Wednesday, September 28, 2011

Managing millions of pages of records - how do we do it?!?

Jerry Miller, Spectrum's Director of Operations, talks about the importance of process control when managing millions of pages of documents every month and dozens of projects at any one time.

Process Control begins with a clear definition of the task at hand and the key is to make certain that each workflow stage is reduced to its lowest common denominator.  A laser focused approach provides the best results for the client.

Organization and design prior to moving projects to production is crucial.  In addition to process, having highly trained and motivated staff is critical to the success of any project. We take this a step further and make sure that each individual project always has a project leader. We are never on auto-pilot and our lead staff must constantly inspect/audit results and monitor staff performance.

Pre-Requisite:
Ø       A clear handoff from Sales to Operation
o        What is the deliverable?
o        How is the input structured?
o        Is there a clear and objective method to facilitate document separation and a means to index each document?
o        What is the delivery method?
o        Box Review/Client kickoff
o        Testing and acceptance of proof of concept
Ø       Well trained staff to apply conscientious labor to a task driven / results oriented process

Testing/Acceptance and move to Production:
Ø       We utilize an electronic tracking system to provide an audit trail for chain of custody with an analogue work order for backup and auditing.
Ø       Each box is assigned a unique tracking number.
Ø       The client box number is captured.
Ø       Each box is broken down to smaller batches which are also logged into our tracking system.
Ø       Batch control feeds a controlled process.

Ø       Each project has a unique capture workflow designed from document preparation to release.
Ø       Customer data is utilized whenever possible to automate indexing and for auditing purposes.
Ø       Document separation methodology is employed to ensure files are separated correctly.
Ø       Indexing methodology may be automated by the use of OCR and/or barcode logic. 

Ø       Each project will be refined to best practices for each capture workflow stage: Prep, Scan, QC, Validation, Verification.
Ø       Prep
o        This step helps ensure documents are in good condition and can be auto-fed through the scanner for optimum productivity.  Good prep improves image quality, protects documents, and ensures that the scanner operator can be as efficient as possible.
o        Insertion of document separator sheets, if necessary.
o        Identification of document types, if necessary.
Ø       Scanner
o        Ensure that all information is completely captured.
o        Some QC occurs at the scanner, major issues detected and addressed.
o        Recognition that document separation is occurring.
Ø       QC
o        Quality control can be customized to customer expectation level
o        During QC the results from the scanning process are checked to ensure complete capture, image quality, and document separation.  Image quality is subjective so QC is performed by senior staff. QC is the stage where our level of confidence in our process is validated.
Ø       Validation
o        This is where indexing occurs. Good QC ensures that document separation is accurate. With documents accounted for we now use data entry to key in at least a trigger field.
o        Where is the key field? This determines the degree of difficulty. A good process ensures that the task is kept simple relative to the objective of keying in a value. We may have done something at prep to facilitate data entry or the client documents are often structured in a way that simplifies the indexing process
o        Accuracy of the output is dependent on applying an accurate index on every single document processed. We utilize a number of strategies including field validation, reviewing any auto-generated index values against the document, normalizing data output, auditing against existing customer data, and more.
Ø       Verification
o        Workflow stage responsible for adding a double check to indexing by either double checking or going to the extreme: double blind key with a different team member.

Finally we make sure all output processing has been completed accurately and an accounting of work performed is provided to the client.  By leveraging a set of custom reports we are able to account for every document processed from every box, including batch stats, document indexing components captured, and keystroke totals. Our tracking system provides reports that can be audited back to both the analogue work order and our release database. This ensures a complete audit trail for every step of our process.


Monday, September 26, 2011

Digital Lockbox Customer Case Study

Family Medical Group Case Study

Family  Medical  Group  is  a  family  practice  with  five  providers  that  sees  an  average  of  1,800 patients per month.

Family Medical Group was introduced to SIS NW during our search for a lockbox solution.  We have been on an electronic medical record system since 2007, but we continued to operate our business office in the same manner it had been run for years.  We had paper everywhere!  Our employees  were  constantly  duplicating  work.   What  we  found  with  SIS  NW  is  that  they  went beyond being a lockbox provider.  They took the time to gain an in-depth understanding of our practice and our work flow before offering us a solution.

SIS NW went above and beyond to solve our complex work flow.  Thanks to SIS NW our change from  paper  to  a  paperless  business  office  has  been  transparent.   SIS  NW  took  the  time  to understand our needs and create a plan of action that not only solved our problems, but changed our processes so that we can do what we do best, practice medicine.

In addition to providing a great lockbox solution that has eliminated the risk and potential liability of  having  employees  make  bank  deposits,  SIS  NW  also  provided  a  solution  for  managing  our EOB forms.  Our billing staff used to post insurance and private payments to the patient accounts from the paper forms.  Now they all have dual monitors and post directly from the images.  This provides better HIPAA compliance because there is no chance of patient information being seen while in a pile on someone’s desk or information being taken from the office.

We  have  one  biller  that  works  off-site  that  has  secure  access  to  the  EOB’s  through  a  web browser.  This helps reduce costs for providing office space and allows the biller to telecommute.

The lockbox solution makes it next to impossible to embezzle funds.  All deposits are done off-site  by  a  trusted  third  party  and  all  postings  are  also  done  off-site.    Any  authorized  user  can review deposits, check copies, and EOB’s from their PC.  All user activity can be easily audited which is a huge benefit.  We can easily see who has accessed patient information and the date and time of all user activity is automatically recorded.  The search functionality SISNW provided makes it incredibly easy to locate an EOB.  We now have all of our records electronically backed up off-site for disaster recovery purposes.

The  increased  efficiency  can  be  directly  translated  into  time  and  money.    We  were  able  to eliminate  one  staff  person  and  drastically  reduced  our  expenses  for  off-site  storage  and  paper and filing supplies.  We no longer have to pay salary and mileage for employees to make trips to the  bank.    We  have  calculated  that  our  annual  savings  are  over  $50,000  per  year.    That amounts to an extra $10,000 per doctor in earnings each year.  The space we’ve saved will allow us to add two additional practitioners.

We  no  longer  have  the  archaic  business  office  where  employees  spend  time  opening  up envelopes,  standing  by  a  copy  machine  making  paper  copies  of  checks,  spending  money  on “paper products” to produce “paper batches” and most importantly traveling outside the office to go to the bank.  We now manage our accounts receivable without ever having to get up from our desks.   We  also  have  a  more  “green”  workplace.   It  was  the  most  painless  and  transparent workflow change I have ever experienced.

SIS NW is not only our lockbox provider, but our partner at Family Medical Group Northeast, PC

Keirene Adams – Practice Administrator