Project guiding principles Scope and timeline Ambulatory sequencing Provide details around transition requirements Data migration Hardware requirements Training Readiness activities Review a sample of key direction decisions and outstanding questions Registration and scheduling Professional Billing (PB) Health Information Management (HIM) 3rd party vendor overview Wrap up and next steps

Project Guiding Principles

Guiding Principles I The Epic design will be as a single health system on a single platform (i.e., single MPI, standard workflows across common functions, etc.) for both Mount Auburn Hospital and MACIPA. Epic Foundation system configuration and workflows will be the basis for the development of Mount Auburn’s enterprise standard workflows. The work of others will be leveraged whenever appropriate through the use of the Epic Community Library. Decisions will be made quickly and adhered to (i.e., will not revisit without Steering approval) in order to enhance the team’s ability to meet its scope and timeframe commitments.

Guiding Principles II Significant in-person training will be mandatory for providers, nurses, and other staff in order to obtain access to the system. Functionality will be implemented in a “Big Bang” fashion as much as possible – most live events will entail the concurrent cutover of both business and clinical functionality in a given practice, facility or hospital unit. Implementation of new non-Epic applications (e.g. specialty, best-of-breed software) will be allowed only if Epic does not have that functionality (e.g. blood bank), or there are exceptional circumstances not to use the Epic product (impact on revenue cycle, clinical safety, or other extreme circumstances). The Epic Steering Committee must approve exceptions.

Guiding Principles III
Mount Auburn Hospital and MACIPA will go forward in device technology, not backwards. The goal at go-live is for the level of device and technology integration to exceed or match the current environment at Mount Auburn. Additional opportunities for integration will be examined based on benefit, complexity, and impact to timeline/budget and prioritized by the Steering Committee. The Epic chart and associated Epic data warehouse will be considered the source of truth. Because this data is a valuable asset, defining/managing data governance will be crucial, and data will protected to the greatest extent possible. Issues and risks will be identified and escalated as early as possible. We will foster an environment where it is acceptable to raise issues through appropriate channels with the goal of facilitating and enacting solutions to the benefit of the program.

Scope and Timeline

Clinical Applications
EpicCare Inpatient Inpatient EMR ASAP Emergency Department Willow Inpatient Pharmacy EpicCare Ambulatory Ambulatory EMR Radiant Radiology System (will also be used by Cardiology) OpTime Operating Room Management Anesthesia Anesthesia Information Management Orthopaedic Module Orthopaedic-Specific Ambulatory Module EpicCare Home Health Care Management for Home Care and Hospice Beaker Clinical and Anatomic Pathology Clinical and Anatomic Pathology Lab Information System Cosmos DWH EpicCare Link Shared Record for Community Providers Haiku and Canto Mobile EMR Access Care Everywhere – Care Epic Interoperability Platform with Other Epic Systems Stork Obstetrics and Labor and Delivery Module Blood Administration Blood Administration Component Remote Monitoring Connection with Patient Monitoring Devices

Access and Revenue Applications
Cadence Name for Epic's enterprise scheduling product. Used to schedule and track patient appointments. ADT/Prelude Short for Admission/Discharge/Transfer. Used by organizations to track inpatients from their arrival (admission), to their movements inside the hospital (transfer), to their departure (discharge) HIM A suite of products accessed by different groups of users in the medical records department of a healthcare organization Resolute Hospital Billing Epic's Hospital Billing Patient Accounting product for clinics Resolute Professional Billing Epic's Professional Billing Patient Accounting product for clinics Home Health and Hospice Billing Home Care and Revenue Cycle Management

Foundational Modules Cogito Integrated Analytics and Reporting
Pulse and System Pulse Physician System Performance Dashboard EpicEarth Social networking platform for all Epic users Identity Master Patient Index Charge Router Router for Charges from Clinical to Billing Modules Bridges Interface Maintenance

The Big Picture FY 1 FY 2 FY 3 1 2 3 18 Month Inpatient Implementation
Implementation Start (November 2015) Readiness Activities & Planning 18 Month Inpatient Implementation Team Hiring & Certification Groundwork & Direction Workflow Adoption & Configuration 1 Outpatient Go-live (February 14, 2017) Testing 2 Inpatient Outpatient Go-live (May 20, 2017) Wave 1 Prep (3 months) Wave 2 Prep (3 months) 3 Outpatient Go-live (August 1, 2017) Wave 3 Prep (3 months)

Ambulatory Sequencing

Key Factors in Sequencing
Promote effective technology adoption and end user buy-in Ensure that Epic design and testing can be accomplished appropriately for each wave Optimize patient care and experience during the transition Minimize revenue cycle workflow implications

Key Principles The implementation will occur in 3 waves
The hospital will go live during the 2nd wave Hospital-tied practices will go live at the same time as the hospital The project team will build specialties individually

Specialty-Based Sequencing
Wave 1 Wave 2 Wave 3 February 14, 2017 May 20, 2017 August 1, 2017 Primary Care Practices and Pilot Specialty Practice Hospital, Home Health/Hospice, and Hospital-Tied Specialty Practices All Other Specialty Practices (Including Multi-Specialty Practices) Primary Care Internal Medicine* Family Medicine Pediatric Medicine Geriatric Medicine Endocrinology and Weight Management Cardiology Infectious Disease OB/GYN Pulmonary Gastroenterology Surgical Specialties Walk-In Center Radiology Pain Management* Rheumatology* Allergy and Immunology Dermatology Nephrology Otolaryngology Physical Medicine and Rehabilitation Podiatry Psychiatry Urology Belmont Medical*

Transition Requirements

Data Conversion Type of Information
How will I see it once we start using Epic? Patient Information Demographics excluding insurances and guarantors Automatically migrated into Epic. Current Medications, Allergies, and Active Problems Ability to manually reconcile into the patient’s chart in Epic from lists of CCDs. Lab Results Lab results from the hospital will be automatically migrated into Epic for a lookback time period between 5 and 10 years depending on the lab type Imaging and Diagnostic Test Results Results from the past 5 or 10 years (depending on type of test) will be automatically migrated into Epic. Images will not be viewable in Epic. Images will still be in PACS. Vitals Not migrated – they will be viewable in your old system(s). The exception is for pediatric patients. Pediatric vitals will be abstracted prior to go-live from eCW only. Advanced Directives and Living Wills Need to be abstracted from hospital charts. Automatically migrated into Epic from eCW or athena. Immunizations Past Medical, Family, Surgical and Social Histories Histories will be viewable in your old system(s). They will need to be abstracted during the patient’s first visit in Epic. Patient Notes Viewable in your old system(s) - they will not be moved to Epic. Coverage and Guarantor Information This information will not be moved into Epic since the risk of error and impact is very high. This information will be abstracted manually for patients who have existing scheduled appointments after go-live. Moving forward, all patients will need to have their coverage and guarantor information during their first encounter in Epic.

Workstation Purchasing Guidelines
Hardware Teams will assess existing hardware to ensure they meet Epic specifications Haiku and Canto (iPad and mobile phone applications) Workstation Purchasing Guidelines Operating System Windows 8.1 Enterprise Edition x 64 Processor Intel Core i processor (launched Q2 2014) Or, another fourth-generation Intel processor with a clock speed of 3.3 GHz or greater Memory 6 GB Video Device DirectX 10.0 or higher supported Monitor 23” widescreen flat panel (1920 x 1080 resolution) Or, 24” widescreen flat panel for 1920 x 1080 or higher resolution Display 1920x1080 resolution or higher, 32-bit color Network Gigabit (10/100/1000) Network Interface Card or equivalent

Training Overview Wave 1 Wave 2 Wave 3 2016 2017
Wave 1 training begins Wave 2 training begins Wave 1 Begin training registration in September 2016* Conduct training between December and February 2017 (wrap up 2 weeks prior to go-live) Wave 2 Begin training registration December 2016* Conduct training between March 2017 through May 2017 (wrap up 2 weeks prior to go-live) Wave 3 Begin training registration March 2017* Conduct training between June 2017 through July 2017 (wrap up 2 weeks prior to go-live) *Training registration usually takes 3 months (secure backfill and schedules) Wave 1 registration opens Wave 2 registration opens Wave 3 registration opens Wave 3 training begins Wave 1 GL (2/14/17) Wave 2 GL (5/20/17) Wave 3 GL (8/20/17) 2016 Sep Feb 2017 Dec Mar May Jun Aug

Playground Environment Prerequisites – Core Skills E-Learning
Training Approach At Go-Live, end users will need on the job training to reinforce what they learned in class. This is normally at the elbow or done through tip sheets. 5 Post-live training helps staff to continually increase knowledge and efficiency in the system. 6 Post- Live Go-Live Playground Environment Assessment Classroom Training Prerequisites – Core Skills E-Learning After initial training is complete, learners demonstrate their knowledge with simulation or question-based assessments. 3 Learners use their e-learnings and classroom training to get independent, hands-on practice in a practice environment. 4 Next is class time. Learners see demonstrations, participate in follow-along activities, and learn the essential workflows for their role. 2 Start Here! Learners watch brief lessons to get a sneak peek at the tools they’ll use as part of their role. Not intended as a substitute for training, these simply provide users with exposure to Epic before class. 1

Training Next Steps Vacation considerations
Role analysis underway – please respond to Liz or Richard! (due 2/5) Critical for appropriate level of training for each user Liz Tagen and Richard Cerminara available to answer questions afterwards

Readiness Activities Epic Application Subject Matter Expert (SME) meetings (e.g., Cadence, Professional Billing, Ambulatory, Orthopedics) Smaller group of individuals representing a core focus area Used to make decisions, validate build, standardize content, etc. Readiness Owners Individual owners/contacts for a particular practice, location, department, etc. The Epic teams need your help collecting information used for build

Access Cadence & Prelude

Cadence & Prelude Features
Functionality Definition Integrated Registration Once a patient is registered within MAH, MAPS, and MACIPA, their demographic, guarantor, and coverage registration information will be accessible in these encompassed areas. Scheduling Flexibility Cadence provides a robust framework to fit your practice’s scheduling needs and preferences. It utilizes a variety of scheduling tools to aid schedulers and make workflows simpler and more efficient. Real-Time Eligibility (for coverages) Electronic verification of coverages within Epic increases prompt claims submissions and gives organizations time to make self-pay arrangements for non-covered patients. Performing the verification electronically provides registrars and billing staff with fast, consistent workflows to document their results. Referrals Referrals within Epic are used to easily track authorizations for outpatient appointments or procedures and document physician to physician referrals for scheduling and tracking. Authorization information flows from MACIPA/MAPS to the hospital and across practices, eliminating the need for dual entry. Integrated reg - We have a process to develop your scheg reg models Analyze survey results to see what you do today Discuss future state During department interviews and the design process, you will choose which model you fit Coverage verification integrated directly into epic and will file select copays and benefits. Provides seamless query to payors to verify patient eligibility, which will then file data such as copays and help increase copay collection rates. Referrals – integrated, ordering the referral so you won’t need entry. The generation and follow up of referrals will be clear to end users – they won’t be lost in the process. We will be developing strong referral priority and close the loop workflows to make sure we’re not missing patients.

Cadence & Prelude Features
Functionality Definition Schedule Orders Allows scheduling based on a procedure order entered in Epic. The order is then linked to the appointment for easy tracking of results. Reporting The Cogito application within Epic provides not only customizable reports to run your practice from day to day, but larger reports that can help monitor and manage the health of your practices. Orders – aids the scheduling workflow because it defaults in information, remains linked to an appointment once attached. During reporting, we will want to give examples of reports, i.e. copay collection over a day v. over months to a year - cogito = suite of reporting tools within epic that provides real time and long term data to get a sense of how your practice is doing today, this week, this month, this year - examples = third available apt time, schedule utilization, copay collection

Key Decisions Decision Impact Cross Department / Practice Scheduling
Schedulers will be able to directly schedule appointments into other areas within Mount Auburn and MACIPA. Within Epic there are many tools and safeguards to make this work, and scheduling remains essentially decentralized. MSPQ Epic can prompt an end user for The Medicare as a Secondary Payor Questionnaire in a number of ways, but a standard MSPQ will be used across MAH, MAPS, and MACIPA. ABNs Forms the patient signs acknowledging notification (whether they accept or decline) that Medicare likely won’t cover the service being rendered. Users will be prompted at scheduling and check in for the ABN, but providers should also be prompted when placing an order. Referrals Sending departments are responsible for acquiring authorizations and scheduling. Schedulers should be prompted to collect authorization for a referral at the time of scheduling, to be completed by check-in. If schedulers continue without authorization, Epic has safety nets that can be used to catch appointments missing authorization. MyChart MyChart direct scheduling allows patients to directly schedule appointments for themselves in Cadence using the auto scheduler. Patients can be allowed to only schedule certain visit types through MyChart.

Outstanding Scoping Decisions
Topic Explanation and Questions Devices The devices you utilize in your practices today will need to be incorporated within Epic, and will affect build time and strategy. - What devices, i.e. scanning or e-sig, do you use in your practice today? Patient Communication Many patient communication tools are optional and we will need to get a sense of how your practice will utilize them. For example, how do you reach out to patients with an upcoming appointment? - Will you use auto-appointment reminders? Guarantor Account Types A guarantor account in Epic stores demographic information about the person/entity as well as billing information. The Guarantor Account Type describes the purpose of the account or who is represented by the guarantor information and are service area specific. Vendor Selection We need to verify the vendors and third party services you use as practices, or what your future vendor plans will be with Epic. - Will you use third party vendors other than Televox for patient communication and Emdeon for RTE?

Practice Scheduling Strategy
Kick-Off and Introduction Today: Practice Manager Summit Visit Type Strategy Sessions Two hour long meetings by specialty Demo functionality Consolidate visit types across organization Interview Strategy Sessions Meetings grouped by specialty Determine practice scheduling build and preferences

Next Steps Practice Scheduling Customization Operational Workgroups
Compile visit types used today by your practice Send to OneIS Team by February 19 Look out for visit type consolidation sessions Operational Workgroups Referrals Cross-Department Scheduling Workgroups made up of operational users to help us design our workflows as we go forward - we’re in the process of putting together workgroups to represent all areas of the organization who will be helping us plan for both referrals and cross-department scheduling

Professional Billing

Professional Billing Resolute Professional Billing
Integrated with patient access and clinical applications Targeted to specialized users through the revenue cycle Worklists to identify and prioritize charges Robust functionality to handle complex specialty billing scenarios PB for Community Practices Integrated with patient access and clinical applications Streamlined workflows for smaller billing offices My Practice dashboard as single-entry point for all follow-up Shared/standardized functionality allows smaller practices to benefit

Benefits of Resolute PB
Functionality Definition Practice Mode Streamlined workflows to make the system easier to use at practices with fewer than 10 clinicians and/or fewer than 3 billing staff Simplified manual charge entry Efficient payment posting Slimmed down account maintenance My Practice dashboard for revenue cycle follow-up Benefits Engine The Benefits Engine is Epic's tool for calculating patient liability. It can be used to prompt warnings in Cadence, calculate copays in registration, determine whether a charge is covered in billing, and a variety of other functions. If your organization decides to use Benefits Engine you must clearly define which pieces of Benefits Engine you will install. Front-End Cash Collection and Reconciliation Payments can be collected seamlessly in Epic during check-in or check-out. The billing system uses logic to match the copays to appropriate charges so they do not stay as credits on your accounts. The enterprise Cash Drawer module and Deposit Tool allow staff to record information related to money they collect from patients and reconcile that money against information received from your bank. Robust Edit Checking (including CCI/LCD and Medical Necessity) Edits checks can be triggered during order entry, charge entry, charge review and claim edits to prevent billing of charges that are likely to be denied. Visit Filing Order/Retroadjudication Visit Filing Order allows you to control coverage filing order per visit. Retroadjudication is the process of automatically voiding and reposting charges correctly adjudicated based on a coverage change made within the system. All coverage changes occur automatically and are not routed to retroadjudication workqueues. Owner: Lia and Cam (5 minutes) Presenting the benefits of using Epic’s Professional Billing—can cut this short if we think it will take up too much of our time. 33

Benefits of Resolute PB
Functionality Definition Payment Posting Manual payment posting allows staff to specify how to distribute payments on an account. Electronic Remittance allows you to receive electronic payments, automatically apply payments to appropriate charges, and perform payor-specific actions. You can also access a variety of standard remittance reports that will help you with remittance processing and following up on the causes for rejected claims. Statement Design and Processing Statements can be generated directly out of Epic and either printed in-house or sent to a statement vendor. SmartText Statements-Designed and maintained by the OneIS team allowing more flexibility, visual appeal, ad-hoc changes. Delimited Statement File-Send a programmatic file to a vendor to input into a design and print. Plain Text Statement-Print on preprinted forms in your office. Reporting Tools Epic offers several standard tools designed to facilitate different types of reporting Reporting Workbench-Reporting Workbench reports typically have shorter time frames and fill operational needs on a day-to-day basis Clarity/Crystal-Clarity reports typically have longer time frames than Reporting Workbench reports and involve more complex logic Radar-Radar dashboards and reporting homes provide a central hub for reporting content in Hyperspace. These pages can include sections that highlight important metrics, link to favorite reports, or open activities such as In Basket. Application Reports-Application reports vary a lot in look and feel, because they are designed for specialized tasks. They are more common in the revenue and access areas Owner: Lia and Cam (5 minutes) Presenting the benefits of using Epic’s Professional Billing—can cut this short if we think it will take up too much of our time.

DEMO Owner: Cameron (15 minutes)
Demo of the My Practice dashboard for working on issues throughout the revenue cycle.

Decisions Made Area Impact Facility Structure Payor/Plan structure
One service area will be created for each financially independent practice. This will ensure financial data is restricted to selected staff. Payor/Plan structure Financial classes, payors and plans will be shared between the hospital and all practices. MyChart Billing Ability to pay bills, view statements, set up paperless billing, send customer service messages. Benefits Engine Benefit packages, which control what/how certain services will be covered. These will be shared between the hospital and all practices. Workqueue Structure Private practices using practice mode will use standard workqueue structure to integrate with the My Practice dashboard. Owner: Layna (5 minutes) These are some of the high-level scoping decisions that have already been made and that will be standardized for all practices.

Standardization Needed
Area Impact Statement Format and Processing Will use a standardized statement template that is approved with the statement printing vendor. Private practices can customize certain details such as the logo. Statement processing will also need to be standardized with the hospital for MAPS, and is strongly recommended to standardize for private practices. Payment Posting Options Payment Posting options, such as small balance write-off and payment application policies, will need to be standardized with the hospital for MAPS, and is strongly recommended to standardize for private practices. Expected Reimbursement Contracts Currently, MACIPA manages contracts, therefore these will continue to be standardized. Epic Expected Reimbursement Contracts allow you to calculate expected reimbursement, which can be used to report on underpayments or even net down AR. AR Codes AR Codes are used to track different types of payments and adjustments for reporting purposes. These will be shared between the hospital and all practices. Financial Assistance Financial assistance options, such as discounts and payment plan policies, will need to be standardized with the hospital for MAPS and is strongly recommended to standardize for private practices. Owner: Layna (5 minutes) These are the major decisions that are still outstanding that we need practices to standardize

Vendor Selections Area Vendor CCI/LCD/Medical Necessity Checks 3M
Claims Scrubber/Clearinghouse Emdeon Payment Processing Gateway Instamed Statement Printing SmartSource Collections Agency Various .

Outstanding Topics Topic Explanation Outsourcing – Scope of workflows?
Will you outsource any revenue cycle processes? Determine whether outside users will need access to Epic or if information will be exchanged through extracts. Vendor access to Epic will require a nondisclosure agreement and additional training for third-party staff. Extracts require additional build and testing. My Practice If using Epic, will you use the My Practice functionality? Extracts Do you require extracts to send any of the following: Bad Debt (to collection agency) Decision Support (to decision support system/data warehouse) General Ledger (to accounting system) Outsourced Active AR (to billing vendor for certain revenue cycle processes) Refunds (to accounts payable system)? Owner: Layna (5 minutes)

Outstanding Topics Topic Explanation Specialty Billing Scenarios
Do you have any billing scenarios that require special handling? Already in scope for certain practices: OB Billing (fee for service and global option) Global Billing (post-operative services) Cosmetic/Elective Billing (non-covered services) Users & Security How will we collect user role and user security information from your practice? We strongly recommend standardizing user templates as much as possible across both the hospital, MAPS, and private practices. Revenue and KPI Management If using Epic, how will you monitor and manage your metrics? What are your financial goals and how will you maintain revenue integrity through the install? Owner: Layna (5 minutes)

Outstanding Topics Topic Explanation Cash Drawer
Is cash collection tracked by the person who collected it (user) or is it tracked based on where it was collected (workstation)? Scanning EOBs Do you currently scan EOBs for payment posting today? Miscellaneous Payments Do you receive any miscellaneous (non-patient-related) payments, such as: NSF fee Interest payment Tax payment Incentive payments Estimates Do you currently provide patient estimates? SmartText Letters Do you send any standard billing letters today (to patients/guarantors, insurance companies, etc)? Hiding for now since I don’t believe we will have enough time.

Next Steps Determine if you will utilize Epic’s Professional Billing module. Provide practice contact to work with the Epic billing team Complete practice questionnaires and submit to the build team. Engage with the build team for additional system build requirements, design and testing. Owner: Layna (2 minutes)

Questions/Concerns If you have concerns about decisions presented today, or ones that are being standardized, reach out to: Bernadette McCarthy Layna Chuter Deadline: Friday, February 12 Owner: Layna (1 minute) Concerned about: “Decisions Made” and “Standardization Needed” slides (those are the ones we need to hear if there are concerns now so we can start planning) The “Outstanding Topics” will be ongoing conversations with them.

Health Information Management

Decisions Made Area Impact MyChart Legal Medical Record
Patients will be able to request records via MyChart and releasing records to patients via MyChart will not involve a fee. Legal Medical Record There will be a standard inpatient summary and standard ambulatory summary that will constitute the legal medical record. Chart Correction There will be a standard written policy for end-user chart correction in Epic. Scanning OnBase will be the standard vendor for our Document Management System.

Outstanding Scoping Decisions
Topic Explanation Release of Information Will all practices be able to see and release information associated with encounters across all locations? Scanning Mount Auburn Hospital and practice providers will standardize Hyland OnBase as their Document Management System. Will scanning be centralized through HIM? Chart Correction Will you handle your own patient merging and chart correction cases or will you centralize through HIM? Legal Medical Record Will all practices use the standardized MAH Ambulatory Encounter Report as their LMR? Update CRD with explanation We want one patient one chart – it’s extra work and would need to configure workaround workflows For complicated cases, do we want HIM to handle it or do you have your own people? Recommendation: keep as few hands in the pot as possible – but be reasonable? We want to agree on a standardized template for the LMR – should expect in a legal case you’d get the same info as for MACIPA / MAH, Regional representation – practice manager rep 10 practices.

Release of Information
DEMO

Release Ownership Will practices be able to view and release information from Mount Auburn Hospital and vice versa?

Billing Will each practice manage its own ROI Billing?

Scanning Centralization
Will you continue scanning documentation at each individual location or will you consolidate scanning duties by moving to centralized locations?

Scanning Document Management System
Mount Auburn Hospital and practice providers will standardize Hyland OnBase as their Document Management System.

Chart Correction Managing Duplicate Patients
Will individual practices be responsible for analyzing potential duplicate patients and merging?

Legal Medical Record Standardizing the Ambulatory Legal Medical Record (LMR) Will all practices utilize the same standard Ambulatory Legal Medical Record?

3rd Party Vendor Overview

Clinical Impact Name Description Vendor Choice Drug Database
Provides medications data including drug names, pricing, interactions, and default prescriptions, including: NDDF Medication files, Dosage Range Check Module, Drug Interactions Module, and Pharmaceuticals listing for EpicCare. First Databank RxNorm Content Provides mapping between Medispan/Multum and First Databank code sets, which is required for MU. E-prescribing Electronic prescription gateway. Also provides patient medication histories based on patient's pharmacy and prescription benefit manager responses SureScripts Devices for ECG & Spirometry Integration of Spirometry and ECG device results into EHR. Midmark Clinical Content Evidence-based clinical decision support to improve quality across the continuum of care; includes inpatient physician, nursing, and interdisciplinary content. Zynx Order Sets Evidence-based order set and decision support content can be provided directly by vendors. Medication Reference Information Medication reference information links that are visible in order entry or in the MAR. Lexicomp (Wolters Kluwer) Patient Education and Discharge Materials A wide variety of patient education and discharge reference materials that provide consumer-level education. Reference Lab 3rd party specimen and pathology laboratories. Quest Quest Chantilly Ameripath Converge (Acquired by Quest)

Coding Impact Name Description Vendor Choice
Medical Necessity Guidelines Real-time edit checks applied by your Medicare payors against LCD/CCI guidelines 3M Encoder Module that finds and pulls codes such as CPT, ICD-10, HCPCS, DRG, etc. APC Core Grouping Software Provides Claim level APC values on outpatient account claims and is required if you plan to calculate OP expected reimbursement through Epic via APCs. It also provides an additional level of OCE/CCI editing on these claims and routes them to Epic claim edit work queues. DRG and APC Pricer Provides Claim level APGS values on outpatient account claims and is required if you plan to calculate OP expected reimbursement through Epic via DRGs Coding Cross Reference Table Matches non-coded charges (such as operating room time) to CPT coding done by coders. The matched codes are used for claims and reporting. NUBC (UB-04) Codes UB-04 codes are NUBC-standardized values used to convey specific information related to the claim. Examples include value, occurrence, span, condition and revenue codes. Health Language (Wolters Kluwer) Module that finds and pulls codes such as CPT, ICD-10, HCPCS, DRG, etc. 56

Revenue Cycle Impact Name Description Vendor Choice
Real Time Eligibility Automated verification of patient insurance eligibility Emdeon (Has rebranded as Change Healthcare) Claims Scrubber Automatically analyzes and edits claims based on defined rules provided by vendor or developed in house to reduce denials. Claims Clearinghouse Allows for claim transmission to multiple payors that is maintained by the third party. Vendor provides claim status files and are able to send us claim error and claim acceptance info back into Epic. Statement Print Vendor Epic produces rich text formatted statements as PDFs. Most customers choose to send the PDF statements to a vendor for printing and processing. SmartSource Epic Patient Statements Payment Processing Gateway Used to integrate credit card payments via swipe devices and patient portal (MyChart) with EHR. InstaMed Collections Agency Epic can be used for some in-office collections, but customers typically have a separate, outsourced collections agency for their bad debt accounts. Various

Technology Impact Name Description Vendor Choice Faxing solution
In-EHR faxing capabilities Biscom Document Management System (DMS) Capture content like paper forms, faxes, graphics, photos, videos and clinical images and makes them available through a hyperlink within the appropriate Epic application. Epic Media Manager OnBase Learning Management System (LMS) Learning Management System Common Learning Management Systems (LMS) can distribute and track e-learnings and other training completion milestones. HealthStream Issue Tracking System System to track issues from testing, Go-Live, and ongoing support. Improved methods for end users to communicate issues. Enhanced ability for directors to monitor help desk performance and efficiency. ServiceNow Patient Appointment Reminders Provides automated appointment reminders for proactive patient outreach. Televox

Wrap Up & Next Steps

Handouts Data conversion summary MACIPA 3rd party billing summary
Epic workstation purchasing guidelines 3rd party vendor matrix Epic playbook

Next Steps Training Access, Cadence & Prelude Professional Billing
Send role analysis information to Liz Tagen or Richard Cerminara by 2/5 Access, Cadence & Prelude Send visit types used today by your practice to OneIS team by 2/19 Professional Billing Determine and communicate plans for future state professional billing (using Epic’s PB module or a 3rd party) to Layna Chuter by 2/29 Complete practice questionnaire and identify point people to work with the OneIS team during the transition to Epic by 2/5

Key Contacts Training Registration and Scheduling Professional Billing
Liz Tagen Richard Cerminara Registration and Scheduling Suzanne McHale Bernadette McCarthy Professional Billing Layna Chuter HIM Ambulatory (Clinical) Debi Glasheen David Rodriguez

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Practice Manager Town Hall Epic Implementation Details

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