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SIGNATURE Presentation. OAS GOLD. PRESENTED BY.

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Presentation Transcript
slide2

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

slide3
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.

slide4

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

slide5

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

slide6

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

slide7

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

slide8

The original SIGNATURE application was based on a 3270 terminal design.

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

slide11
The Siemens GOLD model was sent to the Baycare body shopto be reprogrammed, redesigned, repainted and enhanced
slide13
GOLDhas 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

slide14
Edits on name and address fields to remove bad characters [email protected]#$%/&*)+? that cause interface errors. Example of a bad character #GOLD will automatically remove:
slide22

Billing warning messages

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

slide23

Tooltip help has full sentences & detailed information for a field

  • Inquiry screens are enhanced for faster searches, such as doctor name inquiries with “quick picks”
slide24

"Minor as the Guarantor" reasons that are easy to select (rather than type in)

Radio button selection will appear as a comment

slide25
VIP

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

slide26
Checkmark lights up green if an HDX inquiry is possible for this plan. Eliminates wasted HDX inquiries for unsupported insurance plans.
slide28
Customized documents and patient face sheets with full insurance company mailing addresses
slide31

Mail statistics:

  • • 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
slide32

Address Verification Benefits

      • 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.
slide35

Address Verification

  • 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)
slide37

If the address was not found, then the

US Post Office returns the following message:

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

slide39

SIGNATURE

OAS GOLD

IMPLEMENTATIONPROCESS

three signature regions
THREE SIGNATURE REGIONS
  • 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
  • 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
slide42

Then a list of the current 3270 issues was compiled.These issues became the reasons SIGNATURE was converted to the GOLD version …

challenges
CHALLENGES
  • 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
  • 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
  • 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
  • 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
  • PM – Patient Management
  • AR – Accounts Receivable

Two training sessions:

training manual
Training Manual

PATIENT MANAGEMENT

training manual1
Training Manual

ACCOUNTS RECEIVABLE

live implementation
LIVE Implementation
  • 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

slide52

OUTPATIENT

CARE

REGISTRATION

PATHWAY

slide57

US Post Office abbreviated the

AVE and corrected the zip 33613

Original address data

Further information is needed

slide58

The USPS supplies

a list of known

addresses to

select from

More information

is required - such

as an OFC, LOT

or APT number

slide59

The US Post Office verified address is then transferred

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

and zip code fields.

slide60

The corrected address is automatically copied to the

demographic screen. The user then adds LOT 71 to

complete a full mailing address.

slide61

GUARANTOR information – will automatically copy

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

slide62

Bottom part of the GUARANTOR information screen is

shown … with COMMENT and EMPLOYMENT options

slide63

INSURANCE

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

slide65

Select an insurance plan

ZZZ identifies a terminated plan

slide66

The managed care plan automatically had a 1 appended to

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

slide68

The INSURANCE flow returns to the

GUARANTOR screen where the button is activated

so the user can continue on to the CASE screen

slide70

Once all required data is completed

the system will show the button.

slide71

ACCOUNTS

RECEIVABLE

PATHWAY

slide74

A R Inquiry

Vital functions automatically selected (radio buttons)

slide75

A R Summary

Collector Name and Comment automatically valued from codes

slide76

Detail Summary

CALCULATOR and EMAIL options added to the Navigator

slide77

Additional Details

REASON codes custom feature added

slide78

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

are there any questions
Are there any questions ?

This concludes our presentation.

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