From Registration to Accounts Receivable – The Whole Can of Worms 2007 UBO/UBU Conference 1 Briefing:Charge Master Based Billing Date:Thursday, March 22, 2007 Time:9:00 am

2007 UBO/UBU Conference From Registration to Accounts Receivable 2 Objectives Provide you with an overview of the Charge Master Based Billing (CMBB) project

2007 UBO/UBU Conference From Registration to Accounts Receivable 3 Summary CMBB is the replacement system for the Third Party Outpatient Collections System (TPOCS) and the billing functions in CHCS – Provides one system for all patient inpatient and outpatient billing within the MHS including Third Party Collections (TPC), Medical Services Accounts (MSA) and Medical Affirmative Claims (MAC) CMBB is a web-based, commercial off-the-shelf (COTS) software product CMBB is currently being configured to meet Department of Defense (DoD) requirements

2007 UBO/UBU Conference From Registration to Accounts Receivable 4 What is Charge Master Based Billing? The Patient Accounting System incorporates two COTS products – Coding and Compliance Editor (CCE) – Charge Master Based Billing (CMBB) CMBB is a patient billing and accounting system that incorporates the use of a Charge Description Master

2007 UBO/UBU Conference From Registration to Accounts Receivable 5 What is a Charge Master? A Charge Description Master, or charge master, is a comprehensive listing of items that could be billed to a patient, payer or healthcare provider Charge Master Based Billing incorporates a charge master as part of the system used for patient accounting A Charge Master is not intended to be used as a mechanism to measure performance (workload)

2007 UBO/UBU Conference From Registration to Accounts Receivable 6 What is the COTS product for CMBB? RITPO, in conjunction with the Services and the UBO, held a best value panel to select a COTS product during the spring and summer of 2006 GE Centricity Business was selected as the CMBB solution

2007 UBO/UBU Conference From Registration to Accounts Receivable 7 I have never heard of GE Centricity Business? GE Centricity Business was formerly known as IDX/Flowcast IDX/Flowcast was purchased by GE in January 2006 and re-branded as GE Centricity Business IDX/Flowcast, as GE Centricity Business, remains a market leader in patient accounting systems

2007 UBO/UBU Conference From Registration to Accounts Receivable 8 CMBB provides a Single Financial Solution GE Centricity Business provides a suite of applications built toward automation and focuses on preventing errors and delays to assure prompt payment – The DoD purchase includes the following products Transaction Editing System (TES) Combined Business Office (CBO), including credit card processing Revenue Cycle Management plays a major role in driving business success and ensuring patient satisfaction through a streamlined revenue cycle

2007 UBO/UBU Conference From Registration to Accounts Receivable 9 What are the benefits? Built-in payer rules ensure that patient information is collected correctly and completely Automatic charge capture reduces the need to process data manually; claims rejections, re-work and lost charges are reduced, maximizing reimbursement Electronic claims, claims status checks and remittance posting drive more efficient overall processing and decrease time to payment Charges are automatically checked for accuracy prior to submission for cleaner claims, fewer rejections and less effort to correct and re-bill denials Workflow tools automate and streamline claims management and production to accelerate reimbursement and maximize staff productivity Simplified, patient-friendly statements reduce patient calls and improves patient satisfaction

2007 UBO/UBU Conference From Registration to Accounts Receivable 10 What is TES? TES is a front-end transaction editing and suspense system designed to capture, evaluate, correct, and extract charge and claim transactions into the CBO program TES helps streamline workflow and prevent incomplete or incorrect information on claim forms – Allows information to be entered as it is available – Tests for missing or incorrect information – Filters transactions into work lists for efficient editing – Allows transactions to be edited for completeness and requested before the transactions are transferred to the CBO

2007 UBO/UBU Conference From Registration to Accounts Receivable 11 What is CBO? CBO provides consolidated operations to improve performance and compress the revenue cycle CBO streamlines workflow by presenting a consolidated view of all hospital and professional financial data for a patient, guarantor or a clinical encounter CBO increases patient satisfaction by combining all charges for both hospital and professional services on a single statement, decreases calls, paper and postage costs

2007 UBO/UBU Conference From Registration to Accounts Receivable 12 What electronic transactions are included? CMBB will incorporate the following electronic transactions: – 270/271 – Eligibility inquiry and response – 837/835 – Claims submission and remittances – 276/277 – Claims status and response When the rules are finalized, GE will incorporate the 275, claims attachment, transaction – CMBB will incorporate this change as part of a COTS upgrade

2007 UBO/UBU Conference From Registration to Accounts Receivable 13 GE Centricity Business provides many standard reports – Current TPOCS reports and CHCS reports will be matched against the standard reports to ensure that the current reporting functionality is met – Ad hoc reporting is available in GE Centricity Business New functionality will be provided through Business Analyzer for Service-wide and UBO-wide advanced ad hoc reporting (version ) Will I get reports?

2007 UBO/UBU Conference From Registration to Accounts Receivable 14 What Claim Forms will be supported? UB-04 CMS 1500 Universal Claim Form Dental DoD-specific forms, including – DD7 – DD7A – DD139 – Invoice and Receipt (I&R) – SF 1080

2007 UBO/UBU Conference From Registration to Accounts Receivable 15 Will training be provided? Training will be provided during deployment Follow-on training will be provided in a manner similar to what TPOCS does today

2007 UBO/UBU Conference From Registration to Accounts Receivable 16 When is CMBB coming? GE Centricity Business is currently being configured to meet DoD requirements Testing is expected to start in early in 2008, including Service supported System Qualification Testing (SQT) in late spring 2008 Milestone C is expected to be awarded by mid- summer of 2008 Limited Deployment to two (2) Service-selected sites will begin shortly after Milestone C is awarded Operational Test and Evaluation (OT&E) will be conducted during Limited Deployment If OT&E is successful, full deployment will begin in late 2009

2007 UBO/UBU Conference From Registration to Accounts Receivable 17 Quiz What is the COTS product for CMBB? What is a Charge Description Master? What modules will be incorporated into CMBB? What EDI transactions will be supported?