Advanced Revenue Cycle Analytics: An Overview
When you’re already very productive and excellent at managing your revenue cycle, finding even more opportunities for time savings can be difficult. That’s the problem that a client of ours recently experienced. This very large orthopaedic practice was already 2x more productive than the national average, and it didn’t seem like there was much room left for improvement. In the midst of back office changes and an increase in an already large encounter volume, upper management wanted their revenue cycle staff to find a way to increase their productivity even further.
Despite these challenges, this orthopaedic practice was able to increase their productivity. With the help of White Plume, some retraining, and adjusting their custom rules, this client saved an additional 9.2 hours per day. Let’s take a look at how they did it.
Big Orthopaedic Group With Efficiency Needs
Rothman Orthopaedic Institute is a large orthopaedic group who has been a White Plume client since 2013. They have grown to become one of the largest and most respected orthopaedic practices in the country. However, because of how large they have grown, they have a massive workload to manage on the revenue cycle side. On average, they process 4,577 encounters per day. With such a high encounter volume, their focus is on optimizing their coding workflow efficiencies.
With White Plume software, they are excellent at managing their revenue cycle. Their coders are 2x more productive than the national average. Despite this amazing success, they needed to find another way to save more time and increase their productivity even further.
Challenge: Back Office Changes
Along with using White Plume ePASS products to efficiently manage their revenue cycle functions, Rothman Institute utilizes White Plume analytics on a quarterly basis to continually measure and improve revenue cycle outcomes. This allows them to track improvements and opportunities as they experience changes in operations. Recently, they experienced a lot of growth, and changes in the back office. Back office growth led to a new pool of employees who needed to receive training quickly to help with their workload.
Not long after these changes, Rothman reviewed their analytics report from the first quarter of the year. After reviewing the analytics, Rothman identified an opportunity to receive retraining for their newest staff members. They recognized the value of reminding staff of best practices so that all of their employees can be as productive as possible. On top of retraining, they spent a lot of time editing their custom rules so that their coders would only be stopped on encounters that needed changes.
In the second quarter, they received analytics again. After the retraining and adjusting their custom rules, Rothman was able to save an additional 9.2 hours per day. If they had performed the same number of encounters at their previous productivity rate, they would have needed those 9.2 extra hours a day to complete them. They would have either fallen seriously behind on their workload, or they would have needed to hire a new coder to handle those extra encounters.
How did retraining & rules hygiene contribute to this jump in productivity?
Solution: Retraining & Rules Hygiene
Between the first and second quarter of the year, White Plume revenue cycle experts conducted an onsite visit to refresh best practices and work on their custom rules. The goal of all of this is to implement the best practice of exception-only coding.
Exception-only coding is an extremely important best practice for revenue cycle staff to follow. Exception-only coding is when coders review encounters on an exception-only basis, i.e. they only review the encounters that include errors. AccelaSMART compares encounters against the industry, payer, and custom rules, and only stops coders on encounters that need to be changed. Coders that trust the software to stop them will be 3x more productive than their peers. The problem is many coders do not follow this best practice, and they waste time reviewing every single encounter.
On top of the retraining conducted by White Plume, Rothman also invested time in rules hygiene. Rules hygiene is a term to describe the process of cleaning up custom rules in your revenue cycle software. AccelaSMART allows practices to build custom rules that meet the needs of that specific practice. Whatever specific payer requirements or coding changes that apply to your practice can be built into a rule so that coders are able to code on an exception-only basis. However, payer rules change often. Keeping custom rules up-to-date, and adding additional rules, is the best practice to ensure your revenue cycle is as productive and accurate as possible.
With excellent, current custom rules and coders committed to an exception-only workflow, Rothman Orthopaedic Institute was able to experience massive time savings. Practices that invest in their revenue cycle people, processes, and technology can always find opportunities for improvement and productivity increases. Find out more about how White Plume could help your practice be 2x more productive than your peers.