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SIGNATURE Presentation. OAS GOLD. PRESENTED BY.

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Signature presentation
SIGNATUREPresentation

OAS GOLD


PRESENTED BY

Debbie  Harkins  Patient Accounts IT Coordinator, Central Business OfficeBaycare Health System, Oldsmar, FloridaAnnette  Yanna  Senior System AnalystBaycare Health System, Clearwater, FloridaDale  Sahlberg  Senior System AnalystBaycare Health System, Clearwater, Florida


What is SIGNATURE ?SIGNATURE is an integrated outpatient management & outpatient accounting application.

Front-office functions include registration, scheduling and report writing tools.

Business office functions manage accounts receivables with collection tools to maximize reimbursements.


SIGNATURE FEATURES

Has advanced collection tools (target files) to maximize allowable reimbursements based on payers and collectorsGenerates 1505 medical billing claim forms (combined charge for services and physician - example: chest X-ray)Produces UB04s - same as an inpatient hospital bill with surgery billing for nurse, facility and supplies ( surgeons do their own billing )Has a combined Patient Management and Patient Accounting database (integrated application) that allows charges to be entered and bills produced that same day (day-end)Utilizes SCHEMES that allow multiple insurance plans to meet the different ambulatory care needs


A patient was registered at the Imaging site for a annual diagnostic mammogram and ultrasound with Medicare and Medicaid plan providing coverage.Scheme 1 - established with insurance plans Z01 Medicare with a priority of 1 and Z25 Medicaid Fl with a priority of 2


The patient was in an auto accident later that day and returned to the Imaging site to have a MRI of the cervical spine. Scheme 2 - established with I16 Auto Allstate Insurance with a priority of 1


The patient was scheduled for a knee arthroscopy due to a work related injury that occurred the previous week.Scheme 3 - established with 0041 Commercial Risk Work Comp with a priority of 1


The original work related injury that occurred the previous week.SIGNATURE application was based on a 3270 terminal design.

The Siemens enhanced SIGNATURE version employs browser technology called OAS GOLD.


3270 version
3270 work related injury that occurred the previous week. version


Original model design for gold
Original model design for work related injury that occurred the previous week.GOLD


The Siemens work related injury that occurred the previous week.GOLD model was sent to the Baycare body shopto be reprogrammed, redesigned, repainted and enhanced


Baycare signature gold
Baycare work related injury that occurred the previous week.SIGNATUREGOLD


GOLD work related injury that occurred the previous week.has new graphical features such as:

check boxes, radio buttons, labels, selectable lines with banners, combo boxes, a calendar, text boxes, images, scroll bars, data evaluators & controllers










Previous accounts had bad information. Previous accounts were bad debt. Previous accounts were charity. Previous accounts had billing problems.


  • Inquiry screens are enhanced for faster searches, such as doctor name inquiries with “quick picks”


Radio button selection will appear as a comment


BOARD MEMBER FRANCISCAN ORDER CLERGY FOUNDATION FRIEND COMMUNITY LEADER GOVERNMENT OFFICIAL FINANCIAL DONOR STAFF PRIVILEGED PHYSICIAN CELEBRITY


  • Checkmark lights up fieldgreen if an HDX inquiry is possible for this plan. Eliminates wasted HDX inquiries for unsupported insurance plans.




Custom Features insurance company mailing addresses


  • Mail statistics: insurance company mailing addresses

  • • 23.6% of all mail in the U.S. is incorrectly addressed.

  • • 2.7% of the total mail volume is undeliverable as addressed.

  • • 1 out of every 32 pieces of first-class mail is undeliverable.

  • Causes:

  • • Incorrect spelling of street or city

  • • Misread the address from a document

  • • Transposed numbers in street or zip code

  • • Misunderstood the person verbally providing the data


Address Verification Benefits insurance company mailing addresses

  • Address validation confirms that a given address is a deliverable address within the United States as defined by the United States Postal Service.

  • Address verification for bills and statements will also improve the ability to collect fees for services rendered.

  • The USPS standardizes the address in accordance with USPS guidelines – example: Road will be abbreviated as Rd

  • Additional Benefits of Address Verification are:

  • • Improve collections by eliminating returned bills & statements.

  • • Reduce staff time & costs formerly spent processing returned mail.

  • • Achieve data integrity through correctness & standardization.


  • Former insurance company mailing addresses 3270 screen was unable to verify a patient’s address with the US Post Office


    The customized insurance company mailing addressesGOLD screen can verify online a patient’s address with the US Post Office


    Address Verification insurance company mailing addresses

    • There is an online address verification for both the patient and guarantor addresses

    • The verified USPS address is automatically returned to the screen

    • Corrects the address: 13618 N FLORIDA STREET

      that should be 13618 N FLORIDA AVE

    • Corrects the zip code: 33631

      that should be33613

    • The US Post Office returns a message if more information is needed (apartment or lot number)


    If the address was not found, then the insurance company mailing addresses

    US Post Office returns the following message:

    Option:GOLD also can inform the user verbally of an error message.


    SIGNATURE insurance company mailing addresses

    OAS GOLD

    IMPLEMENTATIONPROCESS


    Three signature regions
    THREE SIGNATURE REGIONS insurance company mailing addresses

    • St Joseph's Diagnostic Center … 4 Imaging Centers

    • Morton Plant Health Services … 3 Imaging Sites

    • 1 OP Surgery / Endo site

    • Baycare Ambulatory Care … 3 Imaging Sites

    • 2 St Anthony

    • 1 Med Specialist

    • 1 OP Surgery Site

    • 5 Mental Health Sites


    Analysis phase
    Analysis Phase insurance company mailing addresses

    • Examined the model SIGNATURE GOLD application at Siemens headquarters

    • Made site visits to other hospitals

    • Reviewed the Baycare Invision GOLD application which has a similar design

    • Made phone calls to other SIGNATURE users

    • Checked the SNUG users web board for information about current issues

    • Sent Emails to other SIGNATURE users

    • Held many meetings and had extensive collaboration between the Central Business Office, Registration areas and Information Services


    Then a list of the current insurance company mailing addresses3270 issues was compiled.These issues became the reasons SIGNATURE was converted to the GOLD version …


    Challenges
    CHALLENGES insurance company mailing addresses

    • Experienced significant HDX model issues that were unique to the GOLD combined insurance pathway

    • Standardized insurance plan codes for all outpatient sites (example: where A01 means AETNA for all sites)

    • Made revisions prior to the GOLD live to an estimated 1000 pre-registrations that were using the old insurance plans

    • The 3270 Patient Face Sheet had been customized to include full insurance company mailing addresses - which was converted to print GOLD combined insurance fields

    • Needed popup panels to notify users when insurance plans were terminated (should not be selected for a new registration)

    • GOLDnow requires address information be entered for all miscellaneous insurance plans … that used to be an optional PF9 secondary screen in 3270


    Build phase
    Build Phase insurance company mailing addresses

    • Examined the current 3270 SIGNATURE pathways

    • Reviewed the Siemens model SIGNATURE design

    • Created a composite GOLD version of the above two applications


    Testing phase
    Testing Phase insurance company mailing addresses

    • Used predefined scripts for the Patient Management and Accounts Receivable pathways

    • Verified interface transmissions to other systems (such as IDX)

    • Validated facesheets & bills were generated

    • Emulated real patient scenarios for the types of insurances used (managed care, workman's compensation, Medicare, Medicaid, etc …)


    Integrated systems tests
    Integrated Systems Tests insurance company mailing addresses

    • EAD (Enterprise Access Directory)

    • US Post Office address verification

    • HDX (insurance eligibility)

    • ImageCast (Radiology)

    • EDM (Electronic Data Management)

    • Lawson - General Ledger & refunds

    • Target Files

    • TSI (Managed Care)


    Training phase
    Training Phase insurance company mailing addresses

    • PM – Patient Management

    • AR – Accounts Receivable

    Two training sessions:


    Training manual
    Training Manual insurance company mailing addresses

    PATIENT MANAGEMENT


    Training manual1
    Training Manual insurance company mailing addresses

    ACCOUNTS RECEIVABLE


    Live implementation
    LIVE Implementation insurance company mailing addresses

    • Morton Plant Hospital went live first

    • Other two regions are going live in the following months

    • ACBO (Ambulatory Care Business

      Office) is the final live event


    Now we can view an insurance company mailing addresses

    ONLINE DEMO


    OUTPATIENT insurance company mailing addresses

    CARE

    REGISTRATION

    PATHWAY


    Staff can select a printer from this first menu. insurance company mailing addresses


    Patient Management insurance company mailing addresses


    EAD inquiry options insurance company mailing addresses


    After demographic data is filled out, the system will insurance company mailing addresses

    automatically


    US Post Office abbreviated the insurance company mailing addresses

    AVE and corrected the zip 33613

    Original address data

    Further information is needed


    The USPS supplies insurance company mailing addresses

    a list of known

    addresses to

    select from

    More information

    is required - such

    as an OFC, LOT

    or APT number


    The US Post Office verified address is then transferred insurance company mailing addresses

    through this screen and parsed into the street, city, state

    and zip code fields.


    The corrected address is automatically copied to the insurance company mailing addresses

    demographic screen. The user then adds LOT 71 to

    complete a full mailing address.


    GUARANTOR information – will automatically copy

    all patient data and “gray out” the screen to protect data


    Bottom part of the GUARANTOR information screen is copy

    shown … with COMMENT and EMPLOYMENT options


    INSURANCE copy

    Click on PLAN to access a “quick pick” help screen



    Select an insurance plan copy

    ZZZ identifies a terminated plan


    The managed care plan automatically had a copy1 appended to

    the plan code 102 and an MC filled in for the CONTRACT.


    The HDX button copylit up indicating an HDX inquiry is available.


    The copyINSURANCE flow returns to the

    GUARANTOR screen where the button is activated

    so the user can continue on to the CASE screen


    CASE copy


    Once all required data is completed copy

    the system will show the button.


    ACCOUNTS copy

    RECEIVABLE

    PATHWAY


    Accounts Receivable copy

    Main Menu



    A R Inquiry copy

    Vital functions automatically selected (radio buttons)


    A R Summary copy

    Collector Name and Comment automatically valued from codes


    Detail Summary copy

    CALCULATOR and EMAIL options added to the Navigator


    Additional Details copy

    REASON codes custom feature added


    Internal email information is automatically filled in with AR detail … saving time and preventing transposition errors


    Are there any questions
    Are there any questions ? AR detail … saving time and preventing transposition errors

    This concludes our presentation.


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