“[Automating] helped make our work more standardized throughout because we could offer this at the hospital and to our affiliates. It also helped eliminate a security risk for us, and the patients like it,” said Oomen.
Stage 2: Bigger Size + Bigger Efficiencies = Bigger Bucks
Four years ago, leaders at Phoebe Putney Memorial Hospital, a 443-bed facility in Albany, GA, took a look at their revenue management process. The hospital was processing 215,000-225,000 claims per year, yet it had only four auditors, two for inpatient and two for outpatient.
“We were able to audit about 10% of the claims annually. There just wasn’t enough time or personnel to even review the charts for charge accuracy,” explained Wendy Allen, director of revenue management for the hospital. “We would audit a chart if a payer needed something or if a patient requested it, but we didn’t have a formal process in place.”
In this instance, the solution was actually only the beginning for multiple process improvements. Like its counterparts at NOCH, Phoebe Putney added technology from MedAssets-- new charge capture software which improved claims processes. Since adding the program, Phoebe Putney has been able to realize $12 million in net corrections by producing cleaner claims and processing each charge correctly on the first take.
Improving the charge capture process yielded some other important findings pointing to other hospital inefficiencies. The system was able to identify a situation where employees were stealing narcotics.