Availity, the nation’s largest real-time health information network, announced the release of a new white paper identifying critical revenue cycle management (RCM) best practices during Epic EHR installations for two Availity clients-Mercy Medical Center in Baltimore, MD, and UNC Health Care, in Chapel Hill, NC.
According to Availity’s report, “The lines between clinical and financial information are blurring, making it even more important to ensure the revenue cycle is an integral part of the EHR implementation process.” The expense and complexity of an EHR implementation often causes many hospitals and health systems to give revenue cycle a low priority, even though one significant measure of a successful go-live is providers’ ability to effectively manage payments and claims.
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Availity has helped thousands of hospitals and physician practices protect their revenue cycle during EHR conversion, including dozens of customers transitioning to Epic, and recognizes that new EHRs frequently cause changes in charge capture and billing processes.
“Without the Availity team running multiple testing iterations, our client account manager being there by our side-running reports as needed and providing training-our go-live experience with claims submissions could have easily gone the other way,” said Fred Morgan, Senior Director of Physician Patient Accounting, Mercy Health Systems, which, along with Mercy Health Services, operates in more than 95 locations with 50 different specialties.
With each installation, Availity worked with the client health systems and Epic to focus on three main areas:
Establishing claim benchmarks and ensuring work-queue configurations were optimized to mitigate missing or lost claims.
Providing guidance based on business needs for file transfers and reporting post-back configurations.
Leveraging its deep experience with Epic installations to help the health systems avoid common mistakes and focus on detailed integration points and workflows for submission of claims, electronic attachments, converting paper claims, eligibility, remittances, payment auto-posting, and creating the Epic Claim Reconciliation Database (CRD) workflow outlines.
“I knew when we went live, our claims were going to be clean,” said Laurie McDaniel, IT Manager for the Professional Billing Team, UNC Health Care. “We were really excited about the CRD process. Having the claim runs auto-accepted or auto-rejected is so much better than just wondering if the claims made it out of the system. Within an hour we have a response back about any eligibility errors or anything else affecting the claims.”
Mercy realized tremendous success with their claims submission upon go-live. With the engagement of their Availity client account manager and client services team, they protected their revenue stream and helped keep operational performance high. Processing about 80,000 claims per month, Mercy’s clean-claim rate was 95 percent at go-live and within thirty days climbed to 98 percent.
Like Mercy, UNC Health Care went live with their Epic installation on time and with no negative impact to their revenue cycle. By being well-organized and well-prepared, their EHR initiative has stayed on track and is achieving success. Leveraging Availity’s integration and experience with Epic further simplified the transition, heading off troublesome billing issues and keeping their cash flow healthy.
“The cost and complexity of an EHR installation can be daunting for any hospital,” said Russ Thomas, CEO of Availity. “By addressing the revenue cycle prior to implementation and as part of the EHR workflow, hospitals and health systems can seamlessly administer payments and claims and ensure they maintain their financial performance during the transition to the Epic system.”
To download a complimentary copy of the white paper “Revenue-cycle best practices during an Epic installation”, click here. Learn more about Availity health plan solutions at www.availity.com.
