Time for Spring Cleaning!

Categories: PMG Insights Blog

April 14, 2014

Time for Spring Cleaning!

Here in New England the weather has started to warm up.  It will be close to 60 today which for some of you is warm and others is cold.  My plans for the weekend are to open the windows, put away winter and bring out spring.  One of those tasks includes than annual shift in the closet of cold weather clothes to warm weather clothes.  This includes an evaluation of each item – will I really fit into those pants this year, is that color going to be back in style this year, did I even wear that shirt last year or even the year before, etc.  Sometimes during this tedious process I get rewarded by finding money in a pocket!

Often times we don’t think to do this same process at work.  How many times have you heard “that’s the way we’ve always done it” or “we have been doing it that way for as long as I can remember”.  If so it’s time to open up your “closet” and dust off and evaluate your processes. 

This task can be just as daunting as spring cleaning!

  • Where do you start?  If you don’t have formal process documents, pick some processes to review or pick a specific part of the Revenue Cycle to evaluate.
  • What process should you focus on?  Have your staff complete a time study.  Identify those processes that are taking the most time.

 

When evaluating the processes you will need to ask yourself some questions (similar to me deciding what stays and goes in my closet!).

  • Why are we performing this process?
  • What is the end result of this process and are we being successful?
  • Is the process still appropriate?  Often times we create a process due to a “fire” that was burning.  Does the issue still exist? 
  • What is the cost benefit of the process?  If we stopped doing this process or took out some steps what would be the risk?

The most important question to ask is can we do this in a more efficient manner (this is where you might find some money in your pocket!).  Focus on the “work arounds”.  Work arounds are those extra steps staff has to take because they don’t appear to have a system solution.  For each work around identify the reason.

Is the work around payer specific?  Are you doing something different for a specific payer and if so why?  Review the payer manuals and communications to determine if there have been any updates that address this process.   One such process we typically review is claims that continue to go out on paper.  First we identify if the reason for this is related to the payer’s process.   If not, we then focus on the system set up.

Is the work around due to a system limitation?  This is often over looked or not pursued as diligently as possible.   This is a particularly good time to review these areas as many of you are making system upgrades due to ICD10.  If it’s been awhile since you upgraded, take a very detailed look at release notes particularly at any enhancements and fixes that have been put into place.    The reasons for your work arounds may have already been resolved.

Don’t be shy about asking for help … which I end up doing during my spring cleaning!  The more hands and brain power the better.  Utilize your peer groups.   I often find myself asking “how do others handle this issue – we can’t be the only ones struggling with this issue.”  The answers are out there, all you need to do is you ask.

Much like spring cleaning all this appears to be a big challenge to take on and can easily be put off!  However, think about how you feel when that closet is all organized.  You know exactly where everything is and perhaps along the way you found some money in your pockets.