Utilize Custom Workflows to Manage and Reduce Payer Denials
About Hurley
Hurley is a 443-bed premier public teaching hospital recognized as a regional leader in advanced specialized health care. Every year, more than 20,000 people choose Hurley for their inpatient hospital care, and its Emergency Department handles over 80,000 annual emergency cases.
A long-time customer, Hurley Medical Center approached Quadax to help it replace hard-to-balance, labor-intensive manual processes and unite disparate data sources. Together, Hurley and Quadax defined two practical challenges:
Challenge 1: Connect Epic and OnBase
As an Epic® user, Hurley was quick to adopt RemitMax by Quadax, which streamlines billing office workflow and introduces savings by eliminating paper, creating high-quality 835s for automated posting. In Hurley Medical Center’s case, this includes automated filing of electronic documents in OnBase®.
RemitMax delivered immediate efficiencies by automating importation of lockbox correspondence documents, but Hurley Medical Center was still hampered by the need to run Epic and OnBase simultaneously, toggling between the two and executing searches in each separately. The approach was both inefficient and a barrier to full visibility and accountability in the revenue cycle.
Goal: Increase efficiency and performance visibility in the revenue cycle + digitize cash posting verification.
Solution
RemitMax One-Touch Correspondence: Fast, reliable access to correspondence with one click
To streamline access to correspondence documents, Quadax developed RemitMax One-Touch Correspondence. With product integration, single-sign-on technology, and an easy-to-use hotkey, Quadax empowered Hurley staff to reach correspondence documents from within their Epic system, no longer having to leave Epic to perform time-consuming searches.
The RemitMax process classifies document images, crosswalking to Epic BDC codes. Documents are automatically delivered to the appropriate work queue (e.g. a legal workflow, refund workflow, bankruptcy workflow, etc.), linked to the correct account.
All correspondence activity is now occurring, and is trackable, in Epic, yielding full visibility and accountability through Epic reporting.
One-touch access is enhanced by the high degree of image usability thanks to the meticulous indexing of RemitMax processing and patient account matching. But for the small number of lockbox documents lacking a patient account number, the Quadax RemitMax team of problem-solvers engineered a solution to facilitate account identification. Default identifiers signal the need for intervention, and a custom workflow process automatically presents such documents for investigation. The result is a streamlined process and better accountability.
Challenge 2: Automate Cash Posting Verification
Hurley was also frustrated by the time-consuming, manual cash posting process it had to follow in its remittance workflow. Previous attempts to develop a digital procedure in concert with Hurley’s bank proved unsuccessful.
Solution
RemitMax Epic Cash Management Release File
To solve Hurley’s challenge of having to manually query and verify check numbers and trace numbers before cash can be posted, the Quadax RemitMax team worked with Hurley and the Epic Cash Management system to develop a datafile that is output daily to Hurley and fed into the Epic system to verify the checks and electronic fund transfers (EFTs) cleared the previous day. Epic reads the file and releases the corresponding electronic remittances (835s) containing those check numbers and EFT trace numbers for automatic posting, with no manual intervention.
Fast Facts: RemitMax Results at Hurley Medical Center
Days in A/R
Before RemitMax: 60.8
After RemitMax: 50
Cash Posting Staff Overtime
Before RemitMax: 1,725 hours
After RemitMax: 0 hours
Cash Posting Backlog
Before RemitMax: >15 days High volume of
manual posting
After RemitMax: 90+% of all paper remit posting electronically
Insurance Correspondence Follow-Up Backlog
Before RemitMax: >90 days
After RemitMax: =<2 weeks
Staff Allocation
Before RemitMax: 5 FTEs cash posting, including 1 FTE dedicated to manually approving files for posting after checking deposits at bank
After RemitMax: 2 FTEs were re-allocated to other valuable activities.
“We value the partnership that we have built with the individual team members of the Quadax family. At Hurley we attribute our ability to be successful to the relationships that we foster both in the community and through our professional commerce; I believe our partnership with Quadax only enhances those relationships further.”
Kerri Walther, Director of Billing Operations / Epic Development Hurley Medical Center
