Client Specific Modifications and Improvments with Agility Professional Services
Ask yourself a few questions:
- Are you confident your workflows are based on compliant best practices?
- Is your program running at optimal productivity?
- Do you have a dynamic measurement plan in place (KPIs, dashboard, impact metrics)?
- Are you confident your coding, billing, invoicing, and claims processes create a healthy revenue cycle?
If even ONE of these points piques your interest, click here to hear the entire on-demand recording!
You’ll meet two expert operators of Occ Med businesses who developed industry-leading best practices to consistently boost revenue, improve workflow efficiency, and mitigate legal risk.
Learn how a specialized Occ Med EHR, integrated billing and documentation, revenue cycle management (RCM), KPIs, and expert coaching give you the tools to take control of your Occ Med practice and see real results.
A complete solution takes you all the way from visits and claims through dashboard business metrics—enabling you to spot gaps in your workflow and documentation processes before they impact compliance or your bottom line.
Welcome everyone to the webinar this afternoon. Why did we begin offering this service eight months ago, you may ask? The short answer to this is that we’ve had customers and prospects asking for it. But I want to begin by giving a brief history on 360 Services. Net Health actually introduced professional services to our other product lines several years ago with great success. And seeing that our clients were seeing improvements in workflow and use of the software, we really started to assess if there was need for our Agility clients. Now, while many of us knew that a need existed, speaking with many of our clients confirmed the need for this service. And, my first client proved that that was the case, but I’ll go into that just a little bit later.
Now, when speaking with existing clients, we would hear something to the effect of, “You know we’ve been using the software for several years”, and “have had a little bit of turnover. “We don’t need training, or a refresher, rather, we’d like to know how to better optimize what we currently have based on best practices.” In other words, this isn’t just about usage, but more about process and recommendations on how we can improve productivity. That was one of the main issues there. And then from a potential, or a new customer standpoint we heard, “We are a health system considering Agility Occ Med and/or employee health. We’d like a service not only to help us utilize the software according to best practices, but also offer assistance in determining key, specific performance key indicators in this business. We’d like to have them track for us on a regular basis, and then provide recommendations”, like professional services does in other words. So, they want also someone tied to them during the entire term of the contract who is an industry expert, and can measure, and make recommendations on the true needle movers in this business to ensure our mutual success. Again, this is what a professional services does. And because of these conversations, using what I’ve learned in my many years in healthcare, we decided to go ahead and extend this out to our Agility clients. Which truly brings us to where we are here today.
Now, we do want to get a better idea of where you stand. So, we do have a couple of questions for you. So, do you regularly track your KPIs and use them to identify performance gaps? And as you make your selections, we should have what those numbers look like here. Okay, so it looks like that 78% of you do not currently track your KPIs, and 22 do. So, great, okay. So, we’ll go on to the, we’ll make note of that and go on to our next question.
So the next question is gonna be about chart audits. And, does your organization periodically conduct chart reviews. So, never, not regularly, or yes? Okay, great, there was a lot of yeses. So 66% yes. 22%, not regularly. And, 12% never.
Okay, so great. Now that we know you a little bit better, and we made a note of this, but I wanted to talk to you a little bit more about my background in healthcare. So actually my career really has been immersed in the healthcare industry, 21 years of it to be exact. As a medical assistant and x-ray technician, I worked in all aspects of the patient care areas in clinics that I ran in Tennessee. I decided at some point to expand my capabilities into a more administrative role. After years of medical assisting and medical technician, I wanted to really extend my career. I went on to receive my certification as a professional billing coder. And then continuing on to receive my degree in healthcare management. My goal in that organization essentially was to become the CEO of the company. But, of course, I never told the CEO that I was after his job, or I probably wouldn’t be here today.
With each educational accomplishment that I had, I was provided an opportunity in that particular organization to expand my clinical operational skills. And after many years in varying roles, as the director of marketing in Occ Med, and the director of medical staff, I eventually became the director of operations to healthcare clinics spanning multiple states. But as the DOO, I was responsible for the daily operations of more than 11 clinics, and numerous work sites. I had the background of working in the trenches with the staff to understand from their viewpoint, what they do on a daily basis, and was able to help the organization modify their workflows, and optimize their process to utilize various softwares that we actually had at that time. At some point I decided to change careers, and moving to the healthcare software industry after doing operations in healthcare for many, many years.
Now, regarding the Agility software specifically, as Scott mentioned, I’ve had a lengthy relationship within Agility as we utilized it in several of the clinics that I ran in Tennessee. Now, we originally used four programs at that practice. So, our staff had to have a software for practice management, one for coding the E&M level, for our work comp, and urgent care visits. There was another for printing protocols in maintaining our OccMed business. And then, finally, one for document storage.
So, through Agility we were able to combine all of these into one. Of course, the staff was elated to hear this. I was there from the very beginning as we implemented the software, optimized our workflows, and then for many years thereafter. Now, it suffices to say I’ve had a long loving relationship in healthcare, but I do understand the challenges we encounter in today’s market.
So now that we’ve got my background out of the way, I want to talk about on the next two slides, client specific modifications and improvements that we’ve obtained through professional services. So I wanted to share a couple of best practices that we implemented that improved financial performances of our customers.
So, a client in Rochester, New York had an issue with wait times, and a bottleneck at the front desk that they were unable to identify. During my assessment, I determined that their enormous number of drug screens was clogging up the process and slowing up patient check in. As well, patients were coming in and saw that the lobby was full, and walking out. Although, most of the patients that were there were waiting to be seen for some type of employer service, and it was mainly drug screens. The new patient was unaware and left. Well, of course this resulted in a loss of business for this particular organization. As I walked through the clinic, I observed another area in the rear of the clinic with a separate entrance that would be a better fit for their drug screens. So, I made a recommendation that they separate out their drug screens out from their regular patients. And this meant for them a distinct entrance and processing area for those drug screens. Now, this change increased the number of patients processed and decreased the wait time in the main clinic, as they had dedicated staff, and a designated area to now work the drug screens solely. Essentially this particular bottleneck was eliminated.
Now, one of the most drastic financial impacts came from a client in Iowa. With each of the site visits that I do, I conduct a chart review. During this particular review, I’m looking at charting notes and comparing those to claim form if I have them provided to me at the time of my chart audit. Now, in this particular case I did it, and I was surprised to see the level of low office visits being billed out. As well, numerous charts had inaccurate ICD-10 coding. Now, this was due to, there was a duplicate ICD-10 code, or the initial visit code was showing up on a follow up visit. Of course, these errors were leading to denials for which management and providers were unaware. So, during my time with them we discussed a plan for future communication from the billing department to the appropriate managers on denials. Another portion of the plan was to have the billing manager conduct periodic chart reviews to assess coding errors. Lastly, we were able to determine one of their supplies casting materials was not only not being reimbursed, but it was drying out and being reordered by the staff. And as you know, this is quite a pricey supply to have on hand, and then to discard. So, there was a discussion to eliminate this particular supply completely from the formulary.
Now, outside of the financial impact, clients have been able to see improvement in their processing flow based on best practices that we’ve implemented. My first client in Boston, which I discussed at the beginning of our presentation, had been using the software for many years. However, they felt they were not utilizing it to the fullest. Does that sound familiar to anyone? During my initial assessment we realized rather quickly that they were not really using it correctly, which was causing inaccurate reporting. This was due to years of staff turnover and shortcuts that each new staff member developed, which was resulting in inaccurate data being captured. And of course management wasn’t aware of this, and the reason why the reports weren’t matching up. So what they needed was a retraining. Because this was an immediate need, we pulled their staff together and ran through how to use the software. Now, while this is not typical for one of my visits, their need for training was far more important than anything else on the agenda. As we went through their training, we created a harmonious and fluid patient flow. And, at the end of the day, they were satisfied that their staff had the knowledge correctly, and that reports are now going to be accurate. Now that they’re back on track, they’ve since started using the EMR to capture work comp injuries. So, they’ve made great accomplishments based on what I saw when I was there with them.
Now a client in California originally requested my services, as well as a site visit by an implementation specialist to assist them with training. Because typically my site visits are not specific to training, so we’re gonna pull in an implementation specialist to give their entire staff a complete retraining. During my assessment, I soon realized that there was quite a bit of dual entry across the board, but specifically from the providers. They were documenting in the EMR as well as on the physical form. They were documenting the same information several different area in the software. They were actually using the software appropriately, but this multiple entry was cause for increased wait times. Because management was not able to follow patients throughout the process, they didn’t realize that this was occurring. I worked with them to determine the best areas for documenting specific information which would result in a reduction of dual entry in wait times. Now the results of a bottleneck identified during the lab ordering process between provider and nurses. This didn’t even come out until one of the nurses pulled me aside and said that there was an issue. Of course, not talking to management about it either. By tweaking this process slightly, we were able to decrease the wait time, and eliminate this particular hold up as well.
So, fast forward after my visit, we reached out to the contact with this organization to schedule the followup by the implementation specialist, and we were told that they got everything they needed from my visit. So, the training by the implementation specialist was not longer required. They’re now looking at having me come back at some point later in the year to review the recommendations that we put in place on my first visit with them.
Now, one of my most memorable client interactions wasn’t necessarily because of location, Honolulu. Doesn’t everyone want to go there? But, because of the tremendous improvements made since my first visit. Now, unbeknownst to any of us at Agility, this particular client never officially started using the software. Because of their location, they decided that their initial training and go live support would take place virtually, and they would contact us if any issues arose. After several emails from Agility back and forth to this particular client, we left them in good standings, as all was well on their end. They had everything in place for their go live, but immediately afterwards a drastic staff turnover delayed them from continuing. As well, their parent hospital delayed the approval for an Epic and Agility interface, so they thought they’d be able to go live without it. Well, the hospital felt otherwise. Again, does this ring any bells? Essentially, utilization was at a stand still until new staff was hired and trained, and the interface was up and running that allowed that connection to the hospital to continue.
For all the elements to align, it took almost a year and a half before they were given the consent from the hospital to move forward with Agility. And I know we all understand if we’re working with another entity, like a hospital, it could take some time to get approvals. At that point, they had no idea where to even begin. So, they reached out to us to assist with getting them back on track.
When I was first contacted, I insisted we have a face to face meeting to review their current standings, and lay out a plan for resolution. For numerous reasons, they were hesitant to introduce software, that was not Epic, to their new staff, so we laid out a plan to implement them in three phases. Again, we’re customizing what we’re doing for clients based on their need. Now, the first phase was for them to be able to bill out of Agility, so they’re checking patients in and out so that their biller is invoicing for services. The second phase is to have the clinicians or nurses utilize their portion of Agility, with the provider phase being last. We also created workflows that their team can use as their training materials on their new go live date, as well as training materials for new employees. And with my last check in with them, they had been successful at doing just that, and are moving in the right direction for phase two later this year.
As you probably gathered, every client need is different, but the basics are the same. Identifying issues that cause either results or financially oriented impact on your business. So, ask yourself these questions. What are your wait times? What are the bottlenecks? Is it at the front office, ,or the back office? What does your productivity look like? What is your patient load? And, how can you eliminate unnecessary documentation or paper? Are you maximizing all available apace in your clinic? When considering where to make change, the list goes on and on. Now, while many organizations evaluate this themselves, seeing this through the eyes of an outsider opens up the possibilities of positive change and improvement. By inviting someone outside of your organization in, namely a 360 consultant, you see things as you’ve never seen them before, and you get first hand assistance on the best approach to optimizing your workflows. Which if all goes as planned, will increase revenue, productivity, and decrease wait times.