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Penn State Hershey Medical Center. Penn State Hershey Medical Center Outpatient Pre Arrival Services. Presenters Mary Stephens, Manager, Inpatient Access – Previously a Coordinator in Outpatient Pre Arrival Services (6 yrs) Linda Cranston, Manager, of Out Patient Pre Arrival Service

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Penn state hershey medical center outpatient pre arrival services
Penn State Hershey Medical CenterOutpatient Pre Arrival Services

  • Presenters

    • Mary Stephens, Manager, Inpatient Access – Previously a Coordinator in

      Outpatient Pre Arrival Services (6 yrs)

    • Linda Cranston, Manager, of Out Patient Pre Arrival Service

    • LeAnn Stringer, Manager, Eclipsys Application


Penn state hershey medical center1
Penn State Hershey Medical Center

  • 500 bed Tertiary Care Academic Medical Center

  • Adult and Children’s Hospital

  • Level 1 Trauma Accreditation (adult/pediatric)

  • Penn State Cancer Institute

  • 588 Faculty Physicians


Annual clinical activity
Annual Clinical Activity

  • Inpatient admissions – 27, 615

  • OR Cases

    • Inpatient – 10,125

    • Outpatient – 6,564

  • Emergency Room visits – 47,163

  • Outpatient Visits

    • Booked - 1,412,255

    • Actual - 779,520


Hmc systems
HMC Systems

  • Eclipsys AM/PFM

  • Eclipsys Registration data interfaces to 20 systems

    Other Systems used at HMC

    • Cadence (Scheduling)

    • Cerner Clinicals

    • GE Centricity (Radiology)

    • Mysis (Laboratory)

    • Pyxis

    • Seimens (Signature-Professional Billing)


Redesign of front end processes
Redesign of Front End Processes

  • Multi-Disciplinary Team Approach

    • Patient Financial Services (PFS)

    • Nursing

    • Physicians

    • Inpatient Access

    • Health Information Services

    • Information Technology

    • Representatives from various outpatient clinics


Hmc identified financial opportunities
HMC Identified Financial Opportunities

  • Reduce Accounts Receivable

    • Hospital & Physician AR

  • Reduce write offs (revenue deductions)

  • Decrease check in time for outpatients


Team recommendation
Team Recommendation

  • Form the Outpatient Pre Arrival Services (OPAS) Department (2001)

  • OPAS Goal

    • Obtain accurate patient and insurance information prior to the outpatient visit to ensure full reimbursement of services

    • Facilitate gathering and verification of sensitive information to ensure HIPAA compliance and increase patient satisfaction


Opas department goals
OPAS Department Goals

  • Decrease facility accounts receivable days from 86 to 45-55

  • Decrease professional account receivable days from 81 to 51-57

  • Decrease facility write offs from 3.2% to 1.3-1.7%

  • Decrease professional write offs from 2.8% to 1.3-1.6%

  • Decrease average check in time from approximately 6 minutes to less than 1minute


Opas staffing
OPAS Staffing

  • Initial Pilot (3 month period in 2001)

    • 4 new FTEs

    • 2 clinics (Dermatology and OB/GYN)

  • Currently

    • 70 FTE’s (existing and new staff)

    • 43 clinics




System enhancements
System Enhancements

  • Scheduled appointments 28 days out (Cadence Report)

  • Eclipsys pre-clinic visit creation

  • Eclipsys Worklists by service and location

  • Identify & refer S/pay accounts to Financial Counselor


Self pay process
Self Pay Process

  • Price estimate of service is obtained

  • Review patient’s account for payment history

  • Credit report

  • Patient is contacted

    • Provide estimated cost of service

    • 75% of estimate is requested

    • MA process is discussed

    • Financial Risk process

      • Physician makes the decision (based on medical necessity) whether appointment is canceled or postponed


Improved outcomes in clinics
Improved Outcomes in Clinics

  • Decreased denials due to 100% verification of insurance and ability to obtain referrals and authorizations prior to the clinic visit

  • Reduced check in/check out time for patients

  • Increased point of service cash collection

    • approximately $750,000 monthly


Financial improvement outcomes
Financial Improvement Outcomes

  • Facility accounts receivable days reduced from 86 to 45

  • Professional accounts receivable days reduced from 81 to 45.2

  • Facility write offs reduced from 3.2 % to less than 0.5 % of revenue

  • Professional write offs reduced from 2.8% to less than 0.5 % of revenue


Conclusion
Conclusion

  • Questions


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