Centricity Business Enterprise Task Manager
Centricity Business Enterprise Task Manager is a real-time, web-based management tool that analyzes, prioritizes and delivers relevant information to the appropriate individuals for quicker follow-up. Taking advantage of its intelligent, integrated workflows can help you to streamline the billing process, improve revenue cycle efficiencies and increase productivity across your organization.
To address rising costs, shrinking reimbursements and rigorous government regulations, healthcare organizations are re-evaluating their operational strategies. Enterprise Task Manager is a real-time, web-based management tool that creates and displays online tasks to help you analyze and prioritize issues, and make improvements within the existing workflow.
With a focus on enabling accuracy, Enterprise Task Manager helps you:
- Automate routine tasks through built-in intelligence, which analyzes revenue cycle events and automatically triages problems to online work lists, helping to reduce paper and allow staff to focus on high priority activities.
- Reduce questions of missed tasks and 'black holes' with workflows that help provide transparency into the A/R, so management can focus on strategy instead of constant analysis.
- Access relevant resources including clinical documentation, payer web sites, the Internet and intranet, and all Centricity Business functionality to help you accelerate and simplify the workflow.
- Track staff productivity with reports on activities, volumes and actions taken within Enterprise Task Manager, enabling you to monitor staff performance and adherence to established standards and practices. Tasks that are not completed correctly will be returned to the user for resolution.
Enterprise Task Manager seamlessly integrates workflows across multiple Centricity Business applications, including the Transaction Editing System, pre-adjudicated payer edits, post-adjudicated payer edits, and eligibility, providing seamless interaction to drive efficient resolution. For instance, since Enterprise Task Manager is interfaced with Electronic Document Management, important documents and links are built directly into the workflow, reducing the need to back out of the system to complete tasks.
Enterprise Task Manager offers a robust set of integrated workflows to support your organization's efforts to improve efficiency and productivity while reducing redundancy. GE Healthcare has partnered with KAV Consulting to offer you a core set of workflows1 that span the range of claim activities, from pre-visit actions to claim edits, rejections, transaction editing, correspondence and reporting.
Each workflow includes a package of reports that are finalized during design to provide rapid insight into performance. The reporting packages vary slightly between workflows, but most include volume, inventory, and productivity data. The packages are defined to give management key pieces of information to understand workflow activity, help identify trends, drive strategic management and establish productivity metrics. Volume and inventory data is typically reported at the end user level, so individual performance can be tracked, and productivity is always reported at the individual level, so that accountability metrics can be established. The reports are scheduled to run automatically with client defined output formats and distributions. All reports are provided in MS Excel pivot table formats to allow manipulation and drill-through capability of data.
|Pre-Visit Activities||Rejections||No Response Activity||Credit Balance/Refunds|
|Claim Edits||Transaction Editing system||Self-Pay Follow-up||Interface/ADT Edits|
|Claim Payer Edits||Correspondence||Customer Service Calls||Payer Contract Module|
This workflow integrates the Centricity Business Scheduling, Eligibility, and Enterprise Task Manager applications to identify exceptions prior to or upon patient arrival, thereby engaging the patient in resolving issues before revenue is impacted. By building edits specific to your organizational needs you can measure frequency, resolution patterns, and have regular access to the performance of each practice.
Helping you reduce stacks of claim paperwork or combined files, this workflow automatically and electronically sends claim edits that are preventing claim production to the appropriate staff member to resolve. The edits distribute immediately as they occur and begin aging for the owner. Reporting details the aging as well as the individual owners to aid management in planning timely follow-up.
Claim Payer Edits
Pre-adjudicated payer edits or Claim payer edits are analyzed in aggregate to determine the most appropriate follow-up category for distribution. The categories can be utilized as the primary distribution method to increase user familiarity with the type of edits and to help decrease time to resolution. If users make repeated failed attempts to to get the claim accepted then ETM captures the number of failed attempts for management reporting and the repeated edit is escalated to the user with indication that the previous attempt failed. Can be organized into different edit categories so that the work can be distributed to the correct areas for resolution.
Post-adjudicated payer edits, or Rejections, categorizes and prioritizes each rejection code. When a rejection is posted ETM determines the priority rejection and utilizes it and the corresponding category for distribution. Similar to Claim Payer Edits, Rejections keeps track of failed attempts to resolve the Task by tracking repeated Rejections. Rejected invoices remain in the workflow until payment receives, the payer is changed, or the invoice falls less than or equal to $0.00. By keeping the invoices within the flow until true resolution is reached better information is obtained about the resolution process. This workflow allows you to transfer responsibility for rejections (e.g. business office transfers are sent to the charge correction team) while helping to ensure all the work is being resolved.
Transaction Editing System
Prior to invoice creation the TES workflow helps enable clean invoices. Because ETM tracks each edit that occurs ETM is able to report the volume of edits historically for each functional area. The distribution options allows for inventory to be assigned and reported at an end user level. Patient Encounters that require effort from multiple teams can be worked distributed concurrently to expedite resolution. Productivity is measured in Encounters completed and the lag time to completion is captured to help drive performance metrics. Implementing the TES workflow can help you reduce redundant edits, improve your current claims workflow, and provide enhanced reporting.
Correspondence often becomes the immeasurable problem because it remains on paper. Volume, inventory backlogs, and whether users actually work the correspondence is difficult to report. Often correspondence is for invoices that have already been paid making follow-up for specific documents unnecessary. Using Electronic Document Management the documents can be scanned and linked to the appropriate invoice or patient. As they are linked the document type can be leveraged to categorize the follow-up requirements. ETM then creates a Task to manage the follow-up. Depending on the Tasks follow-up requirements ETM may suppress other Tasks until the document is reviewed and resolved or possibly take automatic actions, predetermined by you, to resolve the issue. If ETM identifies that the type of document and the invoice balance make follow-up no longer necessary then the Task is removed automatically. ETM and EDM can turn the immeasurable problem into regular volume, inventory, and productivity reports that detail time to resolution. In Enterprise Task Manager, this workflow routes correspondence to the correct staff, automating actions based on type of correspondence, and enables accurate reporting.
This workflow monitors the invoice as it moves through its lifecycle and determines the points where a lack of activity requires review. Each invoice is categorized based upon its most recent activity. If invoices are pending other exceptions (e.g. Claim Edits, Claim Payer Edits, Rejections, or Correspondence) claims are pending edits, rejections, or correspondence, for which there are other ETM workflow then they are categorized accordingly and suppressed for no activity review. The suppression continues as long as ETM sees that the other workflow Task remains intact. For all other invoices, multiple checkpoints for expected activity occurs and when activity does not occur as expected the Task becomes eligible for review. Users see true exceptions which help increase effectiveness and collection capabilities. Because the workflow tracks and categorizes every invoice it provides a wealth of reporting details of not just inactive but all non-zero invoices. Reporting on every invoice and their appropriate status in the life cycle provides exceptional reporting enhancements.
Self Pay Follow-up
ETM categorizes accounts by dunning level, payment activity, balance, and other client specific criteria to stratify records for strategic follow-up. Management can then assign users based upon multiple variables to drive follow-up efforts into the most productive buckets. Assignments can easily be altered as your strategies shift. Integration points are included for the Customer Service Calls workflow to help ensure that follow-up is suppressed automatically as needed based upon patient calls. Providing the flexibility to pursue collections on accounts that have a high likelihood of payment, this workflow enables the smooth transfer to external collection agencies.
Customer Service Calls
This workflow enables call centers to document calls, perform the required follow-up, and engage other functional areas in the resolution of issues. Each customer is different in how they resolve calls and interact with other functional areas but the workflow allows the flexibility to accommodate these differences. The workflow reporting provides details of the reasons for calls, how calls were resolved, and an inventory of ongoing follow-up activities.
Once an invoice becomes a credit balance ETM begins aging the credit to help you plan timely follow-up. ETM further categorizes types of edits so that unapplied payments and prepayments can be managed differently than insurance and patient overpayments. Identifying credit balance opportunities, increasing the efficiency of the staff and delineating reasons for refunds and enhanced reporting of credit balance aging are all benefits of this workflow.
Incoming interface files may have many different edits that are often allocated to the appropriate staff. If the interface utility cannot be used for resolving these edits ETM can be used to define, track, and resolve issues after the interface has filed changes to Centricity Business. The regular inventory, volume, and productivity data provide benefits above the average interface workflow offerings. This allocation as well as the normal workflow controls will provide an effective tool in managing these edits.
Payer Contract Management (PCM) can be a difficult because of the challenges of keeping contracts up to date, clarifying interpretation differences, and dealing with variances in aggregate. Utilizing ETM for PCM can help alleviate those challenges. ETM analytical ability is leveraged in PCM to automatically categorize resolved variances. If ETM sees that a contract is updated such that a variance is no longer relevant then the variance is appropriately flagged. If a new payment is received that resolves the underpayment then the Task is removed from the workflow and categorical flagged as resolved. Although PCM can have an overwhelming amount of variances, ETM can be used to group records based upon trends. Follow-up can be performed in bulk and details of variances extracted for communication to payers to help increase efficiency. Clients can manage the workflow with minimal staff and a strategic plan to attack large variance trends, or with a large staff and goal to resolve most variances. Reporting details out current variance inventory and volumes but most importantly it categorizes resolved variances to help gain insight into how PCM is helping you drive value. This workflow assists in identifying over and under payments to allow for trending and appeals, both by individual claim and in bulk. Reporting capabilities are the key to the effectiveness of this workflow.
1 Customized workflow solution available upon request.
Centricity Business - Combined Business Office Demo
Watch this demo to learn how you can leverage Centricity Business Enterprise Task Manager to automate and prioritize daily tasks. Enterprise Task Manager gives healthcare providers the high performance revenue cycle capabilities needed to help drive greater profitability and consistent results.
Stony Brook case study
Stony Brook University Physicians reduced paper costs by 40% and reduced Accounts Receivable (A/R) by 11%
St. Vincent Health Case Study
With the help of Centricity EDI Services and Centricity Business - Enterprise Task Manager, St. Vincent Health has reduced cost to collect and lowered days in A/R, while increasing the number of claims per FTE.