using technology to improve your asc colorado ambulatory surgery center association
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Using Technology to improve Your ASC Colorado Ambulatory Surgery Center Association. Contact Information: MediGain Inc. 1-877-237-9539 [email protected] www.medigain.com. MediGain Preserving Healthcare Profits. Some Technology Usage Facts. Before First IBM PC is launched in 1981 - PowerPoint PPT PresentationTRANSCRIPT
MediGain Confidential
Using Technology to improve Your ASC
Colorado Ambulatory Surgery Center Association
Contact Information:MediGain [email protected]
MediGain Confidential 2
Some Technology Usage Facts
Before First IBM PC is launched in 1981 Motorola releases first mobile phone for $3,995 in 1985
• Cellular Technology Industry is formed in 1988 The world wide web as we know it today launched in 1991
• Hotmail is launched in 1996 HIPAA Introduced in 1996
Now Computer ownership in the USA – 80% of population Mobile phone ownership in USA – 81% of population Internet usage in USA – 73% of adults
• Google maps show pictures of your street and house
• YouTube used to watch movies and elections More than 80% of ASC’s and Physician practices still use paper
medical records
MediGainPreserving Healthcare Profits
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Healthcare vs. other Industries
Retail Industry
• Find your favorite store, clothes and sizes
• Purchase online, and track shipping to your doorstep
• Understands customer needs and trends
Airline Industry
• Find destinations, schedules, type of airline that flies
• Purchase tickets online - select seat, food etc.
• Check status via internet, phone or text – notifies schedule changes
• Receive promotions based on customer preference and history
Healthcare Industry
• Minimum or if any web presence
• Most cannot schedule appointments online – no notification on delays
• Minimum knowledge and tracking of information about patient habits
• No infrastructure to share information – loads of paperwork
• Medicare takes 6 months to issue or change a new provider number
First IBM PC is launched in 1981 More than 80 percent of ambulatory surgery centers do not use electronic health records, survey indicates.
Healthcare IT News (4/7, Pizzi) reported, "82 percent of ASCs (ambulatory surgery centers) do not use an electronic health record," according to a survey conducted by Renaissance Research. The survey of 175 ASC administrators found “
that 85 percent...use paper perioperative notes, and 74 percent use dictation and transcription for the generation of physician procedure notes." The survey also found that "49 percent of
administrators had concerns that revenue could be lost in the IT implementation process."
MediGainPreserving Healthcare Profits
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Why Utilize Technology in the ASC
One of the key building blocks of an ASC: Technology Processes Resources
Can provide the following benefits: Increase revenue Decrease costs Improve efficiencies Decrease errors Improve visibility to operations Use it as a strategic advantage over competition Meet government and regional mandates Meet consumer expectations
MediGainPreserving Healthcare Profits
Technology
ProcessesResources
ASC
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MediGainPreserving Healthcare Profits
MediGainPreserving Healthcare Profits
Typical ASC Structure
Customer ServiceTranscriptionCodingBillingCollectionsFollow upMedical RecordsElectronic Claim ProcessingPaper Claims and Statements
ReportingAnalyticsBusiness Intelligence
ClinicalFront Office Back Office
< 20% of Revenue
From Cash
>80% of Revenue
From Insurance
SchedulingInsurance Verification
Patient Info
DiagnosisProceduresDictation
Patient Care
Patient FormsInventory
Management
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MediGainPreserving Healthcare Profits
MediGainPreserving Healthcare Profits
Potential Revenue Losses in an ASC
ASC’s Have Already Done Work and is Owed 100%
Patient Registration/ Eligibility Verification
-5%
Transcription/Coding
Claim Submission
Secondary Insurance & Patient Portions
Potentially Lost Revenue
Revenue Lost by Typical
Facility
Payment Posting/Follow up
-10%
-3%
Fee Schedules/ Charge Master
-4%
-3%
-5%
20% - 30% Loss of 20% to 30% of the money you have already
worked for!
Inaccurate posting can result in inaccurate statements, follow
up, and collections
Many do not send or follow up on secondary and paper
statements
Almost 3% of claims are lost by insurers after positive receipt by
clearing house
Poor transcription and inaccurate coding can lead to
denials and lost rev.
Charges need to be updated and compared with national averages
Lack of proper front office processes and systems impact
reimbursements
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What Processes Do You Automate? MediGainPreserving Healthcare Profits
Process
1. Scheduling
2. Ins Verification
3. Patient Confirmation
4. Chart Preparation
5. Dictn./Transcription
1. editing
2. Signature
3. Distribution
6. Document mgmt
1. Medical
2. Reports
3. Forms
7. Coding
Manual
X
x
X
>82%
>26%
X
X
X
>82%
X
X
X
X
Solutions
Web integration to PM System
Scheduling and clearing house integration
PM Sys and Telephone/Email integration
Electronic Forms and Document Mgnt Sys
Integrated Transcription and PM System
Online editing capability
Electronic signature system
Web, fax and Email distribution
EMR and Electronic Forms with Bar-coding
Scanned or electronic health record
Scanned or electronic health record
Scanned and indexed
EMR/Coding Engine
Pre
-su
rgery
Post
Su
rgery
Cla
im P
rep
.
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MediGainPreserving Healthcare Profits
Process
8. Charge Entry
9. Claim Scrubbing
10. Claim Submission
11. Claim Acknw.
12. Payment Receipt
13. EOB/PMT Posting
14. Denial Mgmt.
15. Reporting
16. Prescription/Labs
17. Materials mgt.
18. Patient info.
19. Marketing
Manual Solutions
X
X
X
X
X
X
X
X
X
X
X
X
Integrate Registration and EMR
Integrated coding engine and edits
Clearinghouse integration with PM System
Clearinghouse integration with PM System
Bank lockbox with web based doc. view
ERA with integration to PM System
Denial tracking, automated appeals
Data capture and business analytics
Prescription and Lab integration with PM system
Integration of PM Sys. and Clearinghouse
Web portal with Integration - Med Rec &PMS
Data capture through PM System/Web/Tel
What Processes Do You Automate? P
ost
Su
rgery
- C
laim
P
roc.
Post
Su
rgery
-O
ther
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Asses Current ASC Situation
Technology• Age and efficiency of current systems
• Tasks that are done manually but can be be automated Staff
• Knowledge of IT staff, and time allocated for technology planning Management
• How the organization implements and integrates technology related decisions
Financial• Budget and availability of funds for technology implementation,
support and maintenance Conduct needs assessment by functions
• Front office – Scheduling, patient access
• Clinical – Materials management, lab/pharmacy integration
• Back office - Billing, Collections, Patient data gathering and distribution
MediGainPreserving Healthcare Profits
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Items to Consider When Investing in Technology
List benefits and calculate ROI
• Staff time that will be saved per month x $/hr
• Increase in revenue per month i.e. reduction in claim denial
Set IT roadmap and priority based on highest ROI and budget Selecting vendors
• Ability to customize, web based
• Customer service, and customer feedback
Other key IT considerations
• Capability to integrate to other systems and other facilities i.e. physicians, hospitals via HL7
• Web enabled access for ease of management and maintenance
• Data exporting, mining and reporting capabilities
Phased deployment
• Phase the deployment to ensure all stakeholders become familiar with new systems – MD’s, staff, patients
• Set project plan and realistic timelines
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MediGainPreserving Healthcare Profits
MediGainPreserving Healthcare Profits
Ideal ASC Workflow
ReportingAnalytics
InventoryManagement
Billing/CollectionsPosting
Coding
Transcription
BankReferring MD
Patient MedicalRecord
Insurance
Phone
Web
Digital Forms
Surgery
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MediGainPreserving Healthcare Profits
MediGainPreserving Healthcare Profits
Example of Opportunity
Current revenue generated = $5,000,000/yr
Conservative estimate of improvement = 10%-15%
Assuming an average ASC
Total revenue increase/yr = $500,000 to $750,000
Total revenue increase/mo = $41,666 to $62,500
Note:
This does not include any cost savings due to increase in efficiencies.
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Where do you want your ASC to be? MediGainPreserving Healthcare Profits
Level 1
Paper records
Manual entry
Manual processes
Paper claims
Delays in billing
Poor collections
Poor cash-flow
No reporting
Obsolete systems
Overworked staff
Reactive management
Afraid of IT
Level 2
Some Scanned records
Min. automation of processes
Some delays in billing
Some electronic claims
Ave. collections
Poor cash-flow
Minimal reporting
New but disparate systems
Overworked staff
Reactive management
IT is an afterthought
Level 3
Standalone EMR
Some Automated processes
Smooth workflow
Min delays in billing
Consistent collections and cash-flow
Basic reporting
Some integration of systems
Adequate staff levels
Some proactive management
Embracing IT
Level 4
EMR accessible to patient/ext. entities
Automated processes
Optimized workflow
Automated billing and coding
Optimized cash flow
Dashboards & Buss. Intel
Fully Integrated systems
Optimized staffing
Leader in industry
Proactive management
Using IT as its advantage
ASC Technology Maturity Model
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Questions and Answers MediGainPreserving Healthcare Profits