There are numerous issues which must be taken into consideration when determining staffing needs for supporting a practice management system which is being sunsetted. Quite often there is substantial volume being passed through the system for several months after the transition from old system to new system has taken place. Late filing of old charges, follow up and rebilling of existing AR can result in the same volume of issue reporting which existed prior to the switch to new systems. Data files must be maintained and updated, user logons supported and claim forms and electronic exchanges must be modified in accordance with payer requirements. In addition, mandates such as v5010 and ICD-10 must be taken into consideration even though the system is being wound down. These mandates are date sensitive and do not take into consideration that they are tied to an old system. As a result there are several consideration which need to be considered when trying to determine the amount of staffing and specific skill sets needed to support a legacy system.
Overall application support must be provided in order to resolve day to day issues which arise. This includes: changes to incorrect data files, problems with end user security and system errors which periodically surface which may require vendor intervention in order to be resolved. These tasks may result in the management of a series of external systems which are used to track statuses on the various issues reported.
5010 –electronic exchange expertise
With changes to ANSI standards which are in process there may be spin off project such as the conversion of all exchanges to the v5010 format in order to meet compliance requirements. As part of follow up on old and existing claims, the submission of these claims must be compliant with newer versions for those claims which are resubmitted electronically. Implementing this process may require a small team of EDI staff working on an aggressive timeline for a limited period of time in order to get this accomplished.
Operation/production staff to support on-going operations
There are numerous considerations for production and operations staff with regards to spinning down an old system. Although the volume will steadily decrease, there is a continued need for both electronic and paper claims submissions to continue as part of AR spin down. In addition, electronic eligibility checking is still likely to take place in the back end office setting as part of follow up processes so these queries and payer check processes must be maintained as well.
Method for converting data to outside vendor
In the back end setting, after all billing efforts have been exhausted, remaining invoices (both insurance and self-pay receivable) are generally sent to an outside company (receivables management/collection agency) as a last stop along the way prior to writing off any residual balances. IT staff are generally responsible for delivery of this data. Depending upon the database size and number of unpaid invoices IT may provide a “data dump” of information to this company. This may be completed by creating flat files from the old system to be converted into a format by the outside vendor. In addition, many organizations are allowing access to their old systems by the vendor to simplify the receivable spin down process.
The above considerations are just a few things to keep in mind when trying to determine specific skill sets which will be needed from a staffing standpoint when preparing to wind down an old system. When planning for a system conversion it is recommended to keep maintenance costs of the legacy system in mind as system support will be required for up to a year post conversion.