“Reducing denials in advance would improve our income, which could be channeled to current and future investments that support our mission.”
–Joshua Gayman, Income Cycle Manager at UT Medical Center
Challenge
The Medical Center of the University of Tennessee (UT Medical Center) is a 710 -bed acute care hospital with a rich history of exceptional patient care and award -winning services. Duration Pandemia, the hospital faced income losses of around $ 45 million that exercise serious tension in their ability to invest in larger and better facilities. UT Medical Center needed to find a strategy to recover some of these income by reducing claims denials at the time of patient registration.
UT Medical Center was based on chosen checks that often lost mistakes in the patient registry, resulting in greater denials of claims, expensive reservoir and waste time. The hospital urgently needed a solution to help staff identify and solve possible registration errors of patients in real time to prevent denials before they occur. Finding a more efficient way of capturing precise data of patients and benefits would be essential. The proactive prevention claim denials would provide the hospital with a very necessary impulse in cash collections and free staff to focus on patient care.
Solution
To address his challenge of claims denials, UT Medical Center associated with Experian Health and implemented Qa registrationA solution designed to find and correct registration errors in advance. Now, when patients arrive for the first time, Front-End staff enter their data to verify insurance. If the QA registration finds an error, alerts the staff in real time so that they can solve it within 72 hours. Together with more than 400 alert rules selected by Experian Health, UT Medical Center also built personalized alerts based on the specific requirements of the organization, using demographic data and benefits.
The tool is easily integrated with existing workflows, and its configurable board provides UT Medical Center Management Insights on department performance and allows staff to track trends and identify areas for improvement. This proactive approach to correct significant reduction errors The risk of downstream denials and helps patient registration personnel to take appropriate corrective actions for their error without management intervention. The most accurate registration of the patient is also better for patients, since Fer errors make a softer admission experience.
Result
UT Medical Center successfully optimized the patient registration by using registration QA to identify registration errors before and at the point of service, reducing denials and increasing income.
In the 12 months after the QA registration implementation, UT Medical Center saw the following results:
- Now that registration errors can be identified before and at the point of service, UT Medical Center has seen the initial denials of an average of $ 5 million per month in 2022 at only $ 1.7 million in 2023, which represents a 66% decrease in monthly average on initial average.
- Cash cancellations also decreased, falling 57% of an average of $ 1 million by just over $ 400k, which helps the organization to keep the debt incobrable.
Gayman points out that the Association of the UT Medical Center with Experian Health was fundamental for the success of his part. Experian Health shared the vision of the organization and tested weekly support to help perform it. They developed a personalized curriculum to ensure that the staff rely on the control of control of registration control and sacrificed the ideas about what was happening more widely in the industry, so the UT Medical Center team could compare their performance against similar sentences.
Thanks to these savings, the hospital can increase its ability to invest in new projects and offer operational excellence, while improving patient satisfaction.
Discover more about how Qa registration It helps medical care organizations to minimize denials and increase cash flow through the patient’s precise record.