leveraging self-service applications to achieve measurable
TRANSCRIPT
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Leveraging Self-Service Applications To Achieve
Jeffrey Nieman,Senior Vice President, Operations
R i Whit
Measurable Returns And Empower Patients
Romina White,Senior Director, Patient Access Operations
PRESENTERS
Jeffrey M. NiemanIs Senior Vice President, Revenue Cycle Operations atConifer Health Solutions, a position he has held since2007. In this role, he has full operations responsibility for$10 billion in centralized billing and collectionsoperations, 7 Centers of Excellence, and more than2,000 employees.
Romina C. WhiteIs Senior Director, National Patient Access Operations atConifer Health Solutions. She has held Patient Accessleadership positions for Conifer since 2004 In herleadership positions for Conifer since 2004. In hercurrent role, she has direct oversight for ten hospitalPatient Access Departments.
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AGENDA
Who is Conifer Health Solutions?
A Case Study in Successful Patient Self-Service
Key Components of Patient Satisfaction
Centralized Financial ClearancePatient Access ManagementReliable Tools & Technologies
What’s the return potential for your hospital?What s the return potential for your hospital?
Results-to-Date for 3 Hospital Clients Lessons Learned
CONIFER HEALTH SOLUTIONS: OUR FOOTPRINT
The 2,200 employees in our Centers of Excellence manage the following functions: Centralized Financial Clearance, Onsite Patient Access Management & Financial Counseling, and Government, Self-Pay, and
Commercial Insurance Processing & Collections
Current Client Locations
Conifer Locations
v
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BEST PRACTICES FOR ACHIEVING PATIENT SATISFACTION
PATIENT SATISFACTION IS ONLY ACHIEVED THROUGH A SOLID FOUNDATION OF PEOPLE, PROCESS, AND TECHNOLOGY
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Centralized Financial Clearance
CENTRALIZED FINANCIAL CLEARANCE
1 Hospital schedules patient
&
2 Centralized Financial Clearance processes the account
Pre-
Reg
iste
r
Insu
ranc
e Ve
rific
atio
n &
Elig
ibilit
y
Pre-
Cer
tific
atio
n &
Pre-
auth
oriz
atio
n
Med
ical
N
eces
sity
C
heck
s (A
BN)
Pre-
Serv
ice
Fina
ncia
lC
ouns
elin
g
PatientsPayors Payors Payors
3 Patient arrives and goes through an expedited check-in at the hospital
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CENTRALIZED FINANCIAL CLEARANCE:Account Segmentation Process
Appropriate authorization obtained, demographics verified and all liabilities have been satisfied by patient (where required). Expedited check-in of the patient (Express Pass)
Either patient liabilities remain to be collected at POS or additional documentation is required.For example - ABN signature
Either no authorization has been obtained or patient has limited to no benefits for services.Client-Hospital should consider rescheduling
Focus: an innovative call-center-like environment with specialized work list capability to increase use of automation
CENTRALIZED FINANCIAL CLEARANCE:Lessons Learned
Control Systems: including call and screen capture technology on all authorization and pre-certification calls with payors
Service Expectations: set standardization and highest level of customer service expectations equal across all hospitals
Reduce Wait Times: hospitals commit to an “Express Pass” process for fully cleared patients operational redundanciesprocess for fully cleared patients, operational redundancies
Technology: a suite of tools that increases pre-service patient / payor contact
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Patient Access Management
PATIENT ACCESS MANAGEMENT: On-Site Patient Access Team
• Eliminates redundant visits to patient rooms
• Faster patient registration times• More accurate patient
PATIENT REGISTRATION PROFESSIONALS
PATIENT FINANCIAL COUNSELING TEAM
• Increases qualifications for government programs*
• Mitigates account assignment to bad debt
pregistration
• Expectations set for patient liability
• Increases POS cash collections*
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BEST PRACTICES FOR INCREASING POS CASH COLLECTIONS
TRAININGTRAINING• POS Collection scripting & scenarios• Online training courses
INCENTIVE PROGRAM• Individual• Team
BEST PRACTICES FOR INCREASING QUALIFICATIONS FOR GOVERNMENT FINANCIAL ASSISTANCE PROGRAMS
ELIGIBILITY APPLICATION PATIENT ASSISTANCE :
• Medicaid/Medi-Cal• Supplemental Security Income• Temporary Assistance for Needy
Families• County Indigent• Social Security Disability
ASSISTANCE:• Home visits• DHS Interview on behalf of
patient • Act as liaison with
caseworker• Represent patient at Fair
Hearing/Administrative Law J d R i • Victims of a Violent
• Crime Fund• State Children’s Health Insurance
Program (SCHIPS is not retro-active)
Judge Review
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Reliable Technologies and Supporting Tools
PATIENT WEB PORTALPATIENT KIOSKS FROM NCR
RELIABLE TECHNOLOGIES & TOOLS:Self-Service Tools
• Reduces patient wait times
• Reduces operating costs
• Maintains a competitive / market advantage with patients and physicians
• Offers additional avenue for payments and account information retrieval for patients
• Reduces the number of phone calls to business office
• Increases patientpayments
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RELIABLE TECHNOLOGIES & TOOLS:What a Patient Sees When Using the Kiosk
Patients can view and update their personalupdate their personal demographic information
Patients can also see their insurance information on file with the hospital
RELIABLE TECHNOLOGIES & TOOLS:What a Patient Sees When Using the Kiosk
Patients can sign forms electronically, which are e ect o ca y, c a eautomatically fed into our VI imaging system
Patients will be able to make co-payments directly at the kiosk
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RELIABLE TECHNOLOGIES & TOOLS:Self-Service Technology ROI For the Hospital
Used data-driven approach to calculating cost savings• Example below: Kiosk cost savings based on e-Signature savings
• Calculated actual number of patient accounts processed and number ofCalculated actual number of patient accounts processed and number of forms/pages required for each
REQUIRED FORMS # of pages % of forms given to patient
Actual pieces of paper used
Conditions of Service (COS) 1 100% 4,107,625
Advance Beneficiary Notice (ABN)** 1 24% 985,830
Advance Directive 1 100% 4,107,625
Notice of Privacy Practice (NPP)*** 4 80% 13,144,400
Patient Rights 1 100% 4,107,625
Important Message from Medicare** 1 24% 985 830
Cost estimates per page $1 (from vendor; we estimated $0.245 base/raw materials cost)
Annual saving potential 80% reduction x 27M pages x $1/page = $22M (conservatively $5M of base/raw material cost alone)
Important Message from Medicare 1 24% 985,830
TOTAL 9 27,438,935
RELIABLE TECHNOLOGIES & TOOLS:Key Statistics and Findings from Kiosk Alpha + Beta Pilots
19,821 Number of patients who used a kiosk for check-in
84% Percentage of patients who didn’t want copies of forms
2.6 Average minutes it took for a patient to check-in
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RELIABLE TECHNOLOGIES & TOOLS:Average Kiosk Check-In Time (minutes) during Pilot
RELIABLE TECHNOLOGIES & TOOLS:Percentage of Patients Successfully Checking In by Kiosk
2.7%of patients
could not check in
97.3%Successful Patient Use
Rate
539 out of 19,821 patients did not successfully check in on their own; they either cancelled out or needed help to complete check-in
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RELIABLE TECHNOLOGIES & TOOLS:Patient Satisfaction Survey for the Kiosks during Pilot
304 o t of 19 821 patients ho
1.6%of patients were not satisfied
98.4% of Patients
Satisfied, found the kiosk easy
to use
304 out of 19,821 patients who used the kiosks reported either …• Too many screens/questions• Uncomfortable with self-service• Signature box was too small• Screens were not responsive
RELIABLE TECHNOLOGIES & TOOLS:Key Findings that Dispelled Some Myths during Kiosk Pilot
48% Percentage of Kiosk users over 55 years old at one site
WILL SENIOR PATIENTS REALLY USE THE KIOSK?
WILL THIS REALLY IMPROVE QUALITY OF DATA?
33% Percentage of Kiosk users who updated their own data at one kiosk pilot site
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RELIABLE TECHNOLOGIES & TOOLS:Supporting Tools
ADDITIONAL TOOLSPATIENT E-SIGNATURE
• Appropriate applications are completed automatically at bedside, including forms and signatures for all associated programs
• ACE® proprietary system • MicroSegmentation℠
advanced technology workflow• Accurint® skip tracing• RAMP® determines best-fit patient
funding sources • Noble® broadcast messaging
ADDITIONAL TOOLSPATIENT E-SIGNATURE
• VIWeb® document imaging• TransUnion® credit score
processing• People Answers® recruiting tool
What’s the Return Potential for Your Hospital?
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WHAT’S THE RETURN POTENTIAL FOR YOUR HOSPITAL?Actual Results to Date for 3 Hospital Clients Who Have Achieved Full Patient Access Integration
Performance Indicators Results (average)
Patient Satisfaction 2%
Quality Assurance 36%
Medicare Secondary Payor Form 53%
Insurance Verification 13%
POS Collections (monthly average) 11%
POS Collections (% of patient payments) 23%
Failure to Obtain ABN Write-Offs (GZ Modifier) 64%Failure to Obtain ABN Write Offs (GZ Modifier) 64%
Employee Turnover 28%
Proof of Eligibility 18%
Medicaid Cash Collections 11%
DISPUTE WRITE-OFFS
WHAT’S THE RETURN-POTENTIAL FOR YOUR HOSPITAL?Actual Results: Dispute Write-Offs
Volume comparisons on Managed Care Write-Offs from Patient Access errors, specific to scheduled inventory financially cleared in centralized format
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WHAT’S THE RETURN POTENTIAL FOR YOUR HOSPITAL?Why Did Self-Service Fail at One Location?
Non-standard processes, and site not supported by centralized pre service financial counseling centercentralized pre-service financial counseling center
Inadequate onsite staff buy-in and time commitment
Placement of devices balancing line of sight from patient traffic, with better feel of privacy
Lack of marketing and promotion at kick-off and ongoing with proper signage
WHAT’S THE RETURN-POTENTIAL FOR YOUR HOSPITAL?Other Lessons Learned
Ensure there is clear understanding of the exact functionality you are implementing
Strong processes and a review of patient flows must be part of the installation in order to best utilize new technology
Involve a multidisciplinary team in development of story boards (patient access, back office, IT and administration)
Be as thorough as possible and follow comprehensive work plans
Make sure you have contingency plans in place
Don’t assume anything
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Self-service technology can be used to improve a hospital’s revenue cycle, if supported by best practices
1.
You must empower your on-site patient access management staff with the supporting tools and processes to proactively meet patient needs
By integrating the appropriate
2.
3 By integrating the appropriate technology for both patients and staff your hospital can increase patient satisfaction
3.
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Thank You!Jeffrey NiemanSVP, Revenue Cycle Operations C if H l h S l iConifer Health Solutions2401 Internet Boulevard, Suite 201, Frisco, TX 75034Office (972) 335-6109 Cell (469) 644-5280e-mail [email protected]
Romina WhiteSenior Director, National Patient Access OperationsConifer Health SolutionsCo e ea t So ut o s2401 Internet Boulevard, Suite 201, Frisco, TX 75034Office (214) 387-6783 Cell (714) 423-7718e-mail [email protected]