From Good to Great: Optimizing the
Front-End Revenue Cycle Experience
Presented by: Mary Godwin, PAS Senior Manager
and Shanna Bradford, PAS System Support
About Baptist Health System
Baptist Health Care (BHC) is area’s only
not-for-profit, locally owned health care
system whose sole purpose is to help
families connect the dots between prevention,
lifestyle and physician-directed care.
•
Founded in 1951, BHC’s mission is to improve the quality of life
for all families throughout our service area that includes northwest
Florida and south Alabama.
•
BHC includes four hospitals, two medical parks,
Andrews Institute
for Orthopaedic & Sports Medicine
,
Lakeview Center
and
Baptist
Medical Group
and
Cardiology Consultants
.
•
BHC team includes more than 6,700 employees and employed
physicians and is the largest non-governmental employer the
area.
•
BHC is honored to be a member of the Mayo Clinic Care Network
and is a 2003
Malcolm Baldrige recipient
.
Optimizing the Front-End Revenue
Cycle at Baptist Health Care
We all dream of going from Good to Great…. But how do
you get there? We’re here to share our journey.
•
Where Did We Start?
•
What Were Our Pain Points?
•
What Solutions Best Met our Needs?
•
What Members of the Team Made it Happen?
•
Strategies and Steps
•
Call Center Structure - VIBES Team
•
2 Team Leads
•
11 OP Dx/Surgery Schedulers
•
3 VIP Specialists
•
4 Verifiers
•
Call Center Monthly Stats
•
AVG Procedures Scheduled-11,000+
•
AVG Orders Received-12,000+
•
AVG Inbound Calls-10,000+
•
AVG Outbound-13,000+
Corporate Director
Systems Coordinator Senior Manager
Patient Access Specialist I (OP Scheduler or Insurance Verifier) Patient Access Specialist II (VIP OP Scheduler / Insurance Verifier) Patient Access Specialist III (Surgery Scheduler) Team Lead, Insurance Verification Team Lead, Outpatient and Surgery Scheduling
• BHC Organization Snapshot
• 4 Hospitals total 679 Beds
• Baptist Hospital-498 Beds
• Gulf Breeze Hospital-77 Beds
• Atmore Hospital-49 Beds (AL)
• Jay Hospital-55 Beds
• 2 Medical Parks
• Baptist Medical Park-Navarre
• Baptist Medical Park-9-Mile
• 2 Outlying Facilities
• Andrews Institute
• Lakeview Center
• Baptist Medical Group
• 170 Owned Physician Practices • 170 Employed Practitioners
• Facility System Users total 1308 • 623 SCI Order Facilitator • 228 SCI Schedule Maximizer • 340 TU MedConnect
• 117 TU/FHS ClearIQ
• Highly Competitive Regional Market • Not-For-Profit
• Locally Owned, Local Board, Local Decisions
•
VIBES Team Schedules for
• Surgery (1 Location)
• Surgicare Outpatient Surgery (1 Location)
• GE Department (1 Location)
• Labor and Delivery (1 Location)
• Cardiac/EP Cath Lab (2 Locations)
• Interventional Radiology (1 Location)
• Radiology (7 Locations)
• Cardiology (6 Locations)
• Infusion (1 Location)
• Sleep Center (2 Locations)
• Wound Center (2 Locations)
• Pulmonary (5 Locations)
• VIBES Team Verifies for
• Radiology (2 Locations)
• Cardiac/EP Cath Lab (2 Location)
• Cardiology (2 Locations)
• Sleep Center (2 Locations)
• Wound Center (2 Location)
• Pulmonary (2 Locations)
•
The
PASS Leadership Team
•
M*
ary Godwin PASS Senior Manager
•
A*
ngie Simpson PASS Physician Office Liaison
•
S*
hanna Bradford
PASS Systems Coordinator
•
Partners and Support
•
SCI Solutions Implementation Team
•
TransUnion Implementation Team
•
MedConnect Implementation Team
•
DynaTouch Implementation Team
•
Overview of Operational Implementations
•
Cardiology Consultants Callout Campaign
•
SM-BH Cath Lab, EP Procedures
•
SM-GB Sleep Lab
•
SM-BH Wound Care
•
VIBES Team-Revamp Procedures
•
SM-BH Cath Lab, Other Procedures
•
SM & ORMIS-GB Cath Lab
•
SM-Jay Hospital
•
Surgery Scheduling-Revamp Procedures
•
Overview of New Technology Implementations
•
SCI Solutions Power Access
•
SCI Solutions Scheduling (Provider) Portal
•
SCI Solutions Consumer Portal
•
TransUnion/FHS ClearIQ
•
TransUnion MedConnect
•
Phase #1
•
Power Access
• No More Paper!
• Streamlined process with fewer errors
• Automatic correspondence
• Significant workflow change
•
Cardiology Consultants Callout Campaign
• Follow-up to letter campaign
• Revamped scripting
• Tracked patient responses
•
Phase #2
•
SM-BH Cath Lab, EP Procedures
• Phase I
• Transition from handwritten appointment book
• Complex rules-building
•
Scheduling (Provider) Portal
• Promoted to BMG Physicians first
• 2 Beta sites chosen based on volume scheduled
• Procedures chosen based on volume & complexity
• BMG, 15 physicians within 8 practices
• Non-BMG, 16 physicians within 4 practices
• Ongoing rollout process
•
Phase #3
•
SM-GB Sleep Lab
• Access for additional patient population
• First open referral
•
SM-BH Wound Care
• Initial Appointment
•
HAPPY HOLIDAYS!
•
Phase #4
•
SM-BH Cath Lab, Other Procedures
•
Phase #5
•
SM-GB Cath Lab
• Brand new Cath Lab
• Opened utilizing SM
•
Consumer Portal
• Initial launch for BHC employees for scheduling Screening Mammograms
• Capability to cancel and reschedule existing appointments
• Available to general public
• HealthyLives Program
• Built & Live in less than a week! • 30+ Locations
•
Phase #6
•
Surgery Scheduling-Revamp Procedures
• Rewrite scripting
• Updated QA process
• Issues tracking to identify opportunities for improvement
• Constant communication with departments
•
TransUnion/FHS ClearIQ
• Accurate patient liability estimate
• All facilities, Verifiers, Registrars, Financial Counselors
• 40,000+ Estimates created across users
•
Phase #7
•
Verification Team-Revamp Procedures
• Team members worked in silos
• No depth in staffing for coverage
• Stepped back, tried several approaches to distribution of work
• Cross-trained all team members
• Re-worked the Verification Worklist
• Now work daily ‘bucket’ spread evenly across team, all types of appointments
•
TransUnion MedConnect
• All facilities
• Organization-wide Training program
• Verifiers, Registrars, Schedulers, Financial Counselors, BMG Schedulers, Lakeview
•
Phase #8
•
SM-Jay Hospital
• Rural 55-bed facility
• Transition from handwritten appointment book
• All BHC facilities schedule through SM
•
Phase #9
•
BMG-VIP1 Concierge Model
• Dedicated phone line for Baptist Medical Group
• Dedicated team cross-trained for all VIBES functions
• ‘One Call Does It All’
• Very successful concept
•
Phase #10
•
Patient ID
• Patient ID & Address verification
• Self-Pay patients at time of scheduling
• Tested & currently analyzing workflow changes
•
Phase #11
•
TransUnion Revenue Manager
• Patient ID & Address verification, automated alerts for ER Self-Pay
• Stand-alone version for ad-hoc inquiries
• Tested & currently analyzing workflow changes
•
Expect significant decrease in returned mail using these
tools
•
There was the flood of June ’12
• Flooded main hospital & Business Office
• Call Center absorbed Customer Service team
•
And the Hurricane (Isaac) that wasn’t
• BHC basically closed for 2 days
• Invoked Incident Command Strategy
• ‘A’ Team deployed for Disaster Management
• Call Center activated
•
Then there was the SNAKE in the Call Center
•
January2014 – Call Center flooded and
center was relocated and up in running in 2 hours.
•
Ice Storm of 2014 –
PENSACOLA and ICE do not mix. Call Center able to reschedule and maintain current volume.•
March 2014 relocated to a flood free zone location adjacent to the
main campus.Results
Results
6.7% growth in scheduled O/P procedures
$602,000 additional revenue first 7 months
17.5% improvement in Scheduler productivity
2010 2011 2012 2013 AR days 46.83 43.95 43.4 40.92 Collections % Net Rev $324 million 103% $341 million 101% $350 million 100.5% $359 million 103% Patient “point of services” collections improvement $3.9 million $4.2 million $4.3 million $4.6 million
•
How in the world did we do it?
•
Consultants...
•
Implementation Specialists…
•
Cart Blanche Access to IT…
•
Lots of Vacation Time…
•
Eager, Attentive Trainees…
•
Baptist Medical Group participation/
• Expectations set…
•
Team Members LOVE Change…
Leveraging technology to…
•
Referral Management strategies
•
Prevent revenue leakage
•
Framework for population health management
•
Efficiencies to have care coordination for specific service lines
•
Streamline bidirectional information EMRs
Roadmap 2013
One Picture
is Worth
a THOUSAND
Words!
•
Summary
•
Collaborative effort between BHC & partners
•
Dynamic departmental plan
•
Engaged team
•
Built strong relationships, internal & external
•
Stayed agile
•
With all you’re trying to accomplish, when it feels like
•
You’re going 100 mph with your Hair on Fire,
•
You can’t take another Day,
•
You’re ready to Cry,
One
Bite
At
A