If you have you have implemented an electronic health record (EHR) or are in the initial phases of adoption, have you considered optimization efforts in your planning? Many organizations struggle to find time for EHR optimization due to competing priorities, but the benefits are well established. Without a plan for regular system updates and optimization, you are at greater risk for revenue leakage, charge capture issues, integration problems, and even non-compliant billing practices.
Consider as an example Laboratory & Pathology services. With a basic maintenance and optimization project that spans only a couple of months you can:
- Identify and incorporate codes for services being rendered but not charged. These could be low-hanging items such as ad-hoc consults, or regular services such as injections and infusions that are simply not being captured accurately or consistently. You can then implement system logic and automation to drop these changes or route them appropriately to claims.
- Provide staff with enhanced tools, views, and insights, making day-to-day work more efficient. Whether this takes the form of improved pathology documentation templates, data extracts, or visible system reminders, there is regularly opportunity for putting time back in staff’s pockets. Furthermore, streamlined and enhanced documentation will generate fewer missed revenue opportunities. System mechanisms and automation can ensure that charges drop effortlessly and appropriately, and good reconciliation reports can provide clear summaries and oversight.
- Improve compliance. A targeted review can bring awareness and attention to items not being billed compliantly or being routinely denied for the same reason(s). And if you don’t find anything to improve at this end of the spectrum, the reassurance ends up being a nice little pat on the back and validation for everyone with a stake in the matter – Department Operations, IT, and Revenue Cycle/Revenue Integrity
In summary, by organizing and executing a short optimization project for an area such as Lab/Path, you can…
- Align your system features and integration points to industry best practices.
- Ensure that your system is working for your staff, not against them.
- Provide additional monitoring or validation for compliant practice, system utilization, and billing expectations.
At The Wilshire Group, we provide a team of experts familiar with assisting clients with EHR optimization that integrates clinical operations with revenue cycle. Whether your upcoming projects are targeted in nature, spanning a service or services like we described today, or more generic in nature, have a conversation with our team before you start, you won’t regret it. We’ll answer the difficult questions you’ve been debating about and set you on a path toward fast-paced and definitive improvement.