Process Improvement Strategies
Experience goes a long way. Since 1986, SSC has been developing industry-leading processes and utilizing state-of-the-art technology and has the ability to diagnose operational deficiencies and integrate technological solutions to pinpoint areas in need of improvement.
For example, an SSC client recently experienced above average timely filing denials equating to millions of dollars in unrecoverable revenue. SSC began reviewing the lag time (date of service to received date) for manual charge entry. Lag time measurement reports were created and allowed the users to drill down and identify specific areas of improvement, from organization to provider level.
The Client Lag Report revealed that 30% of charges received by data entry were over 60 days and 10% were over 90 days from date of service. Further drill down uncovered the lag was predominately incurred on Inpatient visits (about 60%). Operationally, the physicians manually recorded the visits on Inpatient cards which were then submitted for manual review for completeness and then sent on to charge entry. An Electronic Medical Record (EMR) system was being utilized, but SSC recognized that only 3% of the providers employed it. SSC strongly recommended the existing EMR system be adopted by providers to record Inpatient visits to ensure completeness and timeliness of submissions. An electronic interface was built from the EMR to the billing system to download charges nightly, eliminating manual charge entry.
In addition, Lag Time Measurement reports are monitored monthly for provider and monetary penalties are imposed based on lost revenue and provider performance in this area. The lag day report now reveals only 5% over 60 days and less than 1% over 90 days for charge submission. As a result, the client now experiences low volume of timely filing denials and increased revenue.