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Patient Accounting System Charge Master Based Billing (PAS - CMBB). Uniform Billing Office Advisory Work Group Meeting February 26, 2007. PAS - CMBB Benefits.
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Patient Accounting System Charge Master Based Billing(PAS - CMBB) Uniform Billing Office Advisory Work Group Meeting February 26, 2007
PAS - CMBB Benefits • Provide the Department of Defense (DoD) with an enterprise system for cost recovery within the Military Health System’s (MHS) Medical Treatment Facilities (MTFs) • Replace Third Party Outpatient Collections System (TPOCS) and the billing portion of Medical Services Accounting (MSA) and support billing of Medical Affirmative Claims (MAC) • Simplify complicated and cumbersome billing processes
PAS-CMBBBenefits of a Consolidated System • All DoD billing activities (MAC, MSA and TPC) will be consolidated into one system enabling: • Expanding the ability to accurate report Accounts Receivable related to all billing activities • Enhanced ability to monitor payments to ensure accounts are paid at the expected reimbursement level • Enhanced ability to track outstanding Accounts Receivable • Enhanced ability to monitor denials and rejections for all accounts
PAS-CMBBAdditional Benefits for Staff Work Flow • The implementation of GE Centricity Business will provide enhancements to staff workflow such as: • Expanded automated processes • Automated on-line editing of claims data • Automated on-line worklists • Automated payer edits • Implementation of electronic transaction sets to complete • Remittance posting (835 transactions) • Eligibility verification (271 transactions) • Eligibility verification responses (270 transactions) • Claims status response (276 transaction) • Claims status inquiry (277 transactions)
PAS-CMBBAdditional Benefits for Supervisory Staff • Expanded ability for site supervisory staff to manage billing office activities • Manage and monitor staff productivity • Manage work during staff vacations and absence by reassigning worklists • Manage and monitor outstanding accounts receivable by Payer • Identify area of opportunity for improved billing to reduce rejections and denials
PAS-CMBBAdditional Benefits for Reporting • Expanded ability to generate reports based • Ability to generate reports for all billing activity (MAC, MSA and TPC) from one system • Ability to segregate reporting by criteria such as MEPRS Code, Service, Type of Encounter • Ability to generate query reports on demand such as Aged Trial Balance Report to conduct follow up activities • Ability to download reports into Excel formats
PAS-CMBBGE Centricity Business Overview • What was purchased • System overview
PAS - CMBB Project Status • Phase: System Development and Demonstration • Received Defense Business Transformation (DBT) certification approval for Fiscal Year 2007 • Date: 7 September 2006 • Contract award to Unisys/GE for commercial off-the-shelf (COTS) GE Centricity Business software product (formerly IDX/Flowcast)
PAS - CMBBProject Activities - Past Activities during October through December 2006: • Held kickoff meetings with Unisys/GE • Began working with Unisys/GE to draft workflows • Began working with Unisys/GE to identify hardware and non-configurable software items • Installed GE Centricity Business in ATEC for initial scans to identify any mitigations that will be required to install product in the DoD • Began working with Unisys/GE on mitigations • Held meeting with Work Group to introduce GE Centricity Business software product • Identified Functional Teams and requested input from Services and UBO for team membership • Continue to complete documentation in accordance with DoDI 5000.2, including the Capabilities Production Document (CPD)
PAS - CMBBProject Activities - Current Activities during January through February 2007: • Continue to work with Unisys/GE to configure the GE Centricity Business product • Continue to work with Unisys/GE to install hardware and non-configurable software in DISA • Continue to complete documentation in accordance with DoDI 5000.2, including the Capabilities Production Document (CPD) • Held meeting with Work Group to discuss data conversions and review draft workflows • Held Part I of a joint Claims Processing and Payment Posting Functional Team and Work Group meeting to review and approve the Patient Demographic and Visit Management screens • Part II will occur on March 6 • Attend the UBO Advisory Working Group meeting
PAS - CMBBProject Summary – Near Future Activities planned for March: • Continue to work with Unisys/GE to configure the GE Centricity product • Continue to work with Unisys/GE to install hardware and non-configurable software in DISA • Continue to complete documentation in accordance with DoDI 5000.2, including the Capabilities Production Document (CPD) • Continue to hold meetings with Functional Teams and Work Group – upcoming meetings include • March 5: 270/271 Transaction discussion • March 6: Part II of a joint Claims Processing and Payment Posting Functional Team and Work Group meeting to review and approve the Patient Demographic and Visit Management screens • March 8: Requirements clarification (user-defined requirements) • Attend and give presentation at the UBO Annual meeting • March 7: Hold Preliminary Design Review (PDR)
