Departments of Emergency Medicine, Pathology, Radiation Medicine and Radiology 8/ 14/ 2013 1
Overview : Service/ Hospital-Based I BU The Service/ Hospital-Based IBU comprises of 4 departments that have a total of 936 FTEs. On an annual basis, approximately 69,170 financial transactions were processed and 177 cost centers were active. Departm ents Total # of Departments 4 # of FTEs (faculty and staff) 936 # of Financial Transactions (COM and Hospital) 1 69,170 # Cost Centers 177 1. Financial transactions for hospital activities for Radiology, Radiation Oncology, and Pathology will be implemented in phase 1. Financial transactions for hospital activities for ED will be included in Phase 2. 8/ 14/ 2013 2
Em ergency Medicine Billing Coder Principal Coder Senior Coder Associates (3) Pathology Coder Principal Coder Associate Radiation Medicine Coder Principal Service/ Hospital-based HIBU Adm inistrative IBU Steering Com m ittee Lead Radiology Coder Associates (6 ) Finance/ AP/ All Departm ents HR/ Payroll Finance/ AP Lead Finance/ AP (5) All Departm ents HR/ Payroll Lead HR/ Payroll (2) 8/7/2013 3
Service/ Hospital-Based I BU The Charge • Provide a cross coverage safety net • Integrate and standardize services • Improved service consistency through hiring of subject matter experts at a competitive and market pay rate • Gained efficiencies through function consolidation • Continue to provide excellent internal and external customer service • Cost avoidance/ Cost Savings • Incorporate/ Maintain Best Practices • Prepare Research Activities to move to Sponsored Research IBU The Data • Current COM staffing levels for the four departments are 5.92 FTEs for finance and procurement and 2.31 FTEs for human resources. Approximately an additional 2 – 3 non-COM FTEs handle the activities for Pathology, Radiology, and Radiation Oncology. • Our HIBU proposal is 6 FTEs for finance and procurement and 3 FTEs for human resources to process transactions for both COM and hospital. 8/ 14/ 2013 4
IBU OME Emer CVs GME GME Service/Hospital-Based Med. , Billing & Coding Procurement/Ordering/Accounting Travel/Reimbursement/Reports/Finance HR/Payroll/Other General Actions *On or about 12/1/13 target for Hospital & COM combined for all four and CE education, technical billing review, consolidated support functions, etc. depts ; APT processes; facilities activities, academic IT, , Digital Measures; Milestone reporting for Phase II: Subject matter experts for non-regular tasks: . Time needed to review and plan for hospital portions of P & LM and Legend
Service/ Hospital-Based I BU ASSIGNING METRICS BASED ON BENCHMARKS FINANCE, PROCUREMENT AND HUMAN RESOURCES PHASE I HOSPITAL-BASED INTEGRATED BUSINESS UNIT DEPARTMENTS: 4 TOTAL FTE: 936 TOTAL FTE FOR PHASE I: 694 Proposed FTE range Manager Finance/Proc Account Sr. PR/HR/Mgr Payroll/HR TOTAL FTE Cost Center 1-2 1 1 2 Reconciliation 120-150:1 3-4 4 4 Accounts Payable 15,000:1 2-3 1 2 3 Human Resources 327:1 6-9 0 5 1 1 2 9 Total AP for Phase I 1 46,003 Total Cost Centers 177 Total FTE for Phase I 694 Positions Grade Sal Range FTE Positions Grade Sal Range FTE FINANCE HUMAN RESOURCES Business Analyst 10 $44,429-$67,538 1 Admin Serv Asst, Sr 9 $38,938-$58,906 1 Admin Serv Asst/FI 8 $34,278-$51,605 2 Admin Serv Asst (2) 8 $34,278-$51,605 2 Admins Supp Assoc I 7 $30,326-$45,448 3 1. Phase 2 will add an additional ~ 23,167 transactions for AP transactions for ED hospital side, which will require additional staffing. The total AP for phase 2 is 69,170 transactions. 8/ 14/ 2013 6
Service/ Hospital-Based I BU HR and Financial Transactional com bined I BU structure • Hire subject matter experts to maintain/ improve on service and efficiencies • Ensure that we account for all aspects of the “transaction” not just the “heads-down” keying into the system data entry portion. There is a significant time element involved in the front-end for most of these transactions: Gathering back-up receipts or information o Interaction with staff or providers o Providing excellent customer service: internally and externally o Working with multiple vendors o Working with multiple IT platforms o 8/ 14/ 2013 7
U . rvice/Hospital-Based or about 12/1/13 target for Hospital & COM combined for all four CE education, technical billing review, consolidated support functions, etc. e II: Subject matter experts for non-regular tasks: el/Reimbursement/Reports/Finance urement/Ordering/Accounting end tal Measures; Milestone reporting for processes; facilities activities, academic IT, ayroll/Other General Actions g & Coding e needed to review and plan for hospital portions of P & LM and
Billing and Coding I BU structure Chart Abstractors/Certified Coders in all departments • Cross train HIBU department staff for back-up coverage (FML, VL, TDL, etc. • with limitations due to platforms, CPT and disciplines) Cohort on educational opportunities (CEU’s, Webinars, etc.) • Compliance/Audit backup/Cross-coverage • Computer Assisted Coding rollout • ICD-10 continued preparation and training/credentialing then rolling out to • all of our providers Remote Coding: job satisfaction, space savings, increased productivity and • timeliness: all follow UKHR Telecommuting Agreement Reporting done weekly, monthly and end of year to monitor all aspects of the • Revenue Cycle, Compliance, Denials, Open Encounters and Potential Missed Opportunities: (i.e. ED-Radiology Med Necessity report) 8/ 14/ 2013 9
Billing and Coding I BU structure All coders follow Teaching Physician Rules, Medicare guidelines and Correct • Coding Initiatives 576,718 annual transactions take place on the Professional Fee side • Approximately 2.55 million annual transactions take place on the Technical • Fee side, currently overseen by HIM (excluding Radiation Oncology); it is currently outside of scope of the current IBU implementation Maintaining 97%-99% Compliance rate • Overall KMSF performance • Charges: $93.8 mil which is an 8.5% increase since FY11 o Payments: $29.9 mil which is a 6% increase since FY11 o wRVUs: 523k which is an 11% increase since FY11 o 8/ 14/ 2013 10
Service/ Hospital-Based Billing/ Coding I BU ASSIGNING METRICS BASED ON BENCHMARKS THE HIBU REVENUE CYCLE HOSPITAL-BASED INTEGRATED BUSINESS UNIT DEPARTMENTS: 4 TOTAL FTE: 936 VOLUME DATA PERIOD: FY 13 Coder Encounters Procedures Coder Prin Coder Sr Assoc TOTAL FTE EMERGENCY MEDICINE 63,129 4,420 1 1 3 5 PATHOLOGY 65 92,656 1 1 2 RADIATION MEDICINE 3,005 30,705 1 1 RADIOLOGY 2 382,736 6 6 66,201 501,517 3 1 10 14 Positions Grade FTE Salary Range Coder Principal 9 3 $38,938 - $58,906 Coder Senior 8 1 $34,278-$51,605 Coder Associate 7 10 $30,326-$45,448 14 11 8/ 14/ 2013
Service/ Hospital-Based I BU Sum m ary Finance/ HR/ Coding - Budgeted FTEs/ Salaries Finance/ HR/ Coding - Proposed I BU FTEs/ Salaries Eligible Hum an Coders Total Finance/ AP Coders Total Positions Resources Total FTEs 14.55 14 28.75 Total FTEs 6 3 14 23 Total Total $ 1,160,923 $581,746 $562,258 $1,144,004 $273,561 $156,353 $ 731,009 Salaries Salaries 8/ 14/ 2013 12
Service/ Hospital-Based I BU Leadership • Oversight and management placed under the current IBU Administrative Lead for value added expertise and avoiding replication of an Associate position (IBU Manager). Phase I I • Research - will be included in Sponsored Research IBU • IT • Technical Billing and Coding • Appointment/ Promotion/ Tenure (APT) • Digital Measures • Facilities and Equipment Inventory • ED FI/ Procurement 8/ 7/ 2013 13
Service/ Hospital-Based I BU I n Conclusion • The 4 Hospital-based departments have already been operating at or above benchmark capacity. • Utilizing both COM and Hospital, hiring subject-matter experts at benchmark staffing levels; integrated service efficiencies and greater consistencies throughout the departments should be realized. • The current staffing will absorb both the COM and Hospital transactions. • Billing and Coding in the 4 departments are already operating in the “New Generation” coder status. The proposed coder job family will bring the coders compensation levels consistent with those across the enterprise. • Work with ESC and other IBU’s to standardize all processes and remove obstacles that prohibit the projects from becoming fully electronic. 8/ 14/ 2013 14
Service/ Hospital-Based I BU The Chairs Departm ent Faculty Sponsor : Roger Humphries, MD Emergency Medicine C. Darrell Jennings, MD Pathology Mark Randall, MD Radiation Medicine Elizabeth Oates, MD Radiology The Adm inistrators Departm ent Adm inistrative Lead: Rhonda Sewell Emergency Medicine Sandra Jaros Pathology Susan Durachta Radiation Medicine Lisa Disponett Radiation Medicine Denise Quandt Radiology 8/ 14/ 2013 15
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