Challenge
Virtua Health is a great New Jersey health system with more than 2,000 personnel hospital in multiple locations. An inefficient notice of admissions (NOA) was becoming unsustainable for hospitalized admissions, putting income at risk.
“Manuelly Faxing Noas to the payers was an administrative nightmare,” says Ginny Norton, led Virtua Health’s IT applications analyst. “The monitoring of the great volume of NOAS and ensure that they arrived at the payers in time took a long time. The process was inefficient and risky.”
The lack of NOA’s deadline for a payer for a stay for hospitalized patients can result in refund denials throughout the patient’s stay, which endangers cash flow. In Virtua, connectivity problems, defective fax machines and human error left the income cycle team a reliable way of tracking NOA’s presentations or denials of challenge payers. This increased the hood of the probability of lost deadlines and delayed payments. Adhering to different rules and deadlines for multiple payers hindered the control process.
The pressure was performed to find a scalable solution that would avoid a greater loss of income by:
- Minimize manual work for admission personnel and insurance verifiers
- Ensure that they will not be presented on time and within the deadline of each payer
- Improvement of efficiency by freeing staff to focus on more urgent tasks
- Optimize the process of requesting additional payer connections.
Solution
Changing manual to NOAS automated was the obvious way to follow. Cindy Biggio, patient accounting director in Virtua, says ATIVAL HEALTH ATTENTION NOTICE The solution, with the admission warning functionality (NOA), was a natural adjustment, due to its easy integration with its existing Epic® configuration:
“Based on the recommendations of other epic health systems and the integration of Experian with Epic, choosing the care warning was a logical decision for us. We were already using other health solutions, so it made sense to build. Product portfolio.” ”
Because the NOA of Experian Health operates within the Ecare Next® eligibility platformVirtua staff can administer it within their existing workflows. Noas are triggered as soon as the patient’s insurance elegality has been verified. The presentations are sent directly to the payers within their required deadlines, with the patient information and the procedure automatically full to save time and reduce data input errors. Each application is formatted in accordance with the rules of the payer, while the entry responses of the payer are standardized so that the personnel can see them all consistently.
While faxes are still a characteristic of the payout processes, this tool makes them handle them a lot. Capture key information from each fax, left it to the appropriate order and then classify and convert data from multiple types of documents so that the personnel can quickly look for it. This is an important improvement in the previous approach, which required that the personnel monitor and update the state of hand shipping and link with a compensation house on delays and errors.
Norton says that working in close collaboration with Experian Health team was key to easy implementation:
“Clear incorporation processes for existing and new team members helped maintain operations without problems, along with opportunities to find staff comments so that we could continue making improvements … In general, the implementation process and transition to ‘GO. Less chaos without having to administer a paper mountain.
Read more On how automation reduces administrative costs in medical care.
Result
From the implementation NoaVirtua Health has seen improved improvements in its income cycle operations, which include:
- Less manual work, since automation allows staff to operate more efficiently
- Faster and more precise presentations, resulting in feer denials and more income
- Soft dispute resolution, thanks to paper electronic paths
- Better compliance with the requirements of the payer.
“The data is cleaner through all later systems,” says Biggio. “Our renewed electrical reports now provides meeting level data, which sacrifices more processable ideas for our client’s operational equipment.”
The solution also satisfies the need for virtua of a scalable approach to the NOA. Instead of classifying new payers per operational platform, staff can now add all payers through a system. If the requirements of the payer change, Virtua will be ready to adapt.
In addition to the loss of prevention income, Noa has had a significant impact on staff satisfaction. The solution has illuminated workloads, improved daily efficiency and remote works enabled by eliminating administrative retirement tasks. Liberated from the need to visit payer websites or call payers for admission notification and state updates, staff can focus on more complex tasks and pay more attention to the patient’s experience. This benefits the personnel and patients, and positions Virtua as an attractive employer in a adjusted labor market.
Looking towards the future, Norton says that Virtua will focus on adding more payers and will continue using Experian Noa data to improve the processes: “We will continue listening to our staff, which is directed at work, to see if we need to make changes to improve the workflow. Advancing, the leadership will decide to add more solutions based on the needs of our patients, personnel, market and operations.
