A multi-entity health system consisting of physician practice offices and ambulatory surgery centers was structured as multiple corporations working together to serve their patient population. Each organization maintained a separate database for revenue cycle operations. This required multiple patient accounts for any surgical services provided, an account in the professional practice and one or more accounts when services were performed in the ambulatory surgery centers. This resulted in complicated workflow for schedulers, check-in staff, charge entry staff and revenue cycle staff. Additionally, reporting on total organizational activity required consolidation of data from multiple reports.
An analysis and work plan to consolidate the databases into a single, multi-entity database was performed. The practice management system in use supported multi-department, multi-entity with security features to segregate access and data as needed.
The professional services database was selected as the surviving database and was modified to accept and process the facility services of the ambulatory surgery centers. The changes implemented were to:
- Utilize a new hierarchy level to separate the professional services from the facility services.
- Establish the security settings to segregate data access between the entities to assure accurate billing in the consolidated environment.
- Create the facility based claim formats (837i and UB04), as needed, to meet requirements for the carriers contracted that utilize these different formats.
- Train staff impacted by these changes on the new workflows to take advantage of the new set up.
- Establish a communication plan for the transitional period for patients with services spanning the transition as they would receive multiple bills from the ambulatory surgery centers for services based on date of service.
The effective date for the transition would be the beginning of the new fiscal year for the health system to provide the cleanest transition for reporting purposes. This allowed for the impact of the transition and continued reporting from multiple databases to be isolated to a single year.
Improvement in business operations, patient and staff satisfaction was a direct result of this consolidation effort.