The current healthcare environment is creating one of the most active hospital and health system consolidations in history. Independent hospitals, in particular, have been caught up in the trend of consolidation. It is partially driven by hospital and provider responses to the challenges and opportunities created by national and state healthcare reform.
One of the major challenges in this environment is the consolidation of systems and healthcare data migration. Data migration is not as simple as transferring information between systems. Migrating data to a new electronic health record system requires expertise in the legacy EHR, as well as the new one. The migration process needs to be well planned in terms of infrastructure, security, data access, resources, training, testing, etc. A temporary drop in revenue can be expected, although having proper planning and timelines will help to recover quickly.
Vee Technologies has assisted and worked with numerous hospitals and health institutions to mitigate the impact of system migration and the implementation process. One in particular is a large academic hospital, world-renowned for its outstanding care and groundbreaking research. With one academic and two community hospitals, it has more than 2,000 inpatient beds and was named as one of the "Best Regionally Ranked Hospitals" by U.S News & World Report.
The client was in the midst of migrating from their three legacy HIS and billing systems while also undergoing a mammoth implementation of EPIC. In order to train their staff on EPIC, they needed a partner to manage the day to day processing and also work down outstanding AR, both of which resided in their legacy systems.
Vee Technologies was selected as a preferred vendor to manage the legacy AR project and day to day billing operations. The client expected a temporary drop in revenue due to system migration and the learning curve it posed for the staff. They had to put in place a partner to help absorb the workload and to assist in the migration process. Cost savings and staffing efficiency were the critical factors that lead to the selection of Vee Technologies.
Vee Technologies was selected as vendor of choice to manage migration and implementation for the following services:
- Coding assistance
- Coding denials
- Coding edits
- Insurance collections – Prof AR
- Insurance collection – Hosp AR
- Hospital edits
- Credit balances
- Billing and Reg Denials – Prof and Hosp
Legacy AR and Denials – Hospital and Professional
The client had $80+ million hospital and professional AR outstanding in legacy systems that required special attention and quick clean-up. Vee Technologies put together the following solution to address legacy AR:
- Dedicated team to work 90+, 60+ and denials
- Team of analysts to work inventory in two shifts
- Calling-related claims were addressed in regular hours (8AM-5PM ET) and non-calling claims (IVR, website etc.) were addressed during the off hours (10pm-7AM ET).
- A focus on resolution of claims
- Strong quality process
- Coding assistance to reduce coding related denials
- Action tracker and weekly review
- Global issues Identified
- Spreadsheet initiated with the list of patients sent to BCBS for claim status