Process Mapping Your Way to Reimbursement Efficiency and Business Success. Esther Apter, President and CEO MedForce Technologies Chestnut Ridge, NY

Transcription

1 Process Mapping Your Way to Reimbursement Efficiency and Business Success Esther Apter, President and CEO MedForce Technologies Chestnut Ridge, NY

2 CE Credit in Four Easy Steps! 1. Scan your badge as you enter each session. 2. Carry your Evaluation Packet to every session so you can add session evaluation forms to it. 3. Track your hours on the Statement of Session Attendance Form as you go. 4. At your last session, total the hours and sign both pages of your Statement of Session Attendance Form. Keep the PINK copy for your records. Put the YELLOW and WHITE copies in your Evaluation Packet. o Make sure a completed Session Evaluation Form is in your Evaluation Packet for each session you attended. o Miss one? Extras are in a file near Registration. Complete the General Attendance Evaluation Form located in your Evaluation Packet. Fill out the information on the outside of your Evaluation Packet envelope, seal it, and drop it in the box near Registration. Applying for Pharmacy CPE? If you have not yet registered for an NABP e Profile ID, please visit to do so before submitting your packet. o You must enter your NABP e Profile ID in order to receive CE credit this year! 3/26/2013 2

3 Speaker Disclosures Esther Apter has no disclosures or financial conflicts of interest to share. Clinical trials and off label/investigational uses will not be discussed during this presentation. 3/26/2013 3

4 Learning Objectives Your business operates based on a set of rules. How do you manage and control your business processes? Explore the concept of business process management as it applies to a home infusion provider s business model. Learn about the different types of business rules that make up the complete process needed to run your business from human resources, to purchasing to accounts payable and last but not least customer service and billing.

5 Learning Objectives Learn how Business Process Management (BPM) can help your business. Stop bottlenecks before they start Eliminate duplicate steps in processes Streamline your operation to ensure efficiencies and compliance Empower your staff to make decisions based on rules without interrupting you or other managers Explore the benefits of process mapping key business functions.

6 Increase Profits Increase sales without increasing expenses Decrease expenses maintain sales

7 In Order To Survive You Must Reduce costs Improve your ability to support the business Business Process Management is The Secret to Doing More With Less

8 Have You Ever Asked Yourself These Questions: What are my employees doing every day? Could my employees do more in less time? Are processes clearly mapped out to confirm with required procedures? Are all task performed consistently? Are we tracking and eliminating ineffective processes? Have we defined best practices? Have we defined priorities for each task within a process? Have we defined minimum productivity requirements for each task? Are there functions that could be combined or eliminated?

9 What Does Your Process Entail?

10 Process Management Imagine what the world would look like if Henry Ford had not implemented the assembly line concept in making cars? Assembly line End of the Line. The Model T's body is joined to its chassis at the Highland Park plant

11 How Do You Stay Informed? Like This.

12 How Do You Stay Informed? Or This.

13 People are Managed Processes are Seldom Managed 10 People Handling Exact Same Responsibilities Guarantee: At least 6 different ways of doing the job

14 Why?? Different personalities with different strengths and weaknesses Without clear process mapping new employees are trained by someone who might already be performing a cloned and diluted process

15 This is the Way Managers View Their Workflow

16 However, This is the Way Work Gets Done!

17 The Trick is to Figure out the Process

18 And Then Begin to Clean Things up

19 Order Process Before CSR contacts patient to discuss insurance and co-pay After CSR contacts patient to discuss insurance, co-pay and delivery schedule Send to distribution Send to distribution Distribution assigns to truck / delivery Distribution assigns to truck / delivery Driver calls to schedule time slot to deliver Deliver Deliver

20 This is What You Want Everything else is expense

21 Misplaced or Lost Files? 2.7 billion sheets of paper are created daily 200 million documents are filed daily The average document is copied 19 times for faxing, mailing, reviewing by others, etc. A typical office worker spends 40% of their time looking for information I had the patient file on my desk, then Mary took it to copy and Bob took it to fax, and then I lost track of where it went.

22 So practically speaking what does that do for my business?? How much money can a true Document Management system save? Why do I need Business Process Management Tools?

23 Let s Start by Figuring out How to Calculate How Much Paper You Generate 10 New Patients a Day Generate a Minimum of 100 Documents Per Day 1 Intake sheet 1 Referral form 1 Insurance verification form 2 medical documents 1 Assignment of benefits form 1 Supplier standards 1 Equipment training 1 Delivery ticket 1 Other (safety hazard, rental agreement, copay agreement)

24 What Does it Cost to File Documents? Based on 250 work days per year and 25,000 documents per year Paper Filing time for paper documents: 40 minutes per day for 100 documents Cost per Year $2,000 5 minutes to alphabetize 100 documents 15 minutes to create 100 new folders 15 minutes to put the folders in the cabinet for the new patients 5 minutes to put the documents in the folders 40 minutes per day x 250 workdays /60 x 12 per hour (includes benefits) Electronic Filing time for electronic documents: 5 minutes per day for 100 documents Cost per year $250 No alphabetizing No folders to create Auto filing eliminates the need to put the files into the file folders 5 minutes per day x 250 workdays/60 x 12 per hour (includes benefits) Savings $1,750

25 What Does it Cost to Retrieve Documents? Based on 6 cases worked per hour x 250 work days per year =12,000 documents Paper Retrieval time for paper documents: 4 minutes Cost per Year $9,600 1 minute to get to the cabinet and locate the document 2 minutes to get back to desk and copy / fax / review document 1 minute to refile document 4 minutes x 12,000 /60 x 12 per hour (includes benefits) Electronic Retrieval time for electronic documents: 1/2 minute Cost per year $1,200 No getting up from desk No copying No refiling 1/2 minute x 12,000/60 x 12 per hour (includes benefits) Savings $8,400

26 Some Signs That You Need Business Process Management Tools (BPM) Exceptions to rules result in constant interruptions for assistance Lost productivity due to: Inconsistent prioritization and execution Inefficient physical work environment Inability to chance processes as frequently as business demands change

27 Control Processes. Make Sure Bad Debt is Not Hidden in Write Offs.

28 Control Processes. Track and Document Compliance.

29 Infusion Patient Management Process Patient Referal Care Plan Development Discussion with Patient Intake Referral Patient Assessment Nursing Agency Collaboration RPh Assessment CMW AC Assessment Delivery Active Care Plan Assessment Complete Care Planning Team

30 Infusion Patient Management Process Patient Calls CMW Rph & RN Access For Change in Care Plan Weekly Call to Patient End of Therapy Phone Call to Patient Weekly Status Report Discussion with Patient CMW AC Revision Discussion Complete Revise Care Plan Discussion with Patient

31 Control Processes. Ensure Consistency and No Missed Steps

32 Control Processes. No Unnecessary Moving Around The Office or Waiting For The Previous or Next Step in The Workflow.

33 How BPM pays for itself Can you put a value on the following?: A single lost order or delayed order can ruin a relationship with a referral source resulting in loss of revenue A single non compliant order can trigger an audit resulting in thousands of dollars of refunds

34 Success PDPT People Right people in the right jobs Data Metrics Results used to measure and evaluate processes Process Defined, evaluated and manage Technology To accomplish all of the above

35 Do More With Less BPM/S isn t going to cause a massive loss of jobs, replacing people with technology Will shift responsibilities and create more knowledgeable workers Ensure compliance with business rules

36 Questions?? Esther Apter, President / CEO MedFORCE Technologies, Inc