Presentation on theme: "Revenue Cycle Management Medical Technology Acquisition and Assessment Team Members: Joseph Dixon, Michael Morotti, Mari Pirie-St. Pierre, David Robbins."— Presentation transcript:
Revenue Cycle Management Medical Technology Acquisition and Assessment Team Members: Joseph Dixon, Michael Morotti, Mari Pirie-St. Pierre, David Robbins and Nicole Wayne July 9, 2009
Introduction of Team Members Joseph Dixon, Database Analyst Michael Morotti, Medical device manufacturing and development Mari Pirie-St. Pierre, Health Information Management Director, Behavioral Health Facility David Robbins, Management Consultant Nicole Wayne, Neonatal Intensive Care Nurse
Revenue Cycle Management at River Center Hospital What is revenue cycle management Why do we need revenue cycle management Hospital size is 400 beds Case Mix – 55% commercial heath insurance – 30% Medicare – 12% Medicaid – Remaining self pay
Background SOW Section 1 Current processes encompass – ADT, credit/collections, patient billing. Future needs – ICD-10-CM – HIPAA 5010 – Increase customer satisfaction – Participation in Regional Health Network – Integration of financial and clinical information
Objectives SOW Section 2 Maintain ALL of the existing functionality of the current system while supporting the following new requirements: Transition to HIPAA 5010 claims attachments prior to January 2012. Transition to ICD-10-CM coding prior to October 2013. Consistent documentation and coding practices in order to accurately reflect patient severity and care delivered
Objectives (cont.) SOW Section 2 Improve customer satisfaction through expansion of patient services: – Schedule appointments online – Perform online payment for services – Review provider charges and payer reimbursement Meet standards for interoperability in order to participate in Regional Health Network. Integrate financial and clinical information Train staff members on new technology. Analyze and apply meaningful use criteria in order to maximize ARRA incentive pay.
Scope SOW Section 3 Revenue Cycle Management System (ADT/registration, credit/collections, and patient billing) is obsolete and needs upgrade/replacement to address and support current and future revenue growth in the following areas: Cash flow improvement HIPAA claims attachment Severity Adjusted DRG ICD-10-CM Coding Outcomes reimbursement Optimizing billing collections and lowering cost Denial management Operational assessments to analyze policies, work flows, staffing, and resource utilization, etc.
Included & Excluded SOW Section 3.1 & 3.2 Patient Enterprise Revenue System Decision Support and Reporting Data Conversion and Migration Integration and Interoperability Training and Education Hardware (excluded item)
Deliverables SOW Section 4 List all the major project deliverables – ie. Statement of Work List Responsible Party, Acceptance Criteria, Due Date. Define required system documentation and user documentation. – Require documentation to include customizations and configurations specific to this project. Quantities, locations, dates for delivery and period of performance for services. Interim deliverables may be included in this list if the final deliverable requires a lot of effort and a long time to complete. Indicate who will review and sign-off for approval. Use tables – rather than a narrative – to enumerate the deliverables is preferred (even for simple SOWs).
Milestones SOW Section 5 MilestoneResponsibleTarget Begin Date Target End Date Develop Statement of Work and Responsibility Matrix Hospital Executive Committee 06/27/200907/9/2009 RFP Completion and Submission Hospital Executive Committee 07/21/0908/01/2009 Vendor Selection Hospital Executive Committee 8/2/20098/12/2009 Develop Implementation Plan Steering Committee Implementation Team Vendor 8/14/20099/1/2009 System ImplementationVendor Implementation Team 1/2/20101/2/2011
Change Control SOW Section 7 Defined: A change is any material deviation from a baselined and approved scope document. Process: 1. Submission of Change 2. Assessment of Change 3. Analysis of Cost / Project Impact 4. Program Office / Project Management Recommendation 5. Steering Committee Decision 6. Communication & Documentation
Project Reporting & Communication SOW Section 8 Overview: Provides information, forms and templates to give personnel a starting point for managing and creating communications for the project Project Documents: Baselined and resource loaded project plan, Issue log, Risk Log, Change Log, Dependency matrix, Communications Plan, Training Plan Committees: – Weekly Project Management Meetings – Bi-Weekly Stakeholder Meeting – Monthly Steering Committee Meeting
Responsibilities Sow Section 9 RoleNameOrganizationResponsibilitiesTime to project CIO HospitalOversees vendor, implementation, and installation and monitoring of system, looks at possibilities of consolidation with vendor. Oversee training, give feedback. Approve system specifications and implementation, oversee: data migration and configuration, software validation, validate data sources. Progress review. Member of steering committee. 10% Project Leader HospitalOversees vendor implementation -all aspects. Approve system specifications and implementation, oversee: data migration and integration, and software validation, validate data sources. Establish power users. Progress review. Member of steering committee. 15%
14 Responsibilities (cont.) Sow Section 9 T 14 RoleNameOrganizationResponsibilitiesTime to project VendorLegacyLegacy Systems Meets the hospitals needs for the plan, gives, information as to how they can best meet these needs including: implementation, trial period, modification and maintenance To be determined CNO HospitalIdentify specific needs to make the new system work, and give feedback. Oversee training. Member of steering committee. 5% CMO HospitalIdentify specific needs to make the new system work, and give feedback. Oversee training. Member of steering committee. 5%
Responsibilities (cont.) Sow Section 9 RoleNameOrganizationResponsibilitiesTime to project CFO HospitalIdentify specific needs to make the new system work, and give feedback. Oversee training. Give return on investment data (of new system). Member of steering committee. 5% CEO HospitalKeeps the Board of Directors, Chair of Audit, and Finance Committee informed and obtains their support. Member of steering committee. 2%