1 1 1 Technology Ideas to Enhance Business Office Efficiencies

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3 IPC Healthcare, Inc. – FACTS! Fred Torres: Vice President, Central Business Office (CBO) Anna Torosyan: Manager, Receivables Management A few interesting IPC Facts: Founded in 1995 About 2500 providers, practicing in 28 states Providing care in over 1900 medical facilities In 2014, approximately 7 million patient visits Headquartered in Los Angeles, with nearly 300 employees in the CBO We bill to over 3,000 payers nationally

4 The Business Office Environment With over 7 million patient encounters each year, like most business offices, we are very busy. The standard uses of automation are available Electronic claim submission Electronic payment posting Automated insurance verification Billing/coding scrubbing tool But what if there is no available automated solution?

5 Create A New Automated Process  We assessed five different areas within the CBO that had a high work volume and no available automated alternative  These options were not initially provided during our transition to Group Management from our legacy billing system

6 Batch Name Scrubbing Tool 1 st Process Automatically fixing/editing an entire batch name where previously it had to be done manually.

7 Needed A Solution If the payment poster entered the incorrect batch name as they posted a payment or left it blank, they would need to manually change the batch name on each payment. There must be a better way to do this!!!

8 Batch Name Scrubbing Tool  Our current manual process was very involved, especially for large batches with thousands of lines of payments that had to be corrected  We asked a question to GE and provided the data elements involved to research if something could be done to assist us  A special program was created for us, which has saved hundreds of hours each year

9 Batch Name Scrubbing Tool Used when an ABA # is posted incorrectly on a payment. It will automatically update the entire batch to avoid fixing it manually.

10 Automated Posting From a Spreadsheet 2nd process Automatically posting payments for a payer that does not have an available electronic remit process.

11 Automated Posting From a Spreadsheet Requirements: Payers that are not currently set up for electronic payments or remits Payers that send spreadsheets or PDF files that can be converted to an excel file The file must contain patient information, DOS and the amount of the payment to post

12 Automated Posting From a Spreadsheet acctcharge nodoscheck nobatch name/abapayment codeadj codecontrol grpins codepmt amt /24/ TMC6RPPTRPPA /16/ TMC6RPPTRPPA /17/ TMC6RPPTRPPA /18/ TMC6RPPTRPPA /05/ TMC6RPPTRPPA /06/ TMC6RPPTRPPA /02/ TMC6RPPTRPPA /23/ TMC6RPPTRPPA /24/ TMC6RPPTRPPA /25/ TMC6RPPTRPPA

13 Automated Posting From a Spreadsheet Prep Time: May need to run a report against open balances if some information is missing, such as account or charge number The excel file needs to be formatted in the correct order according to the program’s specifications The file is saved as a tab delimited text file in the FTP server A special program is run and the file is processed

14 Automated Posting From a Spreadsheet Results: Takes between 1 – 2 hrs of prep time, depending on the size of the file and amount of missing information A file with 1,000 payments can be processed within a few minutes, otherwise it would take more than 6 hours to manually post

15 Automated Productivity Calculation 3rd process Automating our daily production worksheets to assess total amount of work performed in the task management queues.

16 Automated Productivity Calculation Group Management does offer some productivity reports, but they do not measure what we would like to measure.

17 Automated Productivity Calculation Results: Every Saturday, a report is generated automatically and available in printer management Data: Contains information of the employees tasks that were worked through task management Detailed productivity Report contains: a) Charges/Accounts and Tasks worked b) The Queue name and time/date worked c) Charge owed Amount Eliminated manual dailies for production and quota assessment

18 Automated Productivity Calculation

19 Working With Large Amounts of Data 4 th Process Automatically posting denial/payment message codes and/or rebilling by report.

20 Working With Large Amounts of Data Requirements and Benefits: Spreadsheet of charges to be rebilled or denials posted –Mass rebill of payer issues identified The file must contain Account #, Charge #, insurance code, denial reason and/or if a rebill is needed File prep and loading takes seconds File is uploaded and processed in the evening –Claims get billed the next day and/or next billing run. –Denial codes get posted in the evening

21 Working With Large Amounts of Data

22 Tranwrite-off Process 5 th Process Automatically adjusting charges owed or transferring charges to patient in bulk- real time.

23 Tranwrite-off Process Write-off Charges or Transfer Charges to Patient in bulk: Process:  Spreadsheet of Charges- Upload through FTP server  Thousands of charges can be billed to patient or adjusted in less than a minute

24 Q & A