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September 28, 2013

Article: 5 Ways to Ensure a Smooth Flight through the Revenue Cycle

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SAN ANTONIO, TX (May 2011) — At the annual conference for the National Association of Healthcare Access Management (NAHAM), attendees had the opportunity to learn how they could improve the revenue cycle flight experience at their facilities by using “black box” technology from Trace.

Just like the black box on an airplane, Trace can capture communication that occurs across the healthcare revenue cycle. In times of turbulence, this helps to safeguard hospitals against more than just denials; it also protects quality, compliance performance and ultimately, the patient’s hospital experience.

Taking the audience through the flight plan were four panelists that included (from L to R): Holly Hiryak from the University of Arkansas for Medical Sciences; Yvonne Chase from Mayo Clinic in Arizona; Kimberly Lebo-Brooks from Health First, Inc. in Florida; and Yvonne Focke from St. Elizabeth Healthcare in Kentucky. Blair Wright from Vyne Medical moderated the session.

Preparing for Flight: What to Know Before You Go

Preparation for a flight begins long before the plane leaves the ground. In the same way, Trace can help to prepare hospitals for turbulence they may face in the revenue cycle.

Blair Wright (Moderator): “What do hospitals need to know about how reform is going to change the current healthcare environment, and how will Trace impact that?”

Yvonne Focke: “As we prepare for flight and think of where we’re moving with healthcare reform in the revenue cycle area, three things come to mind. Certainly we’re going to experience less reimbursement, another area is increased focus on compliance, and finally value-based purchasing.”

Trace has already proven to be beneficial in the area of reimbursement, as it has been used for proof of denial activity. “Our care management uses Trace and we have been able to overturn at least $600,000 a year just because of that proof.”

Trace is helpful to Focke’s hospital on the front end when they call patients to explain their bills. Having the conversation recorded has helped bring a stop to the patient denying responsibility for payment. “It really has helped us to collect more up front.”

The capability to capture screen shots in Trace saved Focke’s hospital frustration in a case where they were not getting the approval letters they needed from a payer. Focke’s team was able to take screen shots of the payer’s website and save both time and money with concrete proof of the payer’s policy.

“We’ve gone out of the box now in terms of using Trace. Our radiology department uses it when they call to notify referring physicians of critical patient results, and they love it.”

“It’s not like you need to reference the black box on every occasion, thank goodness. It’s not always needed in the aviation industry either, but when you have it, it’s a beautiful thing.”

Yvonne Chase: “As we prepare our patients, we work with 350 referring physician’s offices. They used to fax us the records and we would review each one to determine which physician needed to read the records and see the patient. Now we set up a queue line through the Trace fax tool so that when those faxes come into the queue, they’re vetted out through the fax line directly to the physician’s inbox; and from there they can determine what needs to happen. We’ve reduced the process from 5 days down to a two-day period of time.”

Booking the Flight: Ensure a Smooth Process

With paperwork being such a large part of a hospital visit, it’s easy for it to pile up and become unmanageable. Trace can help with that, keeping the process streamlined from the very beginning.

Blair Wright (Moderator): “How does Trace help a hospital get off on the right foot from the very start?”

Kimberly Lebo-Brooks: “One of my largest frustrations on a daily basis was our fax process. Papers were everywhere, and there were lost faxes constantly. A patient would show up at one of our 5 facilities, and it would be the wrong one or they simply didn’t have a fax so we’d have to look for it. The patient would then have to be rescheduled or wait 45 minutes until we could find the fax. When I heard that we could have these faxes stored electronically in one location so that anyone in our hospital system could pull them up at any time, I perked up!

And that was not the only advantage she received from Trace. “I also got unexpected benefits from recording calls in that it gave me a way to protect my staff. We used to have physicians that would abuse our staff, but after they found out that we could get the transcript and send it to our administration, that no longer occurred.”

Health First has expanded Trace to its sleep lab, pharmacy and case management departments. “I just believe in it so much and it helped my staff so much that I was able to go out and speak to other departments that needed a similar solution.”

Getting Ready for Take-Off: Give Clear Instructions

Much like the safety instructions at the beginning of a flight, hospitals must set clear expectations for their patients. In the event of a misunderstanding, Trace is there to set the record straight and make “he-said, she-said” a thing of the past.

Blair Wright (Moderator): “What does it mean to set clear expectations with the patient up front so that everything goes smoothly when they arrive?”

Yvonne Chase: “We often hear from patients, ‘You never told me I had to pay. I wasn’t given clear expectations.’ So we offer, ‘I think we were clear, but maybe we made a mistake. Let’s listen to the call with your registrar and see what wasn’t clear.’” By using Trace to record these discussions, Mayo Clinic has been able to increase point of service collections by 13%.

Chase found that Trace has been pivotal in reorganizing her department’s training process, which in turn garners fewer patient complaints. “We tell the patient that we’re recording calls and that we’re doing it for quality assurance, and it has helped us with complaints. We listen to a random number of calls, and it really helps define where we need to concentrate our training; i.e.: What are we not telling the patients? What are we telling the patients too much of?” Chase is also able to monitor productivity by tracking the number of calls employees have made to patients and insurance companies.

Chase also touched on the fact that Trace documentation has been helpful in avoiding potential litigation. “We work as an advocate between insurance companies and the patients, but patients sometimes claim that we haven’t done enough with their insurance or haven’t told them the right things. The documentation we now have [through Trace] is extremely helpful.”

“From the time we implemented Trace technology it has done nothing but take off. Every opportunity for us to streamline processes, this tool is really at the heart of it.”

“In the first year with Trace, we overturned $1.2 million in denials. Trace overall has been a great benefit to our healthcare facilities.”

On-Board: Ensure Customer Service and Quality

While in the air, it’s comforting to know the pilot and other airline staff know how to do their jobs and enjoy doing them well. Thanks to black box technology, hospital employees are able to comfortably do their jobs, knowing that when they follow protocol, they will be rewarded with proof of a job well done.

Blair Wright (Moderator): “How does Trace ensure patient/employee satisfaction?

Holly Hiryak: “I don’t think my staff would work for me if they didn’t have this tool available for them. Because it’s become not only a quality tool but one that we can rely on to support the staff in the event that we get into a ‘he said/she said’ situation. And that can be with the patient, the insurance company or even another department.”

In one case, Trace helped her hospital overturn a denial for a claim that involved multiple births. The savings ended up being more than it cost to use Trace for the entire year. “It was a tremendous save. It paid for itself easily for this year, and it really supported my staff…they never had to worry that they had done anything incorrectly or that they were going to be blamed for anything at all because they followed the process.”

Thanks to Trace, interaction between Hiryak’s staff and other hospital employees has improved. “I can tell you the behavior has changed significantly. [Calls from other hospital staff] have become very friendly. The rude calls have really turned around, because I was able to play them back for leadership and for [the caller] so they can hear how they sound over the phone. A lot of times in the heat of the moment you don’t really realize what you’re saying or how you’re being heard on the other end.”

Hiryak echoed the other panelists in that she too has seen improvements in her training processes. “We are able to use the tool in a very friendly and productive way. It’s not a ‘gotcha!’ It’s more like, ‘Here’s what we can do to make our processes better for the patient.’ So it is a real positive for us.”

After the Flight: Establish an Audit Trail

Trace “black box” technology documents each step of the patient’s journey from beginning to end. The result is an audit trail that can be used to protect reimbursement, prove compliance and drive performance across the revenue cycle.

Holly Hiryak: “We’re a tertiary care facility so we get a lot of requests for referrals to our appointment center. This is probably about 150 new faxes a day, which are records coming in from other facilities and even the contiguous states. It was just a nightmare to manage that much paper. And of course paper was lost; you can’t keep up with that much. Now we can index that and send it to the appropriate provider. Our next step is to set up all employees in the facility with their own Trace fax so we can fax directly to them, rather than having to touch it again. It’s going to be a huge improvement.”

Hiryak says it’s been a life changer for backing up staff in situations when it’s a disgruntled patient’s word against the employee’s. If a patient disputes a bill with front-end collections, “we can go back to the patient and say, we have this recording and we did use the word ‘estimate,’ so yes you are liable for that amount due.”

“We’re also using it in our pre-op clinic. We get a lot of documents for patient’s medical histories, and our physicians can pull them up in the room when they’re visiting with the patient. If they need a particular piece of paper printed, they can print that one page and they don’t have to print 150 pages, so it really is a nice tool for them to have to support what they’re doing.”

“It’s almost like whenever we have an issue or a problem, if you really think through it, Trace can help you with that problem. It’s worth it and it will save a lot of money in the long run.”

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