Best Practices: Using Lynx Mobile to Maximize Charge Capture in the Infusion Suite If you need assistance with Lynx Mobile, please call 800.482.6700, option 2, or email msh.techsupport@mckesson.com.
Best Practices: Using Lynx Mobile to Maximize Charge Capture in the Infusion Suite We recently published a white paper titled Value of Technology for Community-based Oncology Practices that presents various metrics and describes technology and processes that are helping practices across the country improve their financial health with an emphasis on complete charge capture and improved reimbursement through automated technology. We ve created this step-by-step best practices guide so you can learn how to adopt the same processes and use Lynx Mobile in a similar fashion as the practices that are represented in the white paper. This will assist you in capturing every appropriate charge in order to achieve full reimbursement, faster. We recognize that there are many types of technology configurations currently available, and some practices have connected Lynx Mobile directly with their billing system and/or EHR. In most cases, these processes apply whether you have connected your systems. The Lynx Mobile support team is available to help you identify specific process adjustments to fit your individual workflow. Using Lynx Mobile to Maximize Charge Capture in the Infusion Suite 1. Start with the SuperBill Report... 3 2. Identify who did (or didn t) receive treatment today... 5 3. Reconcile selected inventory with a quick hand count... 5 4. Validate waste charges... 6 5. Adjust discrepancies... 8 6. Capturing more than drug codes... 9 7. Interfaced? Timing is everything.... 9 8. Give your billing staff the access they need to succeed... 9 9. Compare HCPCS totals between systems... 10 2
1. Start with the SuperBill Report You can run the SuperBill report as a treatment is completed for each patient or you can run the report cumulatively at the end of the day. Your clinical and billing staff can use the SuperBill Report as a quick reference to what has been charged and can quickly see what needs to be adjusted. Instructions for using the SuperBill Report: From the Lynx Mobile home page, navigate to Reports SuperBill Select a date range: Date of Service, Date Dispensed and/or Date Queued Range Select optional search parameters: Patient Name, Patient ID, Primary Physician, Supervising Physician, User Name, HCPCS/Billing Code, Insurance, ICD-9 Code and/or Clinical Trial You can also choose to: o Show Waste Transaction Only, Show NDC Details, Show escript Activity Click In the Report Summary, you can choose Printable details for all days, selected patients/days or this day 3
Instructions for using the SuperBill Report (continued): The SuperBill Report provides substantial detail about the items dispensed through Lynx Mobile. The header for each patient provides patient information, physician, insurance, date of service and diagnosis information. The SuperBill includes: 1. Billing Codes and Billing Unit Totals 2. Billable Units by Dose Dispensed, Waste and Total 3. Item NDC Codes 4. Item Description 5. Amount Used by Dose, Waste and Total 6. Supervising Physician 7. Dispensing User 8. Sequence Number (optional setting in Item Detail used to sort items in reports) Additional options within the report include the ability to: Download to Excel Enlarge the Font Print one SuperBill per Page Print the entire SuperBill report (several per page) Close the Window 4
2. Identify who did (or didn t) receive treatment today Reconcile the SuperBill against a reference that lists patients scheduled for the day for instance, the practice management system schedule, an EHR list of patients with orders for the day or a medication administration record (MAR) report. Hint: Double-check that patients scheduled for treatment who appear on the reference list but do not have transactions on the SuperBill did not receive treatment. 3. Reconcile selected inventory with a quick hand count Hand counting items at the close of your treatment day will allow you to verify that all items removed from inventory throughout the course of the day have been charged out of Lynx Mobile. A full daily inventory is not always a realistic expectation for staff members. Performing an accurate, daily inventory for approximately 10 of your highest-cost agents may be a better solution than an inaccurate inventory of all items. Growth factors should be counted daily and you may also wish to select a handful of other top cost items, especially if those items are in an unsecured (unlocked) location. Instructions for Inventory Reconciliation Hand-Count Inventory Navigate to Inventory Inventory Admin Storage Location: Refrigerator Click then wait for refrigerator to unlock Compare Inv Qty to hand-count of item Repeat process to open other Storage Locations: Drawer A (or other location containing the items you wish to your hand-count) Hint: For single dose vials (SDVs), there should not be any partial Qty listed. Verify that the Partial Qty column shows a zero when you inventory SDVs. 5
4. Validate waste charges Make sure that the process of discarding single use vials is coordinated with evaluation of waste data. Every waste amount physically discarded should have a corresponding Lynx Mobile waste transaction. While taking a hand-count of inventory, verify that waste was charged out for all single dose vials used today and that there are no partial single dose vials in the inventory. Navigate to Inventory Inventory Admin Select a Storage Location Click the Partial Qty column header this will group all partial vial listings together Scroll to bottom of inventory page all partial vials listed should be physically in your inventory (in fridge, under hood, etc.) If a partial vial is listed for a single-dose vial item, you will need to identify which patients were dispensed drug but not billed for waste Navigate to Reports Item Audit Report to determine which patients were dispensed drug but not billed for waste. Select the timeframe waste likely occurred and Patient Activity as the Transaction Type Click Select the item(s) you d like to audit (to select multiple items, click on the first item, then hold down the Ctrl key while clicking on additional items). Click 6
Item Audit Report Navigate to the Dispense menu, search for patient or locate patient in lists on right side of screen. Click UPDATE HISTORY to the right of the patient s name Locate the incorrect transaction and in the Waste column, enter the partial vial amount that was discarded from the vial Click Dispense the transaction from the Queue Hint: Use the Auto-Waste feature to automatically track waste on SDVs to reduce common inventory errors resulting from users forgetting to indicate waste amounts. Locate the item in Inventory Admin, click on item name to get to item detail page, check the Auto-Waste box and click SAVE. 7
5. Adjust discrepancies Ensure that edits to your charge capture documents are done immediately upon the review of Lynx Mobile data. If you use encounter/charge sheets, you will need to make adjustments in Lynx Mobile if: A transaction was missed Waste was incorrectly documented Patient treatments were planned and dispensed but not actually given Taking inventory frequently will make identifying and resolving discrepancies much easier. Correcting errors is easier to accomplish while the day s work is still fresh in mind, especially if your practice staff rotates work schedules throughout the week. Instructions for discrepancies between hand count and Lynx Mobile inventory Navigate to Reports Item Audit Run the report for each specific item that has a discrepancy. For items that come in several vial sizes, you may wish to run the report for all vial sizes, since discrepancies can arise if a user logs a dose out of one vial size in Lynx Mobile but physically pulls a different size vial of the same drug. Hint: The Item Audit Report can also show where an incorrect dose or waste amount may have been charged. Partial vials appear as a + sign. To correct the error the dose should be updated to the correct amount: Navigate to Dispense > locate patient > UPDATE HISTORY 8
6. Capturing more than drug codes If you use Lynx Mobile to capture administration and supply charge codes, ensure that every treatment given has appropriate CPT or Level III code items dispensed. You can review orders and MAR data to obtain time data for infusions/administrations, what the various primary/concurrent/secondary services for each patient should be and enter them into Lynx Mobile. Determine which patient care records should be reconciled against Lynx Mobile to ensure total charge capture. 7. Interfaced? Timing is everything. If you use a billing interface, make sure all adjustments in Lynx Mobile are done prior to leaving for the day. Billing interfaces usually run at night. If some problem is caught the next day or later, make sure to inform the business/billing office since the interface might not send the updated data subsequently. 8. Give your billing staff the access they need to succeed Give billing staff Lynx Mobile reports only access if you haven t already. This empowers non-clinical staff to get the information they need to move forward, while responsibility to make adjustments to transactions remain with the clinical staff/pharmacy. Billers can electronically access up-to-date, comprehensive data (including NDC numbers and billable units broken down by dispense and waste amounts, all necessary for billing). Hint: Navigate to Admin User List to add your billing staff as users to Lynx Mobile. Click the None headers to disable location and Web Site Permissions, then make sure to provide View or Update access to Reports. 9
9. Compare HCPCS totals between systems Lynx Mobile Patient Transaction Monthly Totals Billing Software Monthly Billing Totals Most practice management software systems can generate a charge production report after you ve closed financially for the month. Total units of each HCPCS and CPT (if applicable) should be compared to the totals dispensed through Lynx Mobile to verify that all charges captured in Lynx Mobile have been sent to payers for reimbursement. Close out month financially in your billing software In your practice management system: run Charge Production Report or other report listing total number of billing units billed for calendar month In Lynx Practice Intelligence Reports: run Patient Transaction Report o Navigate to Lynx Mobile > Reports > Lynx Practice Intelligence Reports > Patient Transaction Report o Click the Excel icon to download the Excel version o Choose the HCPC Summaries tab Compare HCPCS Totals to HCPCS Totals from your practice management system report Hint: When you are generating this report, make sure you filter for Dates of Service, not Date Billed to Payer. We re here to help We hope you have found this best practices guide to be informative and useful in your efforts to capture charges in the infusion suite. If you need further assistance or would like to speak with a specialist about your specific workflow, please call 800.482.6700, option 2, or email msh.techsupport@mckesson.com. 10