Bridging the Gap Between Patient Access and Patient Financial Services Lynn Otani, IHHI Julie Kay, MedAssets

Overview Objectives PFS vs. Patient Access The Integrated Healthcare Holdings, Inc.(IHHI) Story Real “work-lives” of IHHI Bridging the Gap Completing the Revenue Cycle Communication Technology Change Final Thoughts 2

Objectives Identify communication process barriers between patient access and patient financial services; Determine appropriate communication types that WORK; Learn how technology can play a roll in building this bridge. 3

4 Established 2005 with 4 hospitals in Central Orange County, California Billed from one Central Business Office

5 Western Medical Center Santa Ana Western Medical Center Anaheim Chapman Medical Center Coastal Communities Hospital Total 762 beds: Acute Care, Cardiac, OB, NICU, Trauma, In and Outpatient Burn Units, In-Custody patients, Psych, Chemical Dependence, Obesity and SubAcute Units.

PFS vs. Patient Access Patient Access is a vital part of the billing and collections process: Percent of data needed for billing originating at registration: 70% National average registration error rate: 46% Percent of denials that could be prevented at registration: >50% Often an adversarial relationship exists Multiple communication barriers 6

Observations CBO “tells” Patient Access management what is needed 1) for United Health use new plan code 12346, has been deleted. 2) MediCal procedure codes xxxxx through xxxxx require a TAR effective xx/xx/xx Patient Access management sends s or memos to the staff of the changes needed Changes are made until new changes are required, the staff focus on the new changes and forget the old changes. 7

Bridging the Gap Communication: Regular face to face meetings: Cross Department Director level Management Staff Discuss controversial topics Organized Communication for Reference Shared Drives to file s and documents Binders by subject rather than date Standard terminology N ewsletters With serious and fun topics 8

Bridging the Gap Training & Education Quick PowerPoints that can be posted Peer Review and Audit Technology Manual processes are labor intensive and often incomplete due to staff training and understaffing Technology can “bridge the gap” by ensuring 100% compliance for fixed rules 9

Completing the Revenue Cycle Treat as one department Encourage relationships Hold staff meetings with representatives from all revenue cycle areas Contributions to agenda Specific scenarios and role playing Emphasize the “GOOD” clean account examples 10

COMMUNICATION 11

Eliminate “ wars” Rewa Cooper, Director of Admitting, Western Medical, Santa Ana, CA (IHHI) 12

Reduce Denials Christina Jimenez, Admitting Manger Western Medical Center, Anaheim, CA (IHHI) 13

One Department – Different Locations Margie Fitzgerald, Director of Patient Services (DPS) / Admitting Manager, Chapman Medical Center, Orange Case management, HIM, ED, and Admitting 14

It Takes a Village 15 to Patient Access, Health Information Management and Case Management: “Zero Collectors worked this case: $120,000 PAID IN FULL 25 days from DISCHARGE!!! This case SCREAMS the undeniable KUDOS to our PATIENT ACCESS & CASE MANAGEMENT & BILLING teams for a job done ONCE, done right!!! THANK YOU ALL: Your great work has really paid off !!!” -Yaman Kahf, IHHI CBO Director

TECHNOLOGY & AUTOMATION 16

Technology Quality Assurance Automated Eligibility & Benefits Scanners ID Advance Directives Insurance Cards Patient Estimation 17

Productivity and Accuracy Daily 18

Opportunity to Make Corrections 19

Details to Mentor 20

Accurate Insurance Plan Selection Eligibility Integrity 21

Automated Eligibility & Benefits Associated with Visit Eligibility Integrity 22

Opportunity to Collect Prior Balances Access Manager 23

Accurate Patient Estimates CarePricer 24

Automated Payment Processing eCash 25

Scripting for Success eCash 26

Change Provides individual opportunity for growth Improves overall revenue cycle results 27

Final Outcomes & Results at IHHI 28

Contact Information Lynn Otani (310) Julie Kay j (972 )