More Related Content
What's hot (20)
Similar to Excellence In Access Let The Data Lead The Way Hfma Philly 2 16 10 (20)
Excellence In Access Let The Data Lead The Way Hfma Philly 2 16 10
- 1. Achieving Healthcares True Return Presented by Michael S. Friedberg, FACHE, CHAM Associate Vice President, Patient Access Services Excellence in Access: Let the Data Lead the Way
- 2. What is the Revenue Cycle? Excellence in Access: Let the Data Lead the Way | Page
- 3. What is the Revenue Cycle? Excellence in Access: Let the Data Lead the Way | Page
- 4. Background Hospitals can benchmark their revenue cycle performance against other facilities using HARA and other benchmark data The most effective method to identify areas of opportunity within your revenue cycle is to manage your trends through Key Performance Indicators (KPI) Excellence in Access: Let the Data Lead the Way | Page
- 5. Excellence in Access: Let the Data Lead the Way | Page Proactive Reactive
- 6. Excellence in Access: Let the Data Lead the Way | Page What are KPIs? Key Performance Indicators are the metrics that illustrate how to improve your revenue cycle
- 7. Why We Use KPIs? Keep a record tell a story Proactive not reactive approach Manage trends not single period results Illustrates relationship between certain KPIs Can establish realistic goals based upon real life trends Fosters accountability Excellence in Access: Let the Data Lead the Way | Page
- 8. Accountability Excellence in Access: Let the Data Lead the Way | Page
- 9. How Do You Get Started? Keep a record tell a story Begin with a Daily Dashboard snapshot of your department Assign ownership If it is important measure it If you decide to measure it manage what you measure Use as a tool at revenue cycle meetings Excellence in Access: Let the Data Lead the Way | Page
- 10. Daily Dashboard Components Mix of indicators and goals Its up to you! Easy to obtain Excellence in Access: Let the Data Lead the Way | Page
- 11. Daily Dashboard: Example Part 1 Excellence in Access: Let the Data Lead the Way | Page Date Daily Census @ 9:00 am ER Holds QA Quality Score MTD Failed Bill $ Staff Call Outs POS Cash POS Cash MTD 5/1/06 5/2/06 5/3/06 5/4/06
- 12. Daily Dashboard: Example Part 2 Excellence in Access: Let the Data Lead the Way | Page Date POS Cash as a % of Goal Complaints to Administration MPI Duplicates Created Patients in House >30 Days % of Eligible Patients Scheduled 5/1/06 5/2/06 5/3/06 5/4/06
- 13. Flexibility New Jersey clients and charity care Pennsylvania client and subscriber name New York client and UT authorizations Excellence in Access: Let the Data Lead the Way | Page
- 14. Excellence in Access: Let the Data Lead the Way | Page Drilling further down
- 15. Monthly Denials Overall denials Clinical denials by reason Technical denials by reason Denials as a % of net revenue Must determine if denials are included in aged accounts receivable communicate with the business office Excellence in Access: Let the Data Lead the Way | Page
- 16. Bad Debt and Charity Care The uninsured is rising Measure as a % of total volume Monitor monthly Excellence in Access: Let the Data Lead the Way | Page
- 17. Point of Service Collections CASH IS KING Increased co-pays and deductibles Now more than ever, hospitals must focus on POS collections Track by month; by area Set goals The British are coming! Excellence in Access: Let the Data Lead the Way | Page
- 18. Clean Claims % > 90% of claims are billed electronically Clean claim target 95% - 100% Claims with errors = manual intervention Manual intervention = payment delays or incorrect payment and a higher cost to collect Drill down to reasons for manual intervention Excellence in Access: Let the Data Lead the Way | Page
- 19. Vendor Performance Successful revenue cycles utilize a combination of internal and external resources Must manage outsourcing partners performance Excellence in Access: Let the Data Lead the Way | Page
- 20. Benchmarking Standard by which something can be measured or judged Where can we get data? The Access Dilemma Why benchmark? Excellence in Access: Let the Data Lead the Way | Page
- 21. Scheduling Benchmarking Excellence in Access: Let the Data Lead the Way | Page Item Standard Scheduling rate of patients eligible for scheduling 100% Scheduling for ambulatory surgery patients 100% Scheduling for high dollar outpatients 100%
- 22. Pre-registration Benchmarking Excellence in Access: Let the Data Lead the Way | Page Item Standard Pre-registration rate for all scheduled patients >95% Insurance verification rate for pre-registered patients 100%
- 23. Registration Benchmarking Excellence in Access: Let the Data Lead the Way | Page Item Standard Average registration interview duration new patient 15 minutes Average registration interview duration repeat patient < 5 minutes Average patient wait time to be registered < 10 minutes Maximum wait time for any patient 15 minutes
- 24. Registration Benchmarking (continued) Excellence in Access: Let the Data Lead the Way | Page Item Standard Average inpatient registrations per shift 15 - 20 Average outpatient registrations per shift including emergency department 30 - 40 Advanced beneficiary notice rate where applicable 100%
- 25. Denials Benchmarking Excellence in Access: Let the Data Lead the Way | Page Item Standard Overall denial rate < 4% Technical denial rate < 3% Eligibility denials rate < 75% Appeals overturn rate 40% - 60%
- 26. Benchmarking Sources HFM article by David Hammer July 2005 Aspen Publishing Registration Newsletter 2006 Local HFMA chapters Local NAHAM chapters Excellence in Access: Let the Data Lead the Way | Page
- 27. Closing Thoughts KPI implementation may be a cultural change for some KPIs do create a culture of accountability but also reward KPIs do simplify the nature of our work Investment in the success of your revenue cycle Excellence in Access: Let the Data Lead the Way | Page
- 28. Shameless Self-promotion Staff Competency in Patient Access: Tools, Tests and Tips for Building a Successful Team 1.877.727.1728 www.hcmarketplace.com Excellence in Access: Let the Data Lead the Way | Page
- 29. Achieving Healthcares True Return Michael S. Friedberg, FACHE, CHAM Associate Vice President, Patient Access Services Office: 973.233.7644 Mobile: 732.809.0260 Email: michael.friedberg@apollohealthstreet.com Learn more at www.apollohealthstreet.com Apollo Health Street partners with healthcare organizations across the country to achieve healthcares True Return the financial strength you need to offer excellent patient care today and tomorrow.