Workqueues in Epic provide powerful functionality to keep business operations running smooth. Epic’s revenue cycle users depend on efficient, streamlined algorithms to organize, prioritize and drive information management and follow-up.
Different workqueue types include Charge Review, Charge Router, Claim Edit, Credit, Remittance, Claim Follow-Up, Retro Review, Patient, and Accounts. Each workqueue type will serve to hold problematic records at different stages of the revenue cycle. Improved workflow efficiency, reduced lag time between manual corrections and faster issue identification are all possible – if your workqueues are setup correctly!
Most organizations build workqueues using Epic’s Model System rules in combination with “home-grown” coding and payor-specific rules that impact registration and reimbursement. The effectiveness of each workqueue depends on the quality of the rules that identify records for follow-up. The most effective organizations are committed to maintaining and optimizing their workqueues to meet evolving organizational, coding and/or reimbursement changes.
Some of the more common challenges faced with maintaining workqueues include:
- Poor understanding of payor requirements that leads to inadequately written workqueue rules
- Identifying the most appropriate workqueue for an error
- For example, Registration errors should land in a patient workqueue for resolution by front office staff. This allows charges to enter the system with clean demographics and insurance data, allowing for improved processing in the revenue cycle.
- Optimizing auto-processing functionality within the workqueue allowing the system to resolve errors without human intervention
- For example, building criteria for Credit workqueues to automatically match undistributed payments with open charges is possible.
Build can be as simple or complex as desired. The most successful organizations are committed to continual review and maintenance of their workqueues, learning from past failures while striving to improve the efficiency and workflow of its users.
Have you received feedback from end users that can be incorporated into your support process? Is it time to give your Workqueues a check-up?