We’ve Done IT Before: Cerner Patient Finance

The Client: Our client, a 400+ bed, not-for-profit multi-specialty health system includes an inpatient rehabilitation unit, a behavioral health facility, satellite outpatient diagnostic and rehabilitation centers and more than 80 Physician Clinics. It offers several of the region’s most comprehensive clinical programs like emergency medicine, women and children services, orthopedic services, medical rehabilitation, cardiovascular services, neurosciences and oncology.

Business Issue: Cerner system-wide implementation yielded mixed reviews from users. The client, along with help of Cerner, conducted a SWOT analysis resulting in identification of five areas with major deficiencies. It was determined that the vendor could not address the problem areas. After careful consideration, the client selected MMY for its experience in addressing EMR implementation challenges, its knowledge of Cerner and its ability to develop strong action plans in proactively improving organizational operations.

Collaborative Approach: MMY Consulting provided Subject Matter Expertise to address implementation and workflow shortcomings. MMY staff reviewed clinical, technological processes, and operations as part of the approach. Current-state processes were evaluated and future-state roadmaps were defined to provide recommendations and action items for immediate execution in each area identified in the SWOT analysis.

Challenge: Ambulatory system users were selecting incorrect patient encounters to place orders. Results were posted to incorrect encounters and billing was being charged on the incorrect encounters. The hospital ended up with unbilled revenue as well as results and clinical documentation posting not meeting regulatory requirements.Action: MMY completed situational analysis and identified errors. Ambulatory accounts were corrected. Sub-optimal processes were eliminated, specific system training was conducted along with implementation of new accountability guidelines and updated policies and procedures.Results: Immediate additional revenue of $250,000 was realized in encounter errors. Existing Cardiology Read fees were corrected for over 1000 accounts and Long Term Acute Care fees identified $80,000 unbilled. These changes are expected to exceed $1M annually in revenue for the client.

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