Patient Friendly Registration and Billing

1. Patient Friendly Registration and Billing Kim Tilley IS Specialist Citizens Memorial Healthcare November 8, 2006

2. Patient Friendly Project Overview • Insurance information on the CMH Website • Insurance pre-authorization processes • Patient Friendly Identification Cards • Patient Pictures • Insurance verification • Co-pay opportunity to pay • Charges by documentation • Preliminary bill • Final bill w/in 3 days/5 days • Friendly Statements • Online Billing Portal • Clinical Patient Portal • Into the future: Self Check In

3. Insurance Information on the Web

4. Insurance Pre-Authorization • Assure that tests/treatments that require pre-authorization are pre-authorized • More and more companies are requiring pre-authorization for services • Pre-authorization should be completed by the scheduling site • Patient Access can run reports to verify that pre-certification is completed • Pre-authorization fields are reviewed at registration

5. Insurance Pre-authorization

6. Patient Friendly Identification Cards • Assures that the correct patient is identified quickly • Help patient feel that he or she has a personal identity with CMH • Does not expire! • Patient consents for treatment by using the card

7. Express Card: How it works • A unique patient identifier is embedded in the barcode of the card (E#EMR #) • To use, have cursor in patient field and scan the card with the barcode reader • The cards placed additional pressure on registration for an express registration process

8. Initial Rollout (Patient Friendly Cards) • Ordered blank cards with the express card logo on the front • Purchased a Zebra card printer • Created NPR reports that took the list of scheduled patients and excluded patients with duplicate social security numbers • Created an NPR report that bar coded and printed statement on the back of the card • Cards and agreements given to patient at check-in for the scheduled appointment Now, patient friendly cards are printed upon request at check-in

9. Patient Pictures Patient Pictures can help protect our patients by... • Providing a visual indicator that assures the correct patient is selected • Personalizing the registration process

10. Process Patient Picture Routine

11. Subsequent Registrations A. MPI B. Display Picture Button C. Display Routine

12. Initial Rollout (Patient Pictures) • Purchased web cameras and placed them in all registration areas • Assigned a HealthStream (LMS) course to all patient access staff • Phased in the patient picture capture process by area • On-site support and training the day of LIVE for each area

13. Universal Printed Consent • Consent can be printed at the end of each registration and includes the patient’s information • Valid for one year • Valid for both hospital and clinic services

14. Initial Rollout (Universal Consent) • Consulted with our attorney in order to determine the legality of one year universal consent that is valid in all CMH locations • Created/altered our ADM forms to include the patient information and the expiration date • Registration began checking the consent expiration date before asking the patient to sign a consent

15. Insurance Verification • Helps us to verify that we have the correct policy information on file • Identifies the status of a patient’s coverage, i.e. active or inactive • Allows us to verify that we are filing a claim to the correct plan • Can be completed real time while the patient is present or after the fact

16. Insurance Verification

17. Responses and Reporting

18. Opportunity to Pay • Patients asked to pay a deposit on their account • Payment is entered and the patient is given a receipt • Every $ is a small account that doesn’t have to be collected later

19. Charges by Documentation • Clinical modules have been designed to collect charges as a by product of patient care documentation • Decrease charge entry • Even avoid extra clicks • Match documentation to charges • 90% of charges by documentation

20. Preliminary Bill • Goal to produce a preliminary bill at time of discharge of all patients • Raises importance of real time documentation • Allows us to estimate co-insurance % and again, eliminate need to bill later for that amount • Procedure is called OE.ORD.bill

21. Sample Preliminary Bill

22. Final Bill w/in 3/5 Days • If you can’t do it real time – we need to be able to do it by the 3 day IP/5 day OP cutoff • Late charges – after 3/5 day and after coding and dropping - $40,167 in July • Otherwise the bill drops and the claim has to be adjusted and refiled • Patient could be billed later, receiving second bill • Rework for charge entry, billing, coding and unfriendly to patient

23. Changing the “face” of billing Our vision… • All insured patients will be sent a patient friendly billing letter when their insurance has been filed that will include the following: • Thank you to the patient for choosing CMH • Insurance information on file and who to contact if the information needs to be updated • Information about what to expect next (i.e. statement once insurance(s) has processed their account that includes a summary of charges) • Once the balance is the patient’s responsibility, the patient will be sent a statement that will include a summary of charges. If the patient is eligible for a prompt pay discount, discount will be included on the statement • amount and discounted total We will offer our patients a quick and easy way to view and pay their bills online • As an account progresses, the patient will receive progressive statements and/or letters with information about how to set up payment arrangements or what to expect if their account remains unpaid

24. Our plan to get there… • Setup self pay routines in Meditech • Sign with a statement service, such as Emdeon’s ExpressBill, in order to obtain patient friendly correspondences • Move self pay billing and collections to Meditech • Purchase an online solution, such as Verus’ Online Patient Accounts Center (vPAC), that will allow our patients to view and make payments online

25. Friendly Statements

26. Friendly Letters

27. Online Billing Portal

28. Clinical Patient Portal

29. In the future… • View Access for Patients • Patients Self Check Kiosks • Registration Scrubber

30. Patient Friendly Registration and Billing Thank you! Questions and Comments? Kim Tilley IS Specialist Citizens Memorial Healthcare Phone: 417.328.6718 Email: ktille@citizensmemorial.com