Facilitator:
Terri Stoner

Review opportunities to improve collections on claims rendered for Hospital and physician/dentist services to improve timeliness of entering charge data into the billing system, which in turn could yield significant revenue enhancements and operational savings. The team should develop for UI Hospitals and Clinics and College of Medicine a proposed institution-wide policy that would set forth performance parameters for inclusion in department level policies and procedures for submission of charges.

Process Improvements that have been defined and are to be implemented

Original goal - identify ways to enter hospital charges within three days of the date of service, was revised to reduce late charges within current systems.

Recommendations:

1. Develop guidelines to heighten importance of timely input of charges.
2. Eliminate small dollar supply charges that represent Omni reconciliation problems and late postings.
3. Direct pick-up and delivery from Business Office.
4. Identify and train select departments for direct entry of charges, example Air and Mobile Critical Care.
5. Staff training in Pharmacy to expedite entry of pharmacy charges.

1. Develop guidelines to heighten importance of timely input of charges. It was discovered that the current Informm application MSA2 needed to be updated for improved data entry and ease of use to speed the data input process. The program was modified and new classes were established to inservice potential users.

2. Eliminate small dollar supply charges that represent Omni reconciliation problems and late postings. After review, it was discovered that the OMNI Cell units were the source of multiple charging problems, which caused a delay in posting the patient charge. Most of these items were eliminated from the patient charge system or removed from the OMNI cell system. These changes resulted in a significant drop in delayed charges due to processing errors.

3. Direct pick-up and delivery from Business office. The Business Office staff now provides daily pickup and delivery of reports to all areas. This has resulted in improved communications and fewer late charges as a result.

4. Identify and train selected depts. for direct entry of charges, example Air and Mobile Critical Care. Many barriers occurred at this point. Late charges are a result of many processes, some manual, some waiting automation, and often waiting for physician approval or intervention.

5. Staff training in Pharmacy to expedite entry of pharmacy charges. The delay in the pharmacy charging system was related to the very manual process, which will soon be replaced with a new computer system.

This team has progressed as far as it could within the current system environment. The priority has shifted to investigation and then recommendations for purchase of a totally new and improved patient billing and registration process. A decision has been made to discontinue meeting at this time to allow all principle parties to pursue the recommendations for a new system.

When this project began, January 1999, we had an average of 21 percent of all charges posted "late," three days after the service was provided, or a value of late charges of $10,973,364. At the end of May, 2000 we had improved this to an average 6 percent of all "late charges" posted after five days with a resultant value of late charges averaging at $4,325,000.