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Why Should I be Concerned About the QA of My Registration
Data?
Ensuring the accuracy of your registration data (i.e., insurance
plan codes, policy numbers, guarantor address information, and many other
fields) will result in fewer denials, rejected claims, returned statements and
other delays that impede the collections.
Why Do I Need to Examine Every Registration Record?
Every registration record has potential errors that could produce
an inaccurate claim or delay collections in some way. If you miss registration
records with errors, you will miss the opportunity to eliminate the subsequent
manual efforts needed to research problems, correct information and re-bill the
account. Cleaning up data on the front end also allows you to ensure the
accuracy of data that will flow to your Decision Support and other downstream
systems.
Why is AHI QA Such a Unique System?
The “Business Rules” function provides flexibility in defining
parameters and allows you to tailor the error checking logic to meet specific
needs. The Demographic Address Checker uses the U.S. Postal Service database to
identify and correct errors in the guarantor address fields. This automation
allows you to review more accounts with greater consistency and fewer FTE’s.
AHI QA contains a complete reporting function with everything from an Executive
Summary to detailed Employee Error reports.
How Does the AHI QA System Work?
Registration data is imported into the AHI QA system which has
been configured with your Patient Type, Financial Class, Insurance Plans and
Business Rules tailored to meet your needs. Your QA staff signs into the system
and reviews each account for errors highlighted by the Business Rule logic or
the Demographic Address Checker. The appropriate corrections are entered and
the account is then “processed.” Corrections data may be entered back into your
registration system by the QA staff or by the individual registration areas as
you desire.
What Kind of Productivity Gains Can Be Realized With AHI QA?
One FTE can process 500 accounts, or more, per day using the AHI
QA system. Fields containing errors resulting from Business Rule logic and
Demographic Address Checker are highlighted so you don’t have to search for
them. This allows your QA staff to process more accounts with even more
accuracy because they won’t overlook fields that are in error.
What Benefits Will I See After Installing AHI QA?
Benefits will depend on how well you exploit the functions of AHI
QA but the list below are some that all clients can realize:
Error identification and reporting one day after registration
(before claims are submitted)
Error tracking at a departmental or individual employee level
ensures training efforts are directed where most needed
Requires just one FTE to ensure effective QA versus two or three
currently found at most hospitals
Requires just one FTE to ensure effective QA versus two or three
currently found at most hospitals
Reduced error rate on front end reduces percentage of rejected
claims and helps improve your contractual receivables
Feedback to individuals making errors allows improvement and
helps to identify training requirements
Flexible Business Rules definition process includes the ability
to link rules to specific insurance plans
Quick and easy reports generation that help you identify, track
and manage problem areas at all levels
QA reports provide both statistical and graphic representation of
the data for easier analysis and evaluation
Return On Investment in twelve months or less
What Benefits Will I See After Installing AHI QA?
AHI QA has a variety of reports that allow the user to track
errors made during the registration process. Reports are generated at three
levels to facilitate effective analysis and use: Executive, Manager and
Supervisor. The reports function allows for daily, weekly and monthly roll up
to ensure all departments are meeting targets. Employee reports identify
problems at an individual level and help direct counseling and training
activities where they will do the most good.
What Impact Will AHI QA Have on My PFS Performance?
Using AHI QA, the quality and timeliness of claims to insurers
will improve and so will your cash inflow and average AR days. As you receive
fewer denials and errors requiring research, correction and rebilling, your
staff has more hours to perform their primary functions. As you ensure accuracy
within registration data, you will have fewer errors in contractual allowances
and a more accurate view of your actual A/R.
What Impact Will AHI QA Have on My Patient Access
Organization?
AHI QA’s reports will allow you to provide faster and more
consistent feedback to your registration clerks, supervisors and management
team. The database contains all the original registration data as well as
corrections, so each person can see their own errors. Management reports allow
you to view error rates overall and by department to analyze problems and help
identify training requirements.
What Impact Will AHI QA Have on My QA Team?
Armed with a fast and effective tool, quality assurance staff
members can conduct a thorough review on every account. The QA business process
can now perform at optimum speed and efficiency. AHI QA can also help you to
determine problems inherent in your existing business processes and systems
What Technical Environment Does AHI QA Run In?
The AHI QA program uses an Enterprise SQL Server back end and a
familiar web browser front end interface for users (e.g. MS Internet Explorer).
The application and database can be installed on a server within your network
or may be hosted by AHI and accessed via the internet.
Do I Have to Invest in Hardware to Run AHI QA?
Most hospitals already have an MS SQL server in their internal
network and do not need to purchase hardware to install and run AHI QA.
What Has to Occur on the Client (workstation) Side to Access
AHI QA?
No changes are necessary to the workstations that will access AHI
QA from your intranet.
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