Connecticut Children's Medical Center Insources Revenue Cycle Activities While Integrating New EHR
Connecticut Children’s Medical Center (CCMC) and Huron worked together to design and deploy the training, processes and technology necessary to insource revenue cycle operations while simultaneously preparing the organization for a conversion to a new electronic health record (EHR) platform. Improvements in patient financial services, productivity and quality, access, charge capture and managed care contracts integrated seamlessly with the new EHR platform delivering significant financial benefit and value to CCMC.
Challenge
Having historically outsourced a significant portion of its revenue cycle functions, CCMC sought to bring more of the hospital’s revenue cycle activities in house. CCMC also planned to implement a new electronic health record (EHR) and needed to ensure that process improvements to the revenue cycle would support the EHR conversion.
Approach
Huron collaborated with CCMC to design and implement the infrastructure needed to efficiently insource revenue cycle processes, while ensuring smooth integration with the EHR conversion.
Insourcing patient financial services. Huron supported CCMC’s insourcing of all patient financial services, including billing and A/R follow-up and installed proprietary reporting solutions and workflow technology to track key patient access performance outcomes.
Increasing productivity and quality. The implementation of a new revenue cycle operating structure with clear benchmarks and productivity standards for staff yielded 2.5 prospective follow-up FTEs and an 80 percent increase in productivity.
This allowed CCMC to increase coverage of A/R work and enabled patient access staff to work five days ahead of service, an industry best practice.
Re-engineered patient access. Huron implemented improvements to insurance verification processes that document notification, verification and authorization of benefits. These changes resulted in an increase in insurance verification to 98 percent of insured patients.
Improving charge capture and managed care. Charge capture practices were improved across the emergency department and observation services through nursing education and step-by-step management of a managed care contract renegotiation, all of which generated significant financial benefits.
Preparing for EHR conversion. In preparation for a planned EHR conversion, the project team worked closely with CCMC and the EHR vendor to ensure that Huron’s revenue cycle tools integrated seamlessly with the new system. The continuity of Huron’s tools through and after the EHR implementation also allowed CCMC to stabilize rapidly after the conversion.
Connecticut Children’s Medical Center is a nationally recognized, 187-bed not-for-profit children’s hospital serving as the primary teaching hospital for the University of Connecticut School of Medicine Department of Pediatrics.