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Achieving Healthcare’s True Return Presented by Michael S. Friedberg, FACHE, CHAM Associate Vice President, Patient Access Services Excellence in Access: Let the Data Lead the Way
What is the Revenue Cycle? Excellence in Access: Let the Data Lead the Way  | Page
What is the Revenue Cycle? Excellence in Access: Let the Data Lead the Way  | Page
Background ,[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Excellence in Access: Let the Data Lead the Way  | Page  Proactive Reactive
Excellence in Access: Let the Data Lead the Way  | Page  What are KPI’s? ,[object Object]
Why We Use KPI’s? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Accountability Excellence in Access: Let the Data Lead the Way  | Page
How Do You Get Started? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Daily Dashboard Components ,[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Daily Dashboard: Example Part 1 Excellence in Access: Let the Data Lead the Way  | Page  Date Daily Census @ 9:00 am ER Holds QA Quality Score MTD Failed  Bill $ Staff Call Outs POS Cash  POS Cash MTD 5/1/06 5/2/06 5/3/06 5/4/06
Daily Dashboard: Example Part 2 Excellence in Access: Let the Data Lead the Way  | Page  Date POS Cash as a % of Goal Complaints to Administration MPI Duplicates Created Patients in House >30 Days % of Eligible Patients Scheduled 5/1/06 5/2/06 5/3/06 5/4/06
Flexibility ,[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Excellence in Access: Let the Data Lead the Way  | Page  Drilling further down
Monthly Denials ,[object Object],[object Object],[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Bad Debt and Charity Care ,[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Point of Service Collections ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Clean Claims % ,[object Object],[object Object],[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Vendor Performance ,[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Benchmarking ,[object Object],[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Scheduling Benchmarking Excellence in Access: Let the Data Lead the Way  | Page  Item Standard Scheduling rate of patients eligible for scheduling 100% Scheduling for ambulatory surgery patients 100% Scheduling for high dollar outpatients 100%
Pre-registration Benchmarking Excellence in Access: Let the Data Lead the Way  | Page  Item Standard Pre-registration rate for all scheduled patients >95% Insurance verification rate for pre-registered patients 100%
Registration Benchmarking Excellence in Access: Let the Data Lead the Way  | Page  Item Standard Average registration interview duration new patient 15 minutes Average registration interview duration repeat patient < 5 minutes Average patient wait time to be registered < 10 minutes Maximum wait time for any patient 15 minutes
Registration Benchmarking (continued) Excellence in Access: Let the Data Lead the Way  | Page  Item Standard Average inpatient registrations per shift 15 - 20 Average outpatient registrations per shift including emergency department 30 - 40 Advanced beneficiary notice rate where applicable 100%
Denials Benchmarking Excellence in Access: Let the Data Lead the Way  | Page  Item Standard Overall denial rate < 4% Technical denial rate < 3% Eligibility denials rate < 75% Appeals overturn rate 40% - 60%
Benchmarking Sources ,[object Object],[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Closing Thoughts ,[object Object],[object Object],[object Object],[object Object],Excellence in Access: Let the Data Lead the Way  | Page
Shameless Self-promotion Staff Competency in Patient Access:  Tools, Tests and Tips for Building a Successful Team 1.877.727.1728 www.hcmarketplace.com Excellence in Access: Let the Data Lead the Way  | Page
Achieving Healthcare’s True Return Michael S. Friedberg, FACHE, CHAM Associate Vice President, Patient Access Services Office: 973.233.7644 Mobile: 732.809.0260 Email: michael.friedberg@apollohealthstreet.com Learn more at www.apollohealthstreet.com Apollo Health Street partners with healthcare organizations across the country to achieve healthcare’s  True Return  – the financial strength you need to offer excellent patient care today and tomorrow.

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Excellence In Access Let The Data Lead The Way Hfma Philly 2 16 10

  • 1. Achieving Healthcare’s True Return Presented by Michael S. Friedberg, FACHE, CHAM Associate Vice President, Patient Access Services Excellence in Access: Let the Data Lead the Way
  • 2. What is the Revenue Cycle? Excellence in Access: Let the Data Lead the Way | Page
  • 3. What is the Revenue Cycle? Excellence in Access: Let the Data Lead the Way | Page
  • 4.
  • 5. Excellence in Access: Let the Data Lead the Way | Page Proactive Reactive
  • 6.
  • 7.
  • 8. Accountability Excellence in Access: Let the Data Lead the Way | Page
  • 9.
  • 10.
  • 11. Daily Dashboard: Example Part 1 Excellence in Access: Let the Data Lead the Way | Page Date Daily Census @ 9:00 am ER Holds QA Quality Score MTD Failed Bill $ Staff Call Outs POS Cash POS Cash MTD 5/1/06 5/2/06 5/3/06 5/4/06
  • 12. Daily Dashboard: Example Part 2 Excellence in Access: Let the Data Lead the Way | Page Date POS Cash as a % of Goal Complaints to Administration MPI Duplicates Created Patients in House >30 Days % of Eligible Patients Scheduled 5/1/06 5/2/06 5/3/06 5/4/06
  • 13.
  • 14. Excellence in Access: Let the Data Lead the Way | Page Drilling further down
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. Scheduling Benchmarking Excellence in Access: Let the Data Lead the Way | Page Item Standard Scheduling rate of patients eligible for scheduling 100% Scheduling for ambulatory surgery patients 100% Scheduling for high dollar outpatients 100%
  • 22. Pre-registration Benchmarking Excellence in Access: Let the Data Lead the Way | Page Item Standard Pre-registration rate for all scheduled patients >95% Insurance verification rate for pre-registered patients 100%
  • 23. Registration Benchmarking Excellence in Access: Let the Data Lead the Way | Page Item Standard Average registration interview duration new patient 15 minutes Average registration interview duration repeat patient < 5 minutes Average patient wait time to be registered < 10 minutes Maximum wait time for any patient 15 minutes
  • 24. Registration Benchmarking (continued) Excellence in Access: Let the Data Lead the Way | Page Item Standard Average inpatient registrations per shift 15 - 20 Average outpatient registrations per shift including emergency department 30 - 40 Advanced beneficiary notice rate where applicable 100%
  • 25. Denials Benchmarking Excellence in Access: Let the Data Lead the Way | Page Item Standard Overall denial rate < 4% Technical denial rate < 3% Eligibility denials rate < 75% Appeals overturn rate 40% - 60%
  • 26.
  • 27.
  • 28. Shameless Self-promotion Staff Competency in Patient Access: Tools, Tests and Tips for Building a Successful Team 1.877.727.1728 www.hcmarketplace.com Excellence in Access: Let the Data Lead the Way | Page
  • 29. Achieving Healthcare’s True Return Michael S. Friedberg, FACHE, CHAM Associate Vice President, Patient Access Services Office: 973.233.7644 Mobile: 732.809.0260 Email: michael.friedberg@apollohealthstreet.com Learn more at www.apollohealthstreet.com Apollo Health Street partners with healthcare organizations across the country to achieve healthcare’s True Return – the financial strength you need to offer excellent patient care today and tomorrow.