July, 2014:

Epic BI Webinar: Building an Effective Epic EHR Business Intelligence Program

Date: Friday, August 8, 2014
Time: 12:30 – 1:30 EST



Successful Business Intelligence programs, including designing analytics teams and data warehouse architectures are imperative for achieving quality improvement, exceeding federal reporting guidelines, identifying opportunities to understand your patient population, and to improve self-service knowledge transfer within your organization. Many organizations are beginning to focus efforts on leveraging patient data more intelligently, including driving financial reporting, chronic disease management and ACO collaboration.

Architecting a plan that leverages Cogito and possibly third party solutions can be a challenge given competing priorities including optimization, MU and upgrade initiatives.

Culbert Healthcare Solutions invites you to join Jaffer Traish, Epic Practice Director, and a special guest, Michael Bauch, Data Analytics Director, from Meriter Health for a FREE webinar on Friday, August 8th at 12:30 pm Eastern for an insightful look into client approaches to building the process, people, technology and culture to drive the strongest Business Intelligence framework to maximize your investment in Epic.



The Importance of Coding in a Revenue Cycle Assessment

Revenue cycle assessment elements: Coding

When most people consider the elements of a revenue cycle assessment, they think of things such as copay collection, denial rates, and bad debt percentages; but the incorporation of a coding review can be just as important to the health of your revenue cycle.

Below are a few items to consider when integrating coding as a part of your revenue cycle review:

  • Who completes the coding for your practice: physicians, coders, or a combination of both?

o   There is no one panacea for all practices, but it is important to review the coding operation for your practice and its effects downstream in the cycle


  • What types of coding denials are you receiving?

o   This information helps focus the review on the specific areas of coding that may need enhancement


  • Do you utilize a claims/coding scrubber? Can/do you build custom edits to comply with payer guidelines?

o   This goes hand in hand with the previous question. If a coding scrubber is utilized and coding denials are still coming through, there may be enhancements needed to the edits currently in place


  • What is the internal feedback loop to physicians and coders for coding related denials? Is it timely and actionable?

o   If there is no feedback, or it is not detailed enough to provide the needed education and improvements, the same denials will likely continue unnecessarily


  • Is there an independent coding audit performed at established intervals to verify coding compliance?

o   Having a ‘second look’ at coding based on the auditor’s previous experience with other clients and payers can bring an added element of education and compliance that may not otherwise be possible.


By including coding as an integral part of your revenue cycle review; you can increase revenue, efficiency, and compliance while decreasing denials and expenses: all desired components of a successful revenue cycle review.

Epic 2014 Revenue Cycle Updates

In Epic’s 2012 version and even more in the 2014 version, Epic has focused on improving the Revenue Cycle making processes more efficient to keep the health of the Revenue Cycle intact. Below are a few items that clients are finding beneficial as they have or are in process of upgrading.

Charge Reconciliation Process

New reports released in 2012 and enhanced in 2014 are crucial to help the operational owners efficiently review the revenue stream and ensure issues are identified and resolved quickly. Some examples include:

  • Inpatient department managers can now be sure that all charges balance, similar to functionality outpatient department managers have used for quite a while. Clients are reporting the benefits of this being available natively in Epic versus a custom report generated for manager’s review. The report is the Enterprise Encounter Charge Reconciliation report and gives more detail than is available in other reports that customers have been using.
  • A new Reporting Workbench Report for Inpatient Note Charge Reconciliation is another example. This report shows physician notes that are missing corresponding charges. This assists in identification of specific users, departments or overarching trends that should be addressed. Because this report is run via Reporting Workbench, it can be available from a user’s Radar Dashboard for quick access.
  • A new Coding Quality Report identifies charges that can be removed from manual review by coders, allowing more time for the most important charge review.


Dashboards have a continued focus across all applications in the 2014 version. As more clients use Epic’s reporting tools, they are constantly pushing for increased functionality and efficiency, especially in this area. Dashboards make monitoring the revenue cycle more efficient and visual, giving users the ability to drill down right to the details.

  • Self-Pay becomes a focus across both Professional and Hospital Billing this release with new components and a dashboard for use in each application. The self-pay enhancements allow clients to manage the metrics with drilldown support to obtain additional detail.
  • Additional sorting capabilities for dashboards have proven helpful for many clients within three of the end of day dashboards HB staff use. The increased flexibility and options for grouping has been beneficial for clients with non-traditional grouping of their revenue cycle staff.
  • The ability for Office Managers to focus staff in the most needed areas has also become more efficient in 2014. The Pending AR component gives insight into all areas of the Revenue Cycle visually, indicating areas that are higher than expected.

Billing and Insurance

  • Many organizations are looking to MyChart for many clinical and regulatory reasons (Meaningful Use requirements, Risk Management, etc.), however, several organizations are also implementing revenue cycle features if those have not been part of their roadmap previously. So clients are simply continuing to implement enhancements available with each version. Many organizations have found success with integration of patient statements, paperless payment options as well as transparency with self-pay amounts and pricing estimates included via MyChart. As patients continue to be technologically savvy, they are requiring their healthcare providers to offer the same type of services other industries offer via the Internet. What we have seen – organizations are responding!

While the items above are highlights for the Revenue Cycle in 2014, there are several other enhancements that clients are taking advantage of based on organizational initiatives for 2014 and 2015.

From ConnectR to Rhapsody-Allscripts Scores with Interface Shift

With ConnectR support being dropped by Allscripts after 11.4.1, a move to its Common Interface Engine (CIE) is now imminent for Allscripts EEHR customers. Although this may be seen as a daunting task by many, the outcome will far outweigh the work needed to get there. CIE is based upon Orion’s Rhapsody suite and is primarily composed of four major parts: the Rhapsody engine, the IDE, web-based monitoring and the EDI toolset.  The engine is the backbone of the system, working in conjunction with the other components to deliver a robust solution that allows for a far more granular approach to interface design than its predecessor, ConnectR.

The Integrated Development Environment (IDE) is a visual development tool that provides drag and drop components for every point of your interface.  It includes support for multiple types of source and target connections and data formats.  Multiple engines can be connected to from a single IDE session and an extremely useful help and reference set is included.

The EDI tools consist of EDI explorer, EDI Message Designer and EDI Map Designer.  All tools are accessible from the IDE or as standalone programs from the start menu.  These tools provide a means for developing and testing your interfaces that was not found with ConnectR. EDI Explorer lets the user connect, send test data and view responses using imported message definitions or new message definitions created in the EDI Message Designer.  Data can be transformed and mapped in EDI Map Designer and scripting can be performed using Rhapsody’s Symphonia language (Java based).

Web-based monitoring is available from anywhere on the domain and allows interface administrators to delegate day to day monitoring and error-handling without giving access to the IDE.  A solid message search feature, notification configuration and user-management are also included.

The reconciler feature, available to be added for error-handling in any route from the IDE, is another feature that gives administrators the ability to separate high level support functions away from the design of the interfaces.  Pushing unfiled messages (unmatched results, items not found in the OID, etc) to the error queue within Allscripts EEHR allows reconciliation and re-filing to be handled without having to give access to any CIE components.

Although tools for ConnectR to CIE migration are still being developed, with the right planning, support, training and time, a successful shift to CIE can be achieved without too many headaches and/or disruptions.  The end result is an interface design tool that will radically improve dataflow between systems in terms of accuracy and manageability and allow support to be handled at all levels of your EHR team.


Can Epic and athenahealth Play Nice?

Culbert enjoyed playing a pivotal role in developing the integration strategy for this engagement.  Please read the article below published in Healthcare IT News