Providing visibility to data, drives results
Claim submission timelines drive time periods to recieve payment. In a large multi-specialty group, the physicians were pointing fingers and complaining that the central billing office was not entering codes correctly or in a timely fashion. We were asked to develop a daily provider entry report to enable Physicians to see their entered charges. To their surprise everything was available and visible as they had entered.
2 months after implementation of the report, the number of days to enter charges dropped from between 12 and 40 days to average between 1 and 6 days across the organization. In todays environment with decreasing reimbursements, that translates to cash flow.
Consolidate datasources into one reporting center
A practice performing data acquisitions, purchased smaller groups and told them that they could use their existing systems and really have little change to their practice upon completion of the sale with the eventual goal to transition everyone to one billing system. The result of this plan provides multiple disparate data systems, various reporting platforms and a hours of data analytics to create consolidated reports. One practice has 11 different data systems. Cerner, Aprima, Allscripts, McKesson, AS400 (Homegrown), five instances of eClinicalWorks and CPSI. The reporting for this team is an insurmountable task and the practice has 18 months before their system wide single system implementation is complete. We have consolidated their data to create a single reporting solution across all systems.
Another Medical system has created a clinically integrated network for independent physicians and we worked with them to develop a consolidated reporting platform with Practice Management billing data and Electronic Medical Record data. The data was then processed for population management to identify clinical measure compliance and progress.
Expedited data collection to Assess Practices
Large Medical Organizations have been purchasing smaller groups as the landscape continues to change in payer reimbursement and Accountable Care Organizations have created new requirements on practices. Working with a group in the southeastern region of the United states, the practice was able to command their data and negotiate a stronger position in a sale. As the buyer posed questions the practice had the answers and additional data to back it. The buyer asked the practice “Who is providing your data, I don’t want to be on the other side of the table from them.”
We then worked with the buyer to assist them in quick analysis of practices. Within a few weeks they were prepared to return to a practice with a complete analysis of the clinic data along with applying the new fee schedule over the practices existing schedule to see the impact of their coding behaviors. We assisted them in many practice acquisitions but one of the most valuable positions, was providing data that helped them determine which practice they would not purchase.
Identifying opportunity through benchmarking with external sources
Viewing practice data and comparing a provider to their peers can be very helpful in an organization to see who outliers are within the team, however external benchmarks can identify areas of opportunity within a practice. MGMA, CMS, Sullivan Cotter, Regional Deidentified data, etc all provide a glimpse of how other Physician groups are performing. We apply the selected benchmarks to show your team how they are doing. It is now stated that the MGMA 75%tile is the break even point. If you practice is performing at the 50%tile or less, this visibility to data comparison is extremely important.