Departments of Emergency Medicine, Pathology, Radiation Medicine and - - PowerPoint PPT Presentation

Departments of Emergency Medicine, Pathology, Radiation Medicine and Radiology

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Overview : Service/ Hospital-Based I BU

Departm ents Total # of Departments 4 # of FTEs (faculty and staff) 936 # of Financial Transactions (COM and Hospital) 1 69,170 # Cost Centers 177

The Service/ Hospital-Based IBU comprises of 4 departments that have a total

• f 936 FTEs. On an annual basis, approximately 69,170 financial transactions

were processed and 177 cost centers were active.

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• 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.

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Service/ Hospital-based IBU Steering Com m ittee HIBU Adm inistrative Lead

Em ergency Medicine Coder Principal Coder Senior Coder Associates (3) Pathology Coder Principal Coder Associate Radiation Medicine Coder Principal Radiology Coder Associates (6 ) All Departm ents Finance/ AP Lead Finance/ AP (5) All Departm ents HR/ Payroll Lead HR/ Payroll (2)

Finance/ AP/ HR/ Payroll Billing

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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.

Service/ Hospital-Based I BU

*On or about 12/1/13 target for Hospital & COM combined for all four depts . Time needed to review and plan for hospital portions of P & LM and Emer Med. Phase II: Subject matter experts for non-regular tasks: CVs , Digital Measures; Milestone reporting for GME ; APT processes; facilities activities, academic IT, OME , GME and CE education, technical billing review, consolidated support functions, etc.

Service/Hospital-Based IBU

HR/Payroll/Other General Actions Travel/Reimbursement/Reports/Finance Procurement/Ordering/Accounting Billing & Coding

Legend

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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 Reconciliation 120-150:1 1-2 1 1 2 Accounts Payable 15,000:1 3-4 4 4 Human Resources 327:1 2-3 1 2 3 6-9 5 1 1 2 9 Total AP for Phase I1 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

Service/ Hospital-Based I BU

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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.

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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
• Interaction with staff or providers
• Providing excellent customer service: internally and externally
• Working with multiple vendors
• Working with multiple IT platforms

Service/ Hospital-Based I BU

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• r about 12/1/13 target for Hospital & COM combined for all four

e needed to review and plan for hospital portions of P & LM and . e II: Subject matter experts for non-regular tasks: tal Measures; Milestone reporting for processes; facilities activities, academic IT, CE education, technical billing review, consolidated support functions, etc.

rvice/Hospital-Based U

ayroll/Other General Actions el/Reimbursement/Reports/Finance urement/Ordering/Accounting g & Coding

end

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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)

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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
• Payments: $29.9 mil which is a 6% increase since FY11
• wRVUs: 523k which is an 11% increase since FY11

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ASSIGNING METRICS BASED ON BENCHMARKS THE HIBU REVENUE CYCLE HOSPITAL-BASED INTEGRATED BUSINESS UNIT DEPARTMENTS: 4 TOTAL FTE: 936 VOLUME DATA PERIOD: FY 13 Encounters Procedures Coder Prin Coder Sr Coder 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

Service/ Hospital-Based Billing/ Coding I BU

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Finance/ HR/ Coding - Budgeted FTEs/ Salaries Finance/ HR/ Coding - Proposed I BU FTEs/ Salaries Eligible Positions Coders Total Finance/ AP Hum an Resources Coders Total Total FTEs 14.55 14 28.75 Total FTEs 6 3 14 23 Total Salaries $581,746 $562,258 $1,144,004 Total Salaries $273,561 $156,353 $ 731,009

$1,160,923

Service/ Hospital-Based I BU Sum m ary

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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

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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
• bstacles that prohibit the projects from becoming fully electronic.

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Service/ Hospital-Based I BU

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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

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Service/ Hospital-Based I BU

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