1. Patient Access Intake Center
Transitioning Revenue Cycle Processes
to the Front End
Kimberly Ryan- Manager of Education
Mary Ann Rogers-Project I.T. Specialist

2. The Goal
To create an Intake Center that will process all ancillary, surgical and inpatient scheduling, authorization, determine patient liability, pre register and collect patient liability.

3. First Steps Combined the Centralized Scheduling staff & the
Central Authorization Unit staff to one location
Realigned leadership to 1 Manager & 2 Team Leaders
Developed Career Ladders and combined the job
descriptions to create the Patient Access Intake
Specialist role

4. First Steps (cont.) Involved HR in development of compensation plan
Institutued a competency test that would trigger the
compensation plan upon successful completion
* Test designed to prepare staff for NAHAM
ceritifcation exam
Began an aggressive cross training plan to expand over
18 months

5. New Moves Assumed the Surgical Scheduling for three hospitals
and one free standing surgical center
Existing periop staff were transferred to the Intake
Center
Alliances established with Periop Leadership and
Surgeons

6. New Moves (cont.) Standardized scheduling processes at the four sites
Cross trained the schedulers to be able to book at all
locations
Trained the OR schedulers on insurance criteria
* Status C screening
* Contracted Insurances
* Some Medical Necessity

7. Appeals Coordinator
Identified need to have a position dedicated to review
all denials and appeal as quickly as possible
AC is able to identify reason for denial and feed this
information to the Education Manager
Reviews Insurance Newsletters & Bulletins to identify
changes in authorization requirements and parses out
to appropriate service lines as well as Access staff

8. Patient Access Project IT Specialist
Liason between Patient Access and the Southcoast IT department
Handles all dictionary updates
Tracks and follows all Meditech issues and tasks
Troubleshoots software issues
Investigates new technology possibilities

9. Accuracy & Accountability
Implemented Davincian Guardian as our QA tool
* customizable
* allows staff to correct errors real time
* serves as an education tool
* includes NEHEN eligibility
Individual and department score cards
* completed registrations
* accuracy rates
* frequency of error types

10. Upfront Collections Collecting at most points of registration
Dash Boards assist staff with determining co-pay,
deductible & coinsurance:
Surgery ED
Imaging Therapies are next
Track daily collection results on a score card
Collected $3.2 million in 2011
* 28% of potential ED & 18% of potential Ancillaries
* Staff incentive program – 65%

11. Pre-Registration All scheduled appointments are pre-registered
Collection attempt at time of pre-registration
Self pay patients reviewed for HSN or other
assistance
Training staff to estimate payment plans and request initial payment at time of service
Patient reports directly to appointment not Admitting

12. Managed Care Enrollment
Enroll Medicaid and Medicare patients into
contracted Managed Care Plans
Involved most points of registration
Patient Financial Services hosts multiple
community outreach events
Completing Training to Physician Office staff

13. Physician Practice Buy-In
Must work cohesively with MD practices
Absorbed high dollar Radiology Imaging
authorization process
Services 38 offices ( 148 physician’s)
Provide options on method to access the
Intake Center, i.e. phone, fax, electronic
Customer Service visits

14. Education Department
Standardized education to all points of registration
Provides all initial training - 2 week class
* Mandatory annual in-services
Computer Access must be approved by Education
Maintains duplicate medical record data and recommends corrective action – HR approved

15. Revenue Cycle Metrics Clean claim rate - 94.6% Days in AR - 32
Administrative write off percentage - .02%
Upfront collection - $3.2 million
$30 million in documented HSN

16. National Recognition…
Southcoast was named a Revenue Cycle Award Winner by the Revenue Cycle Academy .
Recognized for:
Top Decile performance among all organizations surveyed in net A/R Days (32.0)
Bad Debt write off’s as a percentage of net revenue (0.2%)