Our accuracy within AHIQA across all registrations is running around 88%. This is then translating into a billing system clean claim rate of 84%, up from 62% 18 months ago. This translates into 2 less billers (out of 7 initially).

It has also lead to a reduction in the AR over 90 days from 38% to 20% this month! As bills go out cleaner, fewer get denied and therefore the collectors have fewer rejections/denials to work. The AR over 90 days dropped $8 million for us out of a total gross AR that runs around $98 million. We've collected more cash in 2005 with no more FTEs in a year in which the health system's revenues and volumes were up.  We are now looking to redeploy some of the collectors into other areas as they are not needed in insurance follow-up.

We have also been able to use the AHIQA accuracy percentages to form the basis of an incentive based pay system for the patient access staff. Average pay out was $123 for fourth quarter out of a possible $200. HR loves the quantitative method of determining the payout.

Since the implementation of AHIQA our QA percentage has been maintained to meet our standard of 97% accuracy of all registrations. Prior to AHIQA or accuracy rate was at 90%, we have had a 7% increase.

AHIQA has allowed us to move the QA process from the Verification Department to the front end. This has allowed Verifications to dedicate 3 FTE’s to the outpatient verification and patient financial obligation process, which has increased up-front collections and decreased denials due to lack of precertification.

The Verification Department is now working 70% more outpatient accounts prior to services being rendered. This Department is now also responsible for adding insurance information that is obtained after services are rendered which allows for more accuracy on the back end. They handle approximately 400 accounts a week through this process.

With the Verification Department handling the insurance referrals this has allowed Customer Service to focus on true patient mail rather than insurance related mail.

Less than a year ago our two Training Specialists had responsibility for QA for the 7 hospitals that make up the Baptist Health System.  They were manually checking over 50 indicators per account for 25% of our registrations. 

This took up most of their time.  Other than new employee training, ongoing training and routine duties were pushed to the back burner.

The Patient Access Directors and Training Team began a search for an automated QA Business Partner and after viewing many products we selected AHI.  Within 3 months we went live with our automated QA process.

We implemented the product in October 2005 and started out with QA scores in the 70’s and 80’s.  Last month, January 2006, every facility made their 98% quality goal.

AHI delivered everything they promised.  It is a user friendly service and our goals have been achieved.

We now benefit from 100% QA review.  Productivity results are used for coaching and documenting employee performance records.  Management has access to various reports for trending.  The ‘real time’ functions of this product allows Management to review the number of registrations performed by the PA staff any time during the day.  This is invaluable in coaching and, if needed, for discipline.

The PA staff knows their work is being monitored and they have taken ownership of their work performance, often checking their own scores and announcing when they have an ‘A’.

Aside from the benefits to the upfront side the Training Specialists have been able to return to their primary duties…..training.  They have been able to visit every facility and perform Intake Assessments, provide insurance training classes, all in addition to the routine new employee training.

Our employees participate in an Incentive Plan and quality is worth 75% of the payout with collections making up the other 25%.  AHI QA provides indisputable reviews for this purpose.

Our objectives to provide clean data before the bill drops, improve workflow, positively impact cash inflow and reduce AR days are successful to date.