Patient Access Compass Ensures Medicare Reimbursement

Case study: Houston Methodist Health System

Impact Highlights

Total Dollar Medicare Reimbursement Received in 2012

$43M

Total Dollar Medicare Reimbursement Received in 2013

$26M

Houston Methodist Health System, a five-hospital system in the Houston metropolitan area, utilizes Revenue Cycle Compass and Patient Access Compass together to better manage their revenue cycle from front to back.

Front-end staff are required to ask Medicare patients a series of questions to complete their Medicare Secondary Payer Questionnaire (MSPQ), and without this document, hospitals don't receive any reimbursement for Medicare patients. Using Patient Access Compass on a daily and weekly basis allowed Houston Methodist to track and fix MSPQ errors and ensure reimbursement.

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Reports provide visibility into professional services collections workflow

Opportunity identified

A rule was created in Patient Access Compass to track MSPQ errors, allowing registrars to fix errors quickly so the bill can be dropped and sent for reimbursement.

Work plan/solution

Patient Access directors tracked daily and weekly MSPQ reports to ensure timely follow-up and manage registrar's progress on worklists for MSPQ errors.


Compass automation creates more time for innovation

Strategy implementation

Houston Methodist's dedicated advisor linked Patient Access Compass and Revenue Cycle Compass to allow for easy tracking of MSPQ reimbursement in the future.

Results

Use of error worklists and daily reporting created team transparency and accountability, and the use of Patient Access Compass resulted in $69.4M in Medicare reimbursement for 2012-2013. Front-end education focus and process change led to an overall decrease in MSPQ errors.

Patient Access Compass features:

  • Ability to create unlimited, customizable rules to keep registrars educated on the front-end to ensure registration quality
  • Seamless worklists allow registrars and managers to communicate effectively without one off meetings through the Compass tool
  • Tracking/alerts set to monitor key areas, and identify trends

Next, Check Out

2013 Achievement Award winner: Houston Methodist

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