1. Operational Objectives Reduce no–show rate from 12% to 10% Reduce same day cancel rate from 11.5% to 10% Increase same day booked rate from 9% to 11% Resulting in a negative 9% utilization rate

2. Operational Initiatives Communicate expectations with patients Appointment reminders Revolving wait list – pts expect a call  Utilize cell #, email, daytime phone  Early am staff – call retired and local patients  Late pm staff – focus on filling next day early am appts  24/7 cancellation notification line Rigorous clinic wide procedure for no-shows, same day cancellations  Patients receive progressive ns/sdc letters signed by MD’s  Instituted 3 strikes and you are out policy

3. Triaging Patient Calls Urgent Diabetes Related problems  Identify and document in EMR urgent DM problem  Text page nurse in clinic using guidelines  Follow-up with EMR high priority message to nurse Non-Urgent Diabetes Related problems  Document call in EMR  Send EMR message to nurses on team

4. Revenue Cycle Challenges Co-Payments  What procedures require a copayment?  What Tier level to collect? Referrals  Mental Health  Specialists Nurse Practioner Billing  Collaborative vs. Incident to billing G-Codes MNT Billing Modifiers Denials  Manage by HIPAA denial codes

5. Education Productivity  Metrics Partner visits and JoslinCare Credentialing Groups & 1 to 1 encounters Phones calls Education only referrals Documentation challenges Inpatient education What’s new