1. Welcome to Trace Days!

2. Dave StriddeChief Operating OfficerThe White Stone Group 3. Account Management TeamJo Norris VP of Account ManagementNichole Harmon Indianapolis, INDebra Holman Nashville, TNAljeana Howard Atlanta, GALa Teshia Jones Houston, TXDebbie Lloyd Dallas, TXMichael Mouton Dallas, TXMarcia Patterson Cincinnati, OHDeborah Todd Memphis, TNLynda Clay Nashua, NHLauren Bento Port St. Lucie, FL 4. Sales TeamKen Cassell Senior Vice President of SalesBlair Wright Knoxville, TNJerry Thomas Oviedo, FLWalt Bearden Knoxville, TNLori Forbess Beaverton, ORWindell Yancy Dallas, TXPhillip McClure Fort Worth, TX 5. Our Team - Here to Serve YouTim Hoskins | Director of Enterprise Architecture & SecurityMatt Jernigan | Director of Product ManagementErin McCarty | Director of MarketingBill Milam | Director of Software DevelopmentDerek Morgan | Trace Product OwnerBen OBrien | Director of Support ServicesNicole Shanklin | Director of Implementation & Training 6. Our Lofty GoalTo be the very best support organization in thehealthcare software industry. High value on genuine relationships with our customers High value on responsiveness High value on ROI - ensuring that our products bring realvalue to your organization High value on trustworthiness - we want to be acompany that you can trust to do the right thing 7. Thanks for joining us! 8. Jeff PetersPresident and CEOThe White Stone Group, Inc. 9. Key StatsThe White Stone Grouphas 64 employees 48 at our corporateoffice in Knoxville andanother 16 employeesacross the country. 10. Continuity of KnowledgeThe average tenure of a TWSG employee is over6 years. 11. 05101520253099 00 01 02 03 04 05 06 07 08 09 10 11 12TransactionsinMillionsTrace Usage 12. Where does the growth come from?VoiceFaxElectronic 13. We love to hear from our customers!We have received over 700 inputs from Tell Us! 14. Thank You! 15. Workshop 1:Is Your Revenue Cycle STILL Sufferingfrom Communication Chaos?Rebecca Black, FHFMA, CPAVice President of Revenue CycleSouthern Regional Medical CenterRiverdale, GA 16. IS YOUR REVENUECYCLE STILL SUFFERINGFROM COMMUNICATIONCHAOS?Rebecca T. Black, FHFMA, CPA | Vice President of RevenueCycleSouthern Regional Medical Center | Riverdale, GA 17. Learning ObjectivesWhat are the signs that you still havecommunication gaps in your Revenue Cycle?What are your key feedback loops?How did one hospital use Trace to reducecommunication chaos?How can you track and demonstrate return oninvestment (ROI)? 18. The Cost of Communication ChaosHospitals waste $12 billion a year due to poorcommunication, approximately 2 percent of nationalhospital revenues and more than half the averagehospital margin of 3.6 percent.Source: Amednews.com. Communication failures over diagnostic tests prompting more lawsuits. 2011. 19. Why Do We Still Have CHAOS inthe Revenue Cycle? Very complex Many processes and players Broad spectrum of activities Departments dont align under the same area ofoversightSource: Protiviti. Healthcare Revenue Integrity Strategies: Using High Value Revenue Cycle Assessments to Protectand Improve the Bottom Line. 2012.A provider is at risk every day of losing revenue atmany points in the cycle, especially in routineareas of operations where inefficiency and a lackof communication between departments arecommon. 20. How to Know if You Still Suffer from CHAOS Delayed accounts receivables Initial denial rate Net days in A/Rec benchmark to standards/best practice Collections compared to Net Patient Service Revenue (avg100%) Denied claims Technical (administrative) or clinical rate Overturn rate Data by payer/line of business Rework First pass clean claim rate Volume of required claim edits Volume of manual adjustments Wasted staff time Productivity Cost to collect 21. How to Know if You Still Suffer from CHAOS Frustrated customers Complaint volume HCAHPS scores Cancelled procedures Last minute scheduling changes By procedural area/payer contract Wasted materials/resources High cost radio therapeutic drugs/chemo agents Gaps in schedules (Open rooms in procedural areas) Physician dissatisfaction Complaints to Administration Loss of volume/downward trends Patient steerage 22. Key Revenue Cycle Feedback Sources Who owns these functions: Scheduling Pre Access Point of Service Case Management functions Notification of Admission Status Determination Concurrent Reviews Denials Management Trending Tracking Root cause analysisCommunicationis critical tosolving denialsand harnessinginformation todrive revenuecycleperformance 23. Missing Pieces to Your Bottom Line Denials falling through the cracks Reliance on homegrown databases andmanual spreadsheets to track performance Not prioritizing denied accounts for resolution Inconsistent follow-up activity on accounts Lack of understanding of root causes ofdenials Inability to speed account resolution withpayers Poor communication among departments andrevenue cycle functions 24. Denials: Not Going Away20% of claims are delayed or denied7% of claims are never paidInsurance companies return claims an average of two timesto get the information they require to process the claimSource: PNC. Automated Billing/Payment Process Can Reduce US Health Care Costs Without Sacrificing Patient Care. 2007. 25. Initial Denials: % of Outstanding AR50%19%31%0% - 5%6% - 10%>10%31% of hospitals have initial denials greater than 10%Source: Financial Leadership Council 2011 Revenue Cycle Survey. The Advisory Board Company. 2011. 26. Initial Denials: Sources of ErrorsNearly 3/4 of errors traced back to the front endSource: Financial Leadership Council 2011 Revenue Cycle Survey. The Advisory Board Company. 2011.27%16%30%27%Medical NecessityAuthorizationsDemographic InformationEligibility 27. Denied Claims0.0%0.2%0.4%0.6%0.8%1.0%1.2%1.4%1.6%National Average Top 25% Benchmark1.5%0.6%Source: Healthcare Business Insights. Solution Provider Academy. 2013 28. Denial Write-Offs0.0%0.5%1.0%1.5%2.0%2.5%3.0%3.5%4.0%High PerformanceQuartileMedian Low PerformanceQuartile0.4%1.1%3.9%Source: Financial Leadership Council 2011 Revenue Cycle Survey. The Advisory Board Company. 2011.Percentage of Net Patient Revenue 29. Making Sense of the NumbersHospital A Gross revenue = $1B Net revenue (30%) = $300M Net operating margin of 3% = $9M 1.5% lost to denials = $4.5M left on the table Losing 50% of margin Every year! 30. Are You Protecting Your Dollars TodayAND TOMORROW? Recoupment reasons: Coverage at time of care Type of service provided Existence ofauthorizations Retro reviews wherestatus is changedRetrodenialsarecostinghospitalsmillions 31. How Are You Doing in These Areas? Denial Prevention Authorizations (phone, web or fax) Verification that no pre cert was required POS Collections/Back-end Follow-up & Collections OOP estimates, ABNs for Medicare Promises to pay/claim tracking Patient Satisfaction/Quality Assurance Consistent use of scripting, record of encounter Document consistent adherence to Policy/Procedure Behavior Modification Staff training/retraining And much more 32. Face-to-FaceConversationsPrinterScannerMemoryNote PadFileCabinetCD-ROMDVDTapeRecorderComputer 33. Bringing Clarity to ChaosCentralRecordStorageWebTrackingSystemIndex andArchiveDate-and-Time StampSystem-WideAccessEasyRetrievaland RoutingCentral Repository 34. Saint Josephs Hospital of Atlanta410-bedacute-carefacility servingmetro Atlanta& surroundingareasOne ofSoutheaststop specialty-referralhospitalsChallengingmargins dueto highMedicareutilization &tight marginson managedcareObjective tosupportrevenue cyclebest practices& achievetotal denialrate of < 1%gross 35. Areas of Technology Application Precertification Preregistration process Payment estimates POS collections Verification of claim receipt & promise to pay Denial & appeal management Contract review/payment accuracy Staff education & training 36. Voice Recording ProcessIncoming CallsOutgoing CallsOutgoing VoicemailsVoice solutioncaptures, indexes, and stores theconversation ormessageStaff access thetranscription of thecall or voicemailHospital then usesthe transcripts toresolve disputeswith insurancecompanies 37. Real-Life ScenarioIdentified large volume of denials for lack ofpre-certification/notification from a particularpayer related to outpatient radiology scans(CT, MRI, PET).Almost every denied claim appeared to bepre-certified and had a pre-certificationnumber.The payers Contracting Department wascontacted and several examples were sentfor investigation as to why the claims weredenied. 38. DetailsPatient received 3 CT scans on samedate of service chest, abdomen, andpelvis.All 3 scans were fully authorized.A recorded conversation clearly indicatedthat SJHA obtained the pre-certification andhad explicitly inquired whether a differentprecert number was needed for each scan. 39. Review of Payers ResearchRecorded conversation between facility & Contracting Manager from PayerPayer saysthat only oneof the 3 CTscans wasauthorized. 40. Transcript Emailed Immediately toContracting ManagerThis is the transcript header; it contained the patients name, accountnumber, and time stamps 41. Transcript ContinuedThis is from the body of the transcript where the authorization takesplace; it clearly shows that all three scans were authorized. 42. A Week Later, Payer Calls BackPayer finally acknowledges that they have a core issue between their third-party radiology vendor and their claims processing system. 43. Results of Project Implementation Implemented Dec. 1, 2009 Results as of Mar. 31, 2012 Cash in the door = $458,816 161 accounts, average recoup = $2,849 Average accounts overturned per month = 6.4 Prevented denials 44. Results Improved SatisfactionStaff Members Listening torecorded callshelps staffmembers learnfrom mistakesand find ways tokeep improvingcustomer service Staff membersknow they havedocumentedproof tosubstantiatePatients Increased front-end staff trainingleads to moresatisfied patients Front-end staffhave moreaccountabilityand resources attheir disposal toprovide greatservice topatientsPhysicians Improvedrelations betweendifferentdepartments Less oftenassume an erroris the result ofpatient accessnegligence 45. Lessons LearnedFor SJHA, documentation was invaluable to provingcompliance with prescribed precertification protocols.Without it, inappropriate denials and cash paymentdelays would have continued.Documentation used to assure mutually agreeableprocesses with managed care payers and lessenadministrative burdens for both payer and provider. 46. Calculating ROI: Scheduling, Orders Prevent one cancelled surgery = ___ Retain one physician = ___ Reassign one FTE from scanning, filing, etc. = ___ Prevent one HIPAA violation = ___ Save one hour per day in managing orders = ___ Save one hour per day in document scanning = ___ Eliminate fax machines = ___ TOTAL savings per month = ___ 47. Calculating ROI: Patient Experience Retain one additional patient = ___ Collect one additional payment atPoint of Service = ___ Prevent one patient identity theft = ___ TOTAL savings per month = ___ 48. Calculating ROI: Revenue At-Risk Prevent one denial per month = ___ Overturn one denial per month = ___ Reduce cost to collect = ___ Reduce number of net days in AR = ___ TOTAL savings per month = ___ 49. Calculating ROI: Coordination of Care Prevent one readmission = ___ Prevent one medical necessity denial = ___ Prevent one notification denial = ___ Prevent one EMTALA violation = ___ Reassign one FTE from faxing for dischargeplacement = ___ TOTAL savings per month = ___ 50. ConclusionsRevenue cycle communications are many and varied and far fromperfect.Misleading and inaccurate information is a significant barrier toachieving revenue cycle best practices.Providers can leverage technology to bring clarity to the chaos andgain valuable ground toward achieving best practices.Providers need to increase their knowledge and understanding ofwhat value systems such as Trace provide and endeavor to findadditional ROI opportunities. 51. Questions?Thank You! 52. Which area represents the best opportunityfor growth with Trace at your organization?1 2 3 454%5%24%16%1. Revenue-at-Risk2. Physician Orders3. Care Coordination4. Patient Experience 53. Welcome to Trace Days! 54. Workshops 2 & 5Session 1: Whats New In TraceJo Norris, VP of Account ManagementDerek Morgan, Trace Product OwnerMarcia PattersonDeborah ToddAljeana HowardDebbie Lloyd 55. Tracker Work Lists: Done! 56. HL7 Indexing 57. My HospitalA. Already has an HL7/ADT feed with TraceB. Does not have HL7 with Trace, but we plan to get itC. Does not have HL7 with Trace & we dont really think we need itD. Thinks it would be awesome if we only had the $$ 58. Unassigned Manual 59. Unassigned 60. Reconciling 61. Annotation 62. Signatures 63. AnnotationA. Is great and we will/do use it a lotB. Is not very useful for usC. Doesnt do enough, it needs more workD. Not sure yet 64. Downloads 65. Import 66. Import 67. Coversheet Notes 68. Quick Print/ Custom Button 69. Notification Favorites 70. Notification Favorites 71. List Actions 72. Batch Actions 73. User Preferences 74. User Preferences 75. PixCert XPSIts fast! 76. Reports!A. We need more & better reports ASAP!B. The reports we already have are good enoughC. We love the existing reportsD. We hate the existing reports with a burning hateE. We dont care about reportsF. Reports? I didnt know there were reports. 77. Face to Face Recording/ Photo Capture 78. Questions? 79. Welcome to Trace Days! 80. Workshop 2 & 5Trace Best Practices & User Stories 81. HL7 Integration & IndexingWhat is HL7 integration? It is an interface or communication between yourhospitals patient management system and Trace.It sends the Patients Registration, PreRegistration, Admission, Discharge or Transfer data toTrace.How do you index with the HL7 interface? Simply search in Trace by the patientsdemographics. Then select the correct patientrecord from the HL7 results shown. 82. Downloads Tab This feature gives you the ability to upload and savefiles saved in your documents library or documentsstore in other applications on your desktop. Once saved, you can choose to PixCert & Fax, Notifyor Print your documents. 83. Front-End ProcessesPatient Access, Central Scheduling,Registration, Etc.Nichole Harmon & Lynda Clay 84. Inbound Faxing Physician Order Management Indexing, manual or HL7 integration Custom Fields Reserve Faxes 85. New Inbox Faxes Display 86. Front End Processes Notifications Fax/Image Annotation Fax Back Invalid Orders or Confirmations Standard Cover Sheet Notes Image Export 87. Front End Processes 88. Inbound Faxing Best Practice Physician Orders Pharmacy Bed Status Change Surgery Case Management 89. Front End Processes Value- Prevents lost orders- Audit Trail- Ability to track invalid orders- Eliminate Paper- Accessible to other departments to view 90. Trace Voice Why Record Conversations? Big BrotherOR Capture Prior Authorizations Validate Scripting Eliminate he said....she said VOB/VOE Quality Insurance Scripting 91. Trace Voice4 Voice Recording Options -Choice depends on: Volume Purpose Call Type 92. Trace Voice Auto Record Seamless No end user intervention IndiscriminateBest Practice Scenario Call Centers to support VOBand/or VOE, scripting, pre-registration information 93. Trace Voice On Demand Requires hardware User controlled DiscriminateBest Practice Scenario Collection areas calling onclaim status for multiple claims/patients 94. Trace Voice Anywhere Flexible User controlled DiscriminateBest Practice Scenario Case Managers for billingdisputes, SNF placement conversations, transfers. 95. Trace Voice Face-to-Face In-person User controlled DiscriminateBest Practice Scenario Financial Counselorsreviewing patient financial responsibility andpayment plans. 96. Mid-Cycle ProcessesCase Management, Concurrent Review, Etc.La Teshia Jones & Lauren Bento 97. Case Management Processes Centralized number for incoming faxes Case Managers officed all over the hospital Paper documentation filed in individual deskdrawers Paper shuffling 98. Fax Management with FaxCert Inbound and outbound Alternative to scanning documents HL7 integration for efficient and accurateindexing Departmental notifications 99. Fax Management with FaxCert Value Centralized, electronic storage of faxes Improve workflow efficiency Enhanced departmental communication Paper savings 100. PixCert Capture clinical documentation and fax Capture departmental forms and notify or fax HL7 integration for efficient and accurateindexing 101. PixCert 102. PixCert Value Increased workflow efficiency Accessibility Electronic audit trail 103. Downloads Tab Insurance specific forms Internal documents Authorization changes Schedules Concurrent appeal letters 104. Downloads Tab for Mid Cycle Process 105. Downloads Tab Value Centralized location for frequently used forms anddocuments Capture and store document without having tosave to PC Electronic faxing and combining of documents 106. Trace Voice for Readmissions Reductions Programs Patient Protection and Affordable Care Act (P-PACA) Quality indicator versus reimbursement denial Record discharge instructions Non compliance versus neglect to inform 107. Back-End ProcessesBusiness Office, Denial Management,Appeals, Etc.Debbie Holman & Michael Mouton 108. Back-End Processes Denial, Appeal Management Worklists Downloads Tab, Tools Tab Import Tiff and PDF Feature Outbound Faxing 109. Managing Trace Communication EventsHow do I use my Worklists? Customize Column data to match your workflow Organizes data in an easy to read format whenperforming searches on patient transactions Quickly access transactions forprinting, faxing, emailing transactions Perform batch operations 110. Worklist 111. Download DocumentsDo you have a standard form that you canedit? Upload to your downloads Tab and completewith new patient information. 112. Downloads 113. How do you resubmit your denials & appeals?Answer # 1 - By FaxAnswer # 2 - Print and MailAnswer # 3 - Phone Call and pleading case 114. Tools and Utilities for Back EndImport Tiff or PDF documents Electronic Medical Records Insurance Forms Release of Information or Disclosure FormsBenefits Retrieve and complete on any patient Index form/document and save in Tracker Fax outbound completed documents for denialsmanagement and appeals 115. Tools Tab 116. Outbound Faxing Why Fax Outbound your appeals and claim process?Benefits Easy to locate faxed transactions anddocuments Merge records and documents into a singleTrace transaction to fax Date & Time Stamped - proof that you met thedeadline date Fast and easy process to Resend faxes Saves time- no more running to and from faxmachine 117. With TraceYour Hospital is on theroad to recovery!! 118. Welcome to Trace Days! 119. Workshop 3Trace New & Coming AttractionsMatt Jernigan, Director of Product ManagementDebra Holman, Trace Account ManagerLa Teshia Jones, Trace Account Manager 120. Topics Trace Integration Options Auto Notification of Admission Trace Quality & Coaching Discharge Instructions 121. Trace IntegrationTrace Integration includes two optionsImage Export&Image Import 122. Do you currently print and scan documentsfor the sole purpose of entering into anothersystem?1 2 3 4 531%0% 0%63%6%1. No, not in my area.2. I dont know.3. I think so.4. Yes.5. No, thats whatinterns are for! 123. Image ExportAutomatically transfers images in Trace tovirtually any EMR or imaging system.trace EMR 124. Image ExportSome typical benefits Reduced printing costs Instant access to documents in other systems Documents backed up within Tracker Increased workflow efficiency 125. Image ImportHighly versatile and provides automatic faxingindexing and notifications.traceEMRFaxIndexNotify 126. Image ImportSome typical uses Auto faxing of test results such as radiology ormammography results Consolidate CPOE and faxed physician ordersinto a single system for workflowimprovement 127. Image Import 128. Trace IntegrationRequirements Trace standard HL7 interface Technical service call / project plan Priced per sending/receiving system 129. Trace Integration Options Auto notification of admission Trace Quality & Coaching Discharge InstructionsNext Up 130. Notification of AdmissionProblem Payers often require notification of inpatientadmission within 24 hours. If missed, the claim will be denied for everyday late. Adds pressure on access staff, particularly onweekends and holidays, to notify payers. 131. Notification of AdmissionSolutionAutomatically fax a notification to the payer oninpatient admissions and status changes.trace Payer 132. Notification of Admissiontrace PayerRegistrationHL7 Fax*Notification 133. Notification of Admission 134. Notification of AdmissionAdvantages Trace automates the notification. Within Tracker the notifications can becompared to the patient census. In the event of a denial, proof of thetransaction is in Trace. 135. Would this feature be valuable at yourhospital?1 2 3 457%0%14%29%1. Yes, this would beawesome!2. Interesting, it might behelpful.3. Im not the rightperson to ask but Idlike to tell someone atmy hospital about it.4. No, I dont think this isuseful. 136. Trace Integration Options Auto notification of admission Trace Quality & Coaching Discharge InstructionsNext Up 137. Voice Quality & Coaching 70% of hospitals rank patient experience asone of their top three priorities.* The patients experience is affected by everyhospital interaction including those withinthe revenue cycle.*State of the Patient Experience, The Beryl Institute 2013. 138. Voice Quality & CoachingRevenue Cycle Impact Pre-Service communications set the tone forthe entire stay. Post-Service communication may be the lastimpression made with the patient. 139. Voice Quality & CoachingRevenue Cycle ImpactSatisfied withbilling experience93% Satisfied withClinicalUnsatisfied withbilling experience63% Satisfied withClinicalStudy shows link between patient satisfaction with Billing Experience and ClinicalSatisfaction, Executive Insight 2011. 140. Voice Quality & CoachingVoice Quality and Coaching will be an add-onmodule allowing managers to grade recordingsso that can staff can be coached, qualityimprovedand ultimately the patient experience improved. 141. Voice Quality & CoachingDemo 142. Voice Quality & CoachingAdvantages Create a quality and coaching program. Grade recordings based on your criteria. Identify top performers to use for training. Compare team members to identify coachingopportunities. Track quality scores over time. 143. Would this feature be valuable at yourhospital?1 2 3 443%3%26%29%1. Yes, this is the coolestthing since Trace Days!2. Interesting, it might behelpful.3. Im not the right person toask but Id like to tellsomeone at my hospitalabout it.4. No, I dont think this isuseful. 144. Trace Integration Options Auto Notification of Admission Trace Quality & Coaching Discharge InstructionsNext Up 145. Discharge Instructions The Affordable Care Act established the HospitalReadmission Reduction Program. Requires CMS to reduce payments to hospitalswith excessive readmissions. Common drivers of readmission Lack of a standard discharge process Lack of engagement by patients and families Patients did not understand/correctly takemedications 146. Discharge InstructionsTrace Utilize Trace Voice Face-to-Face to capture. Evaluate quality with Trace Quality & Coachingtool. Review instructions prior to patient follow-up. Provide patients with access to recordeddischarge instructions. 147. Would this feature be valuable at yourhospital?1 2 3 424%9%32%35%1. Yes, I think it would begreat!2. Interesting, it might behelpful.3. Im not the right person toask but Id like to tellsomeone at my hospitalabout it.4. No, I dont think this isuseful. 148. Questions? 149. Welcome to Trace Days! 150. Workshop 4Q&A with Trace ChampionsStephen HovanVice President, Revenue CycleUniversity of Tennessee Medical CenterKnoxville, TN 151. Stephen HovanVice President, Revenue CycleUniversity of Tennessee Medical CenterKnoxville, TN 152. About UHS University Health Systems, Inc., Knoxville, TN The regions only academic medical center Licensed for 581 beds Delivery of care model, Centers of Excellence: Brain and Spine Institute Cancer Institute Center for Womens and Childrens Health Emergency and Trauma Services Heart Lung Vascular Institute 153. The Past Facts for UHS Over $16 million in denials consisting of 8.7million in fatal denials Over 35,000 denials 2.2% of hospital net revenue lost to deniedclaims 96% cash to net patient service revenue Overturn rate less than 35% Less than 20% of all denied claims appealed 154. Our Plan of Attack Define denials Measure & monitor Establish denials champion Tools of the trade 155. Our Tools of The Trade Reporting Workflow Documentation Communication 156. Our Revenue Cycle IndicatorsJanuary 2007 to March 2012 Aged Accounts greater than 90: 31% to 19% 23% increase in Cash Collections 99.5% Cash as % of NPSR 56% decrease in denials from $16M to $9M(Jan 2007 Mar 2010) 51% decrease in fatal denials from $8.7M to $4.3M 71% success in overturning denials!!!! 90% of all denials are reviewed for determination 157. Trace Voice at UHS Scheduling Insurance Authorization Financial Counseling Customer Service Business Office 158. FaxCert at UHS Order management Medical record requests Itemized charges for patients Information requests from physicians Insurance benefit information Notification of admission Discharge planning & notification 159. PixCert at UHSDocumented proof of important onlineprocesses that protects revenue such as:Verification of Benefits and EligibilityClaim StatusPrior AuthorizationAppeals 160. Our Results Overturning and preventing denials Improved revenue cycle productivity Renewed staff confidence to fight a battle and win Courtesy and customer focus among staff Real, live training examples for management team Improved relationships within revenue cycle team,other hospital departments, physician offices,patients and even with insurance companies 161. Our Fatal Denials Reduction$4,000,000.00$5,000,000.00$6,000,000.00$7,000,000.00$8,000,000.00$9,000,000.002007 2008 2009 2010YearYTD Fatal Denials ProgressTot Charges Fatal Denials 162. Our Future State Continue to streamline workflow Expansion of user defined work-lists Integration with optical imaging product Implementation of face-to-face recording Physician order management 163. Questions 164. How effective are you in using Trace toaddress denials?1 2 3 49%21%15%56%1. Were doing great!2. Were doingokay, but could bebetter.3. Weve got a longway to go.4. Were in denialabout our denialproblem. 165. Workshop 4Q&A with Trace ChampionsLynn Arrington, CHAMManager of Insurance Verification,Patient Access Intake CenterTexas Health ResourcesArlington, TX 166. About THR 167. Q&A 168. What is your level of interest in usingface-to-face recording at your hospital?1 2 3 443%10%3%43%1. OMG! I wish I had ityesterday!2. Its sounds cool, but Ihave some concerns.3. Sounds too much likeBig Brother. I cantimagine ever doing that.4. Id like to use it to recordthings my boss says! 169. 7th Inning Stretch 170. Workshop 4Q&A with Trace ChampionsStuart SchiffmanVice President of Revenue ManagementCatholic Health ServicesLauderdale Lakes, FL 171. 2013TRACE DAYS CONFERENCEStuart Schiffman 172. CATHOLIC HEALTH SERVICES Faith Based Organization Mission: To provide health care and services to those in need;To minimize human suffering; To assist people to wholeness;To nurture an awareness of their relationship with God. Vision includes innovative and proactive approaches to: Managing care and providing services Facilitating transitions across levels of care Community partnerships and collaboration Advocacy efforts 173. CATHOLIC HEALTH SERVICES Nursing Homes (Skilled Nursing & Long Term Care) 633 Beds (4 locations) Rehabilitation Hospitals (Inpatient & Outpatient Services) 88 Beds (3 locations) Assisted Living Services 2 locations Home Health Services 2 locations Catholic Hospice Home Services Inpatient Services Cemeteries Elderly Housing (15 locations; 2200 units) Early Education 174. CATHOLIC HEALTH SERVICES 8 Service Lines 30 Facilities 2,700 Employees Total Revenue - $160 Million 175. Revenue Cycle Management Centralized Business Office Billing Collections System Management & Oversight (Net Solutions) Technical Support Charge Entry Cash Posting Customer Service Policies & Procedures Training & Development Managed Care Contracting 176. Revenue Cycle Management PAYER MIX Medicare 40% Medicaid 35% Managed Care/Commercial 18% Private Pay 7% 177. Regulatory Environment Medicaid State Reform Program Mandatory Medicaid Long Term Care Enrollment (Managed Care) Contracting (Letters of Intent; Negotiations) Staff Education Resident & Family Education Insurance Industry Managed Care Payers Individual Requirements Payment Issues Denials 178. REVENUE CYCLE PROCESS 179. Accounts Receivable Management Denials Management Authorization (Extended Stays) Level of Care Disputes Assertive Approach 62% Success Rate Appeals Process (Labor Intensive; Cash Delays) 180. ACCOUNTABILITY Monitoring Performance Reports Cash Collections Days In A/R Bad Debt Census Payer P & L Utilization Individual patient service costs (i.e., Physical Therapy;Pharmacy; etc.) 181. REVENUE CYCLE TOOLS Net Solutions RAM (ADT & Billing) Clinical (Interfacing) SSI Electronic Billing (Edits; Transmissions; Confirmation) Tract Manager Contract Management Authorization Process NS Plan Authorization Report eQ Health (Medicaid) 182. REVENUE CYCLE TOOLS Verification/Eligibility Process Passport Availity Web Sites Medicaid Web Portal Medicare DDE Financial Screening Charity Care Program Search America/Experian Trace *** Denials Reduction Accountability Payers Staff 183. OVERALL PERFORMANCE Days In A/R (Reduced from 45 to 33) Cash Collections (Over Budget by $1.9M & $1.5M) Increased Revenue via Managed Care Contracting Reduced Bad Debt 184. Trace Implementation KeyComponents Senior Management Support ROI Analysis References Facility Leadership Support Key Users Buy In 185. Trace Implementation KeyComponents (contd.) Project Management Trace Oversight Project Charter Ongoing Communication Accountability & Accessibility User Perspective Experience 186. Trace Implementation KeyComponents (contd.) Project Management CHS Approach Departmental Process Reviews (Admissions; CaseManagement; Business Office; CBO) Enhancement vs. More work Pilot Roll Out Assessment/Feedback Improvements Full Roll- Out Assessment/More Feedback ROI 187. Have you been able to quantify the benefitTrace has brought to your organization?1 2 3 423%20%33%23%1. Yes, through increasedproductivity.2. Yes, through increasedrevenue.3. Yes, but dont have themetrics to show it.4. No, havent been able toquantify the benefit. 188. Workshop 4Q&A with Trace ChampionsJeanette McDowell R.N.C./MSNManager of Central Intake and AssessmentPhoebe Putney Memorial HospitalAlbany, GA 189. Q&A 190. What is your interest in using Trace in yourTransfer Center?1 2 3 418%11%39%32%1. Very interested! Its a bigproblem for us.2. It sounds great, but itsnot my area.3. We dont have a TransferCenter.4. Id like to share this witha colleague, but I dontthink I can say PhoebePutney without giggling. 191. Welcome to Trace Days! 192. What movie/TV show best describes yourevening last night?1 2 3 4 59%41%38%3%9%1. The Hangover2. Good Times3. Lost4. Alien5. Home Alone 193. Chance to Win $50 Right Now!Like UsFacebook.com/TracebyTWSGorUse #tracedays in a TweetTwitter.com/TracebyTWSG 194. Workshop 6Making the Most of TraceLori Forbess, Vice President of Enterprise AccountsJo Norris, Vice President of Account ManagementNicole Shanklin, Director of Implementation & Training 195. Is Trace underutilized in your facility?1 2 3 40%27%42%30%1. I think its used to itsmaximum potential.2. There are a few otherareas in which Id like tosee it used.3. There are many otherareas in which it shouldbe used.4. Dont get me started! 196. OptimizationThe act, process, or methodologyof making something (as adesign, system, or decision) as fullyfunctional or effective as possible. 197. Optimization Process 198. Enterprise Tools Usage Matrix 199. Optimization Process 200. Trace Administrator Leadership Planning Configuration Preparation Compliance Follow up 201. Lunch and Learn 202. Trace Assessment Purpose1. Identify current work flow issues2. Make recommendations for optimizing use of Trace3. Identify ongoing training and implementation needs4. Identify opportunities to streamline efficiencies5. Build and maintain a positive customer relationship 203. General Workflow Overview1. What is your department responsible for?2. How is your work divided?3. How many physical sites does your department have?4. What is your biggest source of pain in your workflow?5. What do you like most in your workflow?6. How do you communicate internally?7. How do you document authorization information?8. What EMR system is in place? 204. Department AssessmentPATIENT ACCESS / PFS / SCHEDULING:1. Who handles benefits and eligibility processing?2. How do you document information from insurancecompany websites?3. Does your department schedule appointments?4. How does your department receive physician orders?5. How do you register patients?6. Do you do upfront collections?7. Who handles denials?8. What is your denial rate? 205. Assessment Summary DEPARTMENT: CASE MANAGEMENT WHITE STONE HOSPITAL Contacts: Department Contact: Trace Administrator: Account Manager: Jo Norris Reason for request: Currently uses Trace wants to optimize Trace with consistent process and workflow Improve consistent usage and workflow Determine how to optimally print labels from exported Indexed info Assess need for F to F recording and Voice Recording Recommended Solution: Training for employees w/shortcuts (done) Label workflow reviewed, recommendations made & implemented (Search Tracker, Export List to csv instead of xls and manipulatedata as desired before merging with label function in MS) All Call Solution when White Stone Hospital adopts it as a whole (approximately 10 users) Considers Trace implementation for Outbound faxing if / when applicable For Rxs evaluate Trace Export feature to Prescription system Costs: $0 Maintenance:$0 No additional fax volume already in use. All Call 10 Seats (when proposal actually done, revisit number of seats in case there has been achange) Metrics: Time Savings: Improve Inbound fax processing; Export names to excel for labels Save Money: Paper, Time Value associated with time savings Increased Efficiency: Consistent workflow process, Increase automation Compliance: Audit trails of transactions and workflow, Labels on all documents 206. Enterprise Tools Strategic Plan 207. RoadmapQ2 2012 Q3 2012 Q4 2012Discovery Test/Trainingenvironment Redundancy/DisasterRecovery Prioritize additionalfacilitiesImplementation TBD somedepartments based onprioritized listDiscovery Gap AnalysisImplementation Training Environment Redundancy/ DisasterRecoveryDiscovery Awaiting onprioritized list ofdepartmentsImplementation Outpatient Pharmacy HIM TBD somedepartments based onprioritized list 208. Optimization Process 209. Project Charter Purpose Identify Key Stakeholders Outline Requirements Authorize Resources Contents Strategic Objectives Keys to Success Risk Factors Partnership Team Acknowledgment 210. Project Charter 211. Project Management Plan Scope Management Plano Project charter Time Management Plano Implementation Scheduleo Project Plan Communications Plano Stakeholder Registero Communication methods & frequency Risk Management Plano Change control processo Risk Register 212. Stakeholder RegisterName Primary Role/Designation Title Influence Communications/Strategy wkly call notes risk register updates monthly dashboardex. Vicki Moore Project SponsorVP ofOperationsStrategy /Prioritization/ResourceApprovalRegular briefing, solutions,progress dashboard / Meetingreports , emails N Y YConsiderations: Peer-to-Peer (Trace to Enterprise) mapping for each stakeholder Re-occurring optimization team status meetings 213. Risk RegisterRisk # Date RequestorRiskDescriptionOverallImpact(H-M-L)Probability (%)ScheduleImpact(H-M-L)Mitigation Risk Owner Notes1 7/23/2012TWSGHospitalCurrent enterpriseHIS implementationis delayed. Technicalteam resources mustcomplete HIS projectprior to engagementwith TraceOptimizationM 70%HTeam anticipates 3 week delayif impact is realized. Hospitaland Trace will begin non-technical / implementationsteps: workflow assessments,needs analysis, etc. whileproject waits for technicalresources to be released.Hospital PM Lead / IT DirectorTeam will reconvene weekly to assess probability of impact and will adjustmitigation steps if necessary. 214. Continuing Improvement 215. Questions? 216. Welcome to Trace Days! 217. Workshop 7H. A. & Enterprise SupportTim Hoskins, Director of Enterprise Architecture 218. What Is H.A. And Why Do I Want It? Load / Capacity Availability &Resiliency Continuity 219. What does your day look like if you havedowntime with Trace?1 2 366%19%16%1. Running around withmy hair on fire.2. I hear about it, but itdoesnt impact me.3. Business as usual. 220. Do you use Trace in patient contact or clinicalsettings?1 2 3 428%22%34%16%1. Patient Contact (e.g.Registration, FinancialCounseling, etc.)2. Clinical Setting (e.g.Physician Orders, PatientDischarge/Follow-up, etc.)3. Both4. Neither 221. How Trace Looks TodayIm theDatabase!Im theTraceStorageSystemIm theFaxCertServerIm theTracker WebServerIm the PixCertServerIm theTrace Auto-RecordServerIm theTrace VoiceAnywhereServerImalso the.... 222. How Trace Enterprise Solutions LookIm theFaxCertServerIm theFaxCertServerIm theDatabaseServerIm theStorageServerIm the WebServices VirtualMachine Uh Oh I just010011dmyself, somebody get me atowel!Imgood! 223. The Trace Enterprise Solution Capacity gain with multiple Trace servers The ability to scale as Trace grows Minimize and potentially eliminateunscheduled downtime for all Traceapplications Maximize performance by utilizing existingtechnology investments Enable future cloud based redundancy options 224. Questions? 225. Workshop 7Support ServicesBen OBrien, Director of Support Services 226. Support Services:How Can We Help You? 227. Who Is Support ServicesTrace Support Services is comprised ofAccount Specialists, Product Specialistsand Technical Specialists withexpertise in all Trace products andknowledge of your specificenvironment and needs. 228. Our GoalTo be the very best support organization in thehealthcare software industry. High value on genuine relationships with ourcustomers. High value on responsiveness. High value on ROI ensuring our products bringreal value to your organization. High value on trustworthiness we want to be acompany that you can trust to do the right thing. 229. Contacting Customer Support8 AM-8 PM EDT(Mon-Fri)Available 24x7x365Phone:877-864-2378Email:Support@twsg.comTellUs!(Right from trace) 230. Support ProcessAccount Specialist Product SpecialistTechnical SpecialistImplementation andSupport EngineeringYouAccount Specialist Your first contact for any issuesProduct Specialist Cross functional team to manage your needsTechnical Specialist Your technical server teamImplementation and Support Engineering Dedicated to setup, security and codesupport 231. 2012 We closed over 19,000 Cases,80% of which were closed in less than 1 hour. The average wait time for a Trace supportagent was 40 seconds or less. Created several new roles for our supportteam to better serve your needs. 232. 2013 Close 90% of cases in less than 1 hour Continuous improvement of server monitoring Cut down average queue wait time Continue to put together focused teams ofdedicated people to raise the bar on our levelof support Provide you with more self service options 233. Todays Customer Portal 234. Todays Customer Portal Download help documents Request training Submit a support case Submit new users 235. A Note About Self ServiceOur goal is to provide you as many opportunitiesas possible to get the information, access andsupport that you need, as efficiently as possiblein order to make trace successful in yourorganization. 236. Self ServiceWhat features would you like to see in 2013? 237. Would you like the ability to manage yourcases online?1. Interested2. Not Interested 238. Would You Like the Ability to Have RemoteSupport from Tracker?1. Interested2. Not Interested 239. Would You Like to Be Able to Chat With TraceSupport?1. Interested2. Not Interested 240. How Interested Are You in Ideas?1. Interested2. Not Interested 241. How Interested Are You in Improvementsto User Submission?1. Interested2. Not Interested 242. Questions? 243. Thank You!I want to hear your ideason how we can continueto improve your supportexperience. Email me atben.obrien@twsg.comwith thoughts or ideas.THANK YOU! 244. Final Wrap-Up Surveys Boxed Lunches Rides to Airport Rides to Corporate Office Room Key is Parking Pass