Culbert was recently engaged to assess an existing GE Centricity Business system, struggling with some post live revenue cycle challenges. An analysis of both system and operational workflows was conducted in order to identify opportunities for improvement. The customer’s Centricity Business system had been installed over a year previous to our engagement and tremendous growth in the past year had left the client with a system design that no longer accommodated the organization. New CBO leadership teams were also struggling to learn the system and recognize its potential. Culbert consultants employed several assessment tools to help the customer understand what was hiding under the rocks!
- Errors or omissions at the front-desk of a medical office can have a significant impact on the overall accounts receivable. Observation of front-desk operations often reveals workflow disparities within a practice and across the enterprise. Documented policies and SOPs (Standardized Operating Procedures) are essential to maintaining consistency with operations and provide practice managers with mechanisms to enforce protocols and audit performance. System training must be reinforced with enterprise-wide guidelines with expectations for work assignments. Training manuals should be workflow-based and provide direction for completing tasks and remedial training needs should be addressed promptly.
- Staff and management interviews should be very informal in nature as they are simply information gathering exercises. Interviews are the components of an assessment that can tie up loose ends. Even when an issue is discovered by reviewing the application build or by analyzing reports, it is the interviews with staff and management that usually provide the reasoning behind the current design – and provide clues for how the design can and should be changed to accommodate current and future needs.
ANALYSIS OF REPORTS AND APPLICATION DESIGNS
- Thorough analysis of system reports and application designs will pinpoint functional areas and workflows that require remediation. Evaluation of the system’s core dictionaries is crucial to understanding current obstacles to optimal functionality and potential limitations to implementing necessary system changes. As the saying goes, the best-laid plans of mice and men oft go astray… In this case, the original dictionary designs could not accommodate the current conditions and required updates.
INTRODUCTION OF WORKGROUPS AND/OR COMMITTEES
- System solutions require a close partnership between CBO management teams and the IT department responsible for supporting the revenue cycle systems. The CBO and IT teams should meet regularly and use an “Open Tickets Review” spreadsheet as a working document that can provide a concise listing of open tickets – including assignees, status updates, and next steps – that will facilitate consensus and escalation of issues with the IT support team.
- Oftentimes, customers already understand that there is a need to bring internal teams together to work through outstanding issues, but an external source can serve as the impetus of change. If not already in place, a Revenue Cycle Governance Board should be established with clear accountability and decision-making authority for key revenue-cycle functions.
PROJECT TOOLS AND DOCUMENTS
Preparation of several tools and documents can assist with maintaining project organization, complying with timelines and milestones, and completing deliverables.
- Project Timeline
- A high-level bar graph representing the overall schedule of the project will set expectations and allow the customer to arrange for appropriate resources.
- Project Plan
- A Project Plan should contain the specific tasks to be completed for each phase of the engagement and include assignees and due dates.
- Client Data Request List
- Information about the client’s organization, the current design of their PM system, and copies of existing policies and procedures will be needed to proceed with an investigation and model specific Project Plan tasks.
- Project Snapshots / Executive Status Summaries
- The customer’s leadership team will request periodic snapshots of the current status of the project. This update can be a bulleted list of project milestones in stoplight format (green/yellow/red) that also highlights any issues posing risks to the timeline.
- Assessment Report
- The final assessment report should be prepared in a professional format suitable for presentation to a customer’s executive committee and contain sections that identify the original purpose of the project, all findings, and recommendations.