ROI Healthcare Solutions

Category: Blog

  • An Interview with Sonya Schulte, MBA, PMP

    An Interview with Sonya Schulte, MBA, PMP

    Sonya Schulte

    Spotlight: Sonya Schulte, MBA, PMP

    Sonya is a senior level consultant and implementation manager with excellent leadership skills and project management experience. She has a strong work ethic, provides superior customer service and has excellent oral and written communication skills.

    As a seasoned Infor CloudSuite HCM (Lawson S3) implementation professional with over 23 years of experience, Sonya provides direction, sets project guidelines, and provides a wide range of expertise. She works either independently, or with a team, to meet deadlines and balance multiple priorities in high stress environments. She is a creative and proactive problem-solver, with experience managing change. As a former HR Director and SPHR, Sonya understands the challenges facing HR and Payroll professionals. Sonya has a BBA, Management from Texas A & M University and a MBA, Management/ Human Resources from Texas State University.

    Personal:

    Sonya loves to travel for work and play. Currently she is a “road warrior” and travels nationwide weekly, implementing Infor HR/Payroll software for healthcare clients across the US. Her projects typically last from 6 months to 2-3 years, depending on the size of the client and complexity of the requirements.

    Sonya is a proud Texan! She comes from a very large family; there were 12 kids on each of my parents’ families; She has 50 first cousins and knows them all, including their children, too!  Sonya loves being with her family and sharing priceless moments. Sonya currently lives in Scottsdale, AZ and although she loves the hiking trails in Arizona, plans to return to Texas and build a home in the Palo Dura Canyon near Amarillo.

     

    Philosophy:

    The PMP project management methodology provides the perfect framework for considering all the components in a successful software implementation project.  The more precise and thoughtful the plan, along with diligent management of that plan, the better the outcome for all stakeholders and participants. 

    “My healthcare project management philosophy stems from one of the lessons my father imparted on me and my 3 sisters growing up …. If you’re going to do something, you might as well do it right the first time. The best way to do something right the first time is to plan your work; and work your plan.”

  • An Interview with Tim Barca, PMP

    An Interview with Tim Barca, PMP

    tim

    PM Spotlight – Tim Barca, PMP

    Tim has over 20 years of healthcare information technology experience, including key roles at hospitals and software vendors.  This experience has spanned the implementation and maintenance of Revenue Cycle, Clinical, Pharmacy Automation, and Ambulatory applications in multi-facility healthcare organizations.

    As a Client Services Executive at ROI, Tim has demonstrated a high level of integrity, relationship development skills, and team collaboration across our client engagements. He holds an MBA degree in Technology Management from the University of Phoenix, Pittsburgh, PA and received his Bachelor’s of Science degree in Computer Based Systems Management, Eberly School of Technology, California University of PA, California.

    Personal:

    Tim is originally from Pittsburgh, PA, but currently lives in Myrtle Beach, SC.  When Tim is not busy working, he enjoys spending time at the beach with his wife and dogs, exercising, and playing fetch.  He also enjoys wood-working and creating specific items to decorate for the holidays.  Tim enjoys spending time working on his automobiles and loves taking short weekend trips whenever he can get away with family.

     

    Philosophy:

    “The healthcare IT industry is ever growing. As a project manager, I realize that understanding the nature of healthcare is more and more instrumental to project success. For our clients to be successful, I have treated every task, small or large, as a project that needs the same management, communication, and follow-through to ensure better patient outcomes by way of technology.”

  • You Are Not Alone – The DNFB Challenge

    You Are Not Alone – The DNFB Challenge

    Revenue Management: Patient Registration > Patient Exam > Coding > Charge Entry > Claim Submission > Payment Processing > Patient Billing > Collection > Revenue

    One of the most underestimated vulnerabilities of healthcare providers after a new system implementation or upgrade is an increase in DNFB volume. Accounts included in the DNFB list are, Discharged but Not Final Billed, for a variety of reasons. DNFB is a critical element within your revenue cycle, directly impacting the bottom line.

    The most common reasons that accounts are held in DNFB status, preventing billing and revenue collection activity, include:

    • Registration: Incomplete or inaccurate information obtained by patient access resources.
    • Scheduling: Missed steps in the verification of patient information during scheduling.
    • Coding: Waiting for documentation or dictation can contribute to accounts on the DNFB list. For                  example, if accounts were coded but were rejected during the initial claims-editing process because of        an unrelated HIM element, such as an invalid revenue code.
    • Charging: Services performed, but not charged in a timely manner.
    • Case Management: Connects clinical and financial data—The inability to manage the utilization management work list efficiently can lead to delays in coding.

    These Six steps can improve your organization and reduce your DNFB’s

    1. Ensure your revenue cycle strategy begins with patient access. Becker’s recent article states that, “Physicians often grow frustrated by the administrative burden and delays in care that poor patient access creates.” It further explains how patient access services impacts hospital branding. Providers are beginning to realize that the traditional patient access model needs to be refined to incorporate contemporary patient access technology, quality assurance, and training programs that improve the accuracy and completeness of registration information.With anticipation and appropriate planning, organizations can reengineer their patient access departments and leverage each service component to align with organizational goals. This will increase cash flow, reduce denials, and enhance the patient’s overall experience.
    2. Streamline process automation with revenue cycle technology – healthcare providers should implement solutions that allow revenue cycle processes—such as coding, billing, contract management, and reimbursement—to be managed through streamlined technology.
    3. Invest in targeted training and adequate office staffing levels. Offer online resources and checklists specific to each area of work.  For example, provide a pre-collection script and adequate training on how to use it effectively when calling patients.
    4. Assign dedicated resources to stay knowledgeable about industry developments that could influence revenue cycle processes.
    5. Maintain a quality Charge Description Master (CDM) to sustain an effective coding program and compliant billing practices.
    6. Embrace Analytics – HIM payment related delays can result when the DNFB segment becomes too large. Analytics technology can help HIM departments control this area and accelerate the release of claims to the billing department. Typically, technology can analyze accounts in a DNFB status to surmise the root cause for delay, determine improvements that will have the greatest impact, and recommend action items and initiatives to reduce the DNFB volume.HealthLeaders Media published the specifics of how a Louisiana hospital improved their cash flow by $2.4M. To become the debt free hospital they are today, the hospital harnessed analytics to eliminate manual processes for DNFB accounts and increased their operational efficiency by 95%.

      Are you utilizing embedded and/or third-party software to optimize processes?

    How can business offices help?

    • Create a plan that considers your current issues, root causes, remediation options, and ways to measure your progress.
    • Perform (or revisit) a current state review of your processes, workflows, and tools.
    • Identify the length of time physicians take to complete dictations for reports and patient care.
    • Review staffing issues, expertise levels, and coverage for vacations and holidays.
    • Involve leadership and key staff members involved in day to day operations for their input.
    • Obtain buy-in from your executive leadership team and schedule checkpoints to discuss progress.
    • Talk to departments that currently do not provide data in a timely manner and explain the importance of getting the information as soon as possible.
    • Create a structure to drive accountability.
    • Prioritize improvement opportunities:  Quick Wins, High-impact improvement opportunities, and Long- term strategy
    • Use analytic reports to assist with the identification and measurement of key performance indicators (KPI’s) contributing to DNFB. Healthcare Financial Management Association (HFMA) provides 29 MAP Keys, or strategic KPI’s for hospitals, health systems, and physician practice management groups,  which are industry– standard metrics to track your revenue cycle performance.

    Once a solid plan is in place and changes are initiated, continue to monitor and adjust as necessary.  This will continue to grow the program and decrease your DNFB volume and outstanding A/R days.

    At each moment of success, pause and celebrate your plan!

     

    Facing your own DNFB or other revenue cycle dilemmas?
    ROI has the expertise readily available to deploy to help transform your processes. Our consultants bring over 20 years of combined revenue cycle management experience. We will work with your organization to plan and execute strategies to increase your cash flow by implementing the appropriate industry standards that best suit your needs. Contact Us at: https://roihs.com/contact-us/

     

    Additional Reference Article:

    National Rural Health Resource Center (2014). Rural hospital performance improvement (RHPI) project: Best practice concepts in revenue cycle management.

  • How to Survive A Practice Management System Transition

    How to Survive A Practice Management System Transition

    Transition-1

    Is your practice application approaching sunset? Are you looking to purchase a new system? Have you recently merged with another group and now have disparate systems that need to be consolidated?    

    Regardless of your scenario, whether voluntary or involuntary, physicians, practice owners, and healthcare information systems teams must establish an appropriate change management strategy to accomplish a successful transition.     

    Today, the top drivers for replacing a practice management system include the need for hospital- integrated systems, compliance with state and federal regulations, mergers and acquisitions, cost, data management, patient, and provider satisfaction.    

    What is the future of your practice? Why are you transitioning?  

     

    Before your project begins, it is paramount to have a solid change management plan.    

    • Identify an executive and a physician level sponsor who will remain committed throughout the project. Provide education on sponsor responsibilities and visibility; this is crucial for success.
    • Assemble a cohesive, well balanced team capable of managing effective change. Team members need to understand the practice value and scope of change. They must be comfortable communicating, planning activities to mitigate resistance, and coaching others to embrace the planned change.

    An effective change management strategy includes considerations for business processes, the technology, and for all users of the system. Special attention must be paid to both business operations users and the various clinical groups that will rely on the system to enhance patient care.   

     

    Here are 5 Focus Areas That Drive Successful System Transitions  

     

    1. Research Industry 

    To ensure your practice is compliant with industry standards, examine your current internal operations and identify your future business needs. Utilize MGMA industry benchmark reports to compare and prioritize your practice goals.   

    Today, value-based patient care models are at the forefront of healthcare. This increases the need to demonstrate practice efficiency and quality care for service reimbursement. Fully integrated systems will enhance clinical workflows and facilitate quicker reimbursement processing, allowing providers to spend more time at the point of care.  

    Select a robust practice management system that boasts a unified platform. Examples include systems with secure patient portals, ancillary system integration, revenue cycle management, clinical documentation and decision support.   

     

    2. Governance  

    Governance of the transition is as important as the new application’s functionality. Formalize a governance strategy and identify the key stakeholders who will make or approve policy changes.   

    A successful application migration can drive greater organizational change and lead to overall physician, staff, and patient satisfaction. Strong governance positions the practice to:        

    • Continue to meet regulatory guidelines
    • Continue to meet quality standards
    • Achieve faster adoption and usage rates
    • Improve operational efficiency

     

    3. Strategy

    Practice groups continue to differ in specialty, services provided, practice structure, population served, practice size, and physical location. Support must be customized and delivered to each practice with consideration for the differentiating elements.    

    Who is responsible for leading your clinical and revenue cycle workflow discussions?  

    Consider resources with deep knowledge who add perspective to the process as these specific questions are answered.      

    • Will new technology enhance workflows and aid your efforts to provide quality patient care?
    • Will the new practice management system have similar or new limitations?
    • How will the transition impact your clinical and office support staff?
    • How will the costs associated with new implementation impact your practice budget?
    • What effects will MIPS/ MACRA have on the practice?
    • How will compliance and reporting structures change?
    • Does the sourced vendor meet your practice needs?
    • What are the advantages/ disadvantages to internal vs. remote or cloud storage?

    4. Implementation

    Early engagement of strong project leadership ensures there is a detailed plan and each step aligns with your leadership and practice goals. Effective communication, careful review of current/ future state, planning, execution, and ongoing project monitoring requires expertise.   

    Use a systematic approach when managing:  

    • Data conversion
    • Maintenance
    • Integrated Testing
    • Training
    • Go Live
    • Post Live

    Failure to comply with this recommendation may cause your practice to incur additional project costs. Implementing a new system for your practice is an investment and once your new system is in place, operational excellence and increased ROI are achievable.   

    Have you identified who will lead your implementation?   

     

    5. Lessons Learned

    Due to the complex nature of a system transition, leveraging proven methodologies adds value to the process. Lessons learned from larger, inpatient entities can be scaled to meet individual practice needs. Understanding project management, communication, and risk identification allows for better planning, measurement of value achieved, and project success.    

    What lessons have your team members learned from other system implementations?     

    How can your practice plan for issues with diagnostic or device interfaces, chart abstraction, or choosing an effective training methodology?       

    Where are you in the process? Have you thoroughly considered?       

    • Search & Selection
    • Data Warehousing
    • New Implementation
    • Application or Legacy Support
    • Post Sunset Support
  • These Good Payroll Practices Will Get You Through Year-end Easier

    These Good Payroll Practices Will Get You Through Year-end Easier

    Payroll

    Are you ready for year-end?  What have you been doing all year long to prepare for year-end?

    • Reconciling payroll every pay period
    • Paying tax filings on time and cataloging for quarterly and annual filings
    • Ensuring each quarter totals and filings are balanced to a year-to-date report of taxable wages (think W2’s)

    In the world of payroll processing, there are many disciplines that our payroll professionals follow.  Everything from learning the tax code to tasks and steps in the payroll cycle process that ultimately produce a payroll check.  The post-payroll processing tasks are the steps that will help you prepare for year-end and ultimately help you to keep your sanity.

    As an example, for every payroll, you should do the following:

    • Reconcile the gross to net, tax percentages, deductions, etc. (The devil is in the details!)
    • Validate that the information to appear on the quarterly tax filings is balancing and correct YTD.
    • Maintain a spreadsheet to track your numbers rolling forward with each pay cycle. When you reach the end of the quarter, you have your numbers!
    • Send frequent communications to employees to validate that their current address is correct.
      (Don’t wait until year-end when it becomes urgent! Add the process of managing an address change on your off-boarding checklist).
    • Work with your fellow HR professionals and be sure that you are coordinating payroll data that will affect their business processes, such as annual benefit filings for ACA and others, state time-off and learning contributions, etc.
    • Save a copy of key payroll ‘snapshot in time’ reports.

    These practices will allow you to go into each new quarter or year-end confidently. They will also help with providing the data needed if an unexpected discrepancy occurs.  Not doing these things could result in having to go back and dig through a year’s worth of pay detail and potentially making past quarter adjustments. This could mean refiling and submitting corrected tax filings.

    Think of the implications on the finance side of the organization. What is the impact to the general ledger?  Good payroll practices will help you remain friends with the accounting department! And don’t forget about the importance of payroll data to HR. Ensuring the accuracy of payroll data being provided to HR throughout the year is key for HR regulatory reporting for benefit filings, employment verifications, and even wage and hour audits.

    Maintaining rigorous payroll practices will also help you with:

    • Complying with the rules and regulations of the federal, state and local governments. (Let’s avoid wearing orange or stripes!)
    • Ensuring accurate payroll data is used in corporate financial reporting and analytics, as well as future planning needs.
    • More easily assimilating new acquisitions into your payroll processing, which ultimately helps keep your monthly, quarterly and year-end reporting accurate.
    • Bringing new payroll team members up to speed with your department’s practices.
    • Providing a level of confidence that data provided to auditors is correct, as well as having a document that allows you to prove your payroll is reconciled with the numbers ticked and tied.

    In summary, year-end is always a busy time for Payroll. Following good year-end preparation practices every pay cycle not only helps to ensure the accuracy of each payroll, but this also makes your year-end processing easier and less time consuming. This means fewer year-end adjustments, fewer last minute address changes, fewer returned W2’s (when mailed) and formalized process related to the reconciliation of year-end numbers to summarized quarterly filings. This effort also makes for a better work/life balance for the payroll staff all year long, bringing a new meaning to the phrase “Christmas in July.”

     

    Engage ROI for Payroll Consulting

    If you need help with finishing out the year strong in payroll or planning for your 2019 strategy and approach to efficiency and business value, contact ROI for a quick discussion about your needs.

  • 3 Simple Steps to Facilitate IoT Adoption in Healthcare

    3 Simple Steps to Facilitate IoT Adoption in Healthcare

    The future is unknown. Based on current trends, healthcare IT (HIT) experts can only speculate, at best. The need to continuously change is evident. It’s interesting to see how HIT leaders manage day to day issues; how CIO’s build their enterprise by incorporating advances in artificial intelligence (AI) and Big Data; and how collaborative vendor and interpersonal relationships with employees influence the process. So, where are we today?

    Think about the Internet of Things (IoT). The ability of the Internet to connect with gadgets, devices, and systems to exchange data. The term IoT is used daily in other industries and there is evidence of significant advances as IoT technology continues to infiltrate healthcare. From electronic health records (EHR) systems that interface with ancillary systems, Bluetooth enabled medication carts, Telehealth monitoring mechanisms, or a state-of-the art remote ICU. Currently, this type of IoT technology can undisputedly provide better disease management and ways to improve population health. With a host of available clinical systems with advanced automation capabilities, it makes sense to adopt some proven best practice principles to truly drive success.

    No one wants to reinvent the wheel. Some of the most successful and respected HIT leaders in the nation follow these three simple steps:

     

    STEP 1: Proper Project Planning

    • Source project leaders with experience in clinical system transition, as well as strong cost and time management skills. There is better understanding of how the project management principles apply to healthcare IT.
    • Design a team inclusive of clinical champions to be change agents that support the need for a system (and process) transition.
    • Focus on current regulatory guidelines and the implications on certified EHR systems implementation. Pay close attention to any new HIPAA privacy rules, and have early discussions related to promoting interoperability, avoiding information blocking, and Medicare Access and CHIP Reauthorization Act (MACRA), which provides a new practice model as the healthcare industry moves from fee-for-service to value-based patient care.
    • Identify the needs of your organization, the patient population served, and available resources prior to choosing your system.

    For more information: https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation

     

    STEP 2: Network and collaborate

    • Form a community that encourages the sharing of best practices and how to improve HIT adoption. Clinical informatics teams in healthcare organizations tend to have limited resources compared to the effort required to switch from one clinical application system to another.
    • Network and collaborate with other trusted HIT professionals and other organizations that have best practice processes in place. Adopting electronic physician order sets and clinical documentation templates that include standards of care/practice will decrease system implementation time and will increase overall quality of patient care.
    • Educate the team members on upcoming HIT trends, new terminology, like IoT, and legislation impacting HIT.

    STEP 3: Build & Foster Well-rounded Teams

    It is important to place value on employees. Engage them in the clinical system selection process. Take the time to invest in your team by providing opportunities to engage in focus groups or roundtable talks.

    • Encourage multidisciplinary leaders to assign a resource to attend your IT hosted discussions. Be sure to include unit clerks, nurses, physicians, and ancillary employees, as needed.
    • Create an environment where employees feel safe to provide their thoughts and details of their daily patient care challenges as it relates to the clinical system in use. This format sparks the ideas necessary to help leadership make more informed decisions. The insight the multidisciplinary roles can provide are often unmatched. Once the system selection process is completed, keep these employees engaged throughout the testing rounds, training, and go live activation.
    • Provide the support necessary to avoid burnout by supplementing your employees and providing opportunities for self-care and work/life balance. Consider out-tasking responsibilities to a trusted partner in areas that you may lack expertise or capacity.

    The above points appear to be simple, but are often overlooked. They are necessary to facilitate seamless clinical system transition.

    What best practices has your organization implemented to ensure growth and technological advancement?

    Let’s continue this discussion…

    At ROI Healthcare Solutions, these principles are engrained in our culture, giving us unique perspectives necessary to manage, implement, and solve many of the challenges faced while adopting an IoT initiative. This differentiator keeps clients satisfied. ROI cares about the process and aims to provide an unparalleled experience. ROI can help you transform your healthcare organization by engaging qualified clinical and healthcare IT experts to streamline your workflows, implement top clinical systems, or optimize the use of clinical systems currently in place.

    Speak with one of our dedicated HIS consultants today to discuss how ROI can help your organization remain competitive and support best practice initiatives on your journey for excellence.

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