Download Epic Implementation Details Powerpoint

Practice Manager Town Hall
Epic Implementation Details
February 5, 2016
Meeting Objectives
• Provide high level information about the project
• Project guiding principles
• Scope and timeline
• Ambulatory sequencing
• Provide details around transition requirements
• Data migration
• Hardware requirements
• Training
• Readiness activities
• Review a sample of key direction decisions and outstanding
questions
• Registration and scheduling
• Professional Billing (PB)
• Health Information Management (HIM)
• 3rd party vendor overview
• Wrap up and next steps
2
Project Guiding Principles
Guiding Principles I
• The Epic design will be as a single health system on a
single platform (i.e., single MPI, standard workflows
across common functions, etc.) for both Mount Auburn
Hospital and MACIPA.
• Epic Foundation system configuration and workflows will
be the basis for the development of Mount Auburn’s
enterprise standard workflows. The work of others will be
leveraged whenever appropriate through the use of the
Epic Community Library.
• Decisions will be made quickly and adhered to (i.e., will
not revisit without Steering approval) in order to enhance
the team’s ability to meet its scope and timeframe
commitments.
4
Guiding Principles II
• Significant in-person training will be mandatory for
providers, nurses, and other staff in order to obtain access
to the system.
• Functionality will be implemented in a “Big Bang” fashion
as much as possible – most live events will entail the
concurrent cutover of both business and clinical
functionality in a given practice, facility or hospital unit.
• Implementation of new non-Epic applications (e.g.
specialty, best-of-breed software) will be allowed only if
Epic does not have that functionality (e.g. blood bank), or
there are exceptional circumstances not to use the Epic
product (impact on revenue cycle, clinical safety, or other
extreme circumstances). The Epic Steering Committee
must approve exceptions.
5
Guiding Principles III
• Mount Auburn Hospital and MACIPA will go forward in device
technology, not backwards. The goal at go-live is for the level of
device and technology integration to exceed or match the
current environment at Mount Auburn. Additional opportunities
for integration will be examined based on benefit, complexity,
and impact to timeline/budget and prioritized by the Steering
Committee.
• The Epic chart and associated Epic data warehouse will be
considered the source of truth. Because this data is a valuable
asset, defining/managing data governance will be crucial, and
data will protected to the greatest extent possible.
• Issues and risks will be identified and escalated as early as
possible. We will foster an environment where it is acceptable
to raise issues through appropriate channels with the goal of
facilitating and enacting solutions to the benefit of the program.
6
Scope and Timeline
Clinical Applications
EpicCare Inpatient
ASAP
Willow Inpatient
EpicCare Ambulatory
Radiant
OpTime
Anesthesia
Orthopaedic Module
EpicCare Home Health
Beaker Clinical and
Anatomic Pathology
Cosmos
EpicCare Link
Haiku and Canto
Care Everywhere –
Care Epic
Stork
Blood Administration
Remote Monitoring
Inpatient EMR
Emergency Department
Pharmacy
Ambulatory EMR
Radiology System (will also be used by Cardiology)
Operating Room Management
Anesthesia Information Management
Orthopaedic-Specific Ambulatory Module
Care Management for Home Care and Hospice
Clinical and Anatomic Pathology Lab Information System
DWH
Shared Record for Community Providers
Mobile EMR Access
Interoperability Platform with Other Epic Systems
Obstetrics and Labor and Delivery Module
Blood Administration Component
Connection with Patient Monitoring Devices
8
Access and Revenue Applications
Cadence
ADT/Prelude
HIM
Resolute Hospital Billing
Resolute Professional
Billing
Home Health and Hospice
Billing
Name for Epic's enterprise scheduling product. Used
to schedule and track patient appointments.
Short for Admission/Discharge/Transfer. Used by
organizations to track inpatients from their arrival
(admission), to their movements inside the hospital
(transfer), to their departure (discharge)
A suite of products accessed by different groups of
users in the medical records department of a
healthcare organization
Epic's Hospital Billing Patient Accounting product for
clinics
Epic's Professional Billing Patient Accounting product
for clinics
Home Care and Revenue Cycle Management
9
Foundational Modules
Cogito
Pulse and System Pulse
EpicEarth
Identity
Charge Router
Bridges
Integrated Analytics and Reporting
Physician System Performance Dashboard
Social networking platform for all Epic users
Master Patient Index
Router for Charges from Clinical to Billing
Modules
Interface Maintenance
10
The Big Picture
FY 1
Readiness Activities &
Planning
FY 2
FY 3
Implementation Start
(November 2015)
0
Team Hiring &
Certification
Groundwork &
Direction
Workflow
Adoption &
Configuration
1
Outpatient Go-live
(February 14, 2017)
Testing
18 Month
Inpatient Implementation
Wave 1
Prep
(3 months)
2
Inpatient
Outpatient Go-live
(May 20, 2017)
Wave 2
Prep
(3 months)
3
Wave 3
Prep
(3 months)
Outpatient
Go-live
(August 1,
2017)
11
Ambulatory Sequencing
Key Factors in Sequencing
• Promote effective technology adoption and end user buy-
in
• Ensure that Epic design and testing can be accomplished
appropriately for each wave
• Optimize patient care and experience during the transition
• Minimize revenue cycle workflow implications
13
Key Principles
• The implementation will occur in 3 waves
• The hospital will go live during the 2nd wave
• Hospital-tied practices will go live at the same time as the
hospital
• The project team will build specialties individually
14
Specialty-Based Sequencing
Wave 1
Wave 2
Wave 3
February 14, 2017
May 20, 2017
August 1, 2017
Primary Care Practices and
Pilot Specialty Practice
Hospital, Home Health/Hospice,
and Hospital-Tied Specialty
Practices
All Other Specialty Practices
(Including Multi-Specialty
Practices)
•
•
•
•
•
Primary Care
Internal Medicine*
Family Medicine
Pediatric Medicine
Geriatric Medicine
•
Endocrinology and Weight
Management
•
•
•
•
•
•
•
•
Cardiology
Infectious Disease
OB/GYN
Pulmonary
Gastroenterology
Surgical Specialties
Walk-In Center
Radiology
•
•
Pain Management*
Rheumatology*
•
•
•
•
•
•
•
•
Allergy and Immunology
Dermatology
Nephrology
Otolaryngology
Physical Medicine and
Rehabilitation
Podiatry
Psychiatry
Urology
•
Belmont Medical*
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Transition Requirements
Data Conversion
Type of Information
How will I see it once we start using Epic?
Patient Information
Demographics excluding
insurances and guarantors
Current Medications, Allergies,
and Active Problems
Lab Results
• Automatically migrated into Epic.
• Ability to manually reconcile into the patient’s chart in Epic from lists of CCDs.
Advanced Directives and Living
Wills
Immunizations
• Lab results from the hospital will be automatically migrated into Epic for a lookback time
period between 5 and 10 years depending on the lab type
• Results from the past 5 or 10 years (depending on type of test) will be automatically
migrated into Epic.
• Images will not be viewable in Epic. Images will still be in PACS.
• Not migrated – they will be viewable in your old system(s).
• The exception is for pediatric patients. Pediatric vitals will be abstracted prior to go-live from
eCW only.
• Need to be abstracted from hospital charts.
• Automatically migrated into Epic from eCW or athena.
• Automatically migrated into Epic.
Past Medical, Family, Surgical
and Social Histories
Patient Notes
• Histories will be viewable in your old system(s). They will need to be abstracted during the
patient’s first visit in Epic.
• Viewable in your old system(s) - they will not be moved to Epic.
Coverage and Guarantor
Information
• This information will not be moved into Epic since the risk of error and impact is very high.
This information will be abstracted manually for patients who have existing scheduled
appointments after go-live. Moving forward, all patients will need to have their coverage17
and
guarantor information during their first encounter in Epic.
Imaging and Diagnostic Test
Results
Vitals
Hardware
• Teams will assess existing hardware to ensure they meet Epic
specifications
• Haiku and Canto (iPad and mobile phone applications)
Workstation Purchasing Guidelines
Operating System
•
Windows 8.1 Enterprise Edition x 64
Processor
•
•
Intel Core i5-4590 processor (launched Q2 2014)
Or, another fourth-generation Intel processor with a clock
speed of 3.3 GHz or greater
Memory
•
6 GB
Video Device
•
DirectX 10.0 or higher supported
Monitor
•
•
23” widescreen flat panel (1920 x 1080 resolution)
Or, 24” widescreen flat panel for 1920 x 1080 or higher
resolution
Display
•
1920x1080 resolution or higher, 32-bit color
Network
•
Gigabit (10/100/1000) Network Interface Card or equivalent
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Training Overview
Wave 1 registration
opens
2016
Sep
Wave 1 training begins
Wave 2 training begins
Wave 2 registration
opens
Wave 3 registration
opens
Wave 2 GL
Wave 3 training
begins
Wave 3 GL
(5/20/17)
(8/20/17)
Dec
Wave 1 GL
(2/14/17)
Feb
Mar
May
Jun
2017
Aug
• Wave 1
• Begin training registration in September 2016*
• Conduct training between December 2016 and February 2017 (wrap up 2 weeks
prior to go-live)
• Wave 2
• Begin training registration December 2016*
• Conduct training between March 2017 through May 2017 (wrap up 2 weeks prior to
go-live)
• Wave 3
• Begin training registration March 2017*
• Conduct training between June 2017 through July 2017 (wrap up 2 weeks prior to
go-live)
*Training registration usually takes 3 months (secure backfill and schedules)
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Training Approach
5
6
Post-live training helps staff to
continually increase knowledge and
efficiency in the system.
PostLive
3
After initial training is
complete, learners demonstrate
their knowledge with simulation
or question-based assessments.
At Go-Live, end users will
need on the job training to
reinforce what they learned in
class. This is normally at the
elbow or done through tip sheets.
Go-Live
4
Playground Environment
Learners use their elearnings and classroom
training to get independent,
hands-on practice in a practice
environment.
Assessment
Classroom Training
Prerequisites – Core Skills E-Learning
1
Start Here! Learners watch brief lessons to get a
sneak peek at the tools they’ll use as part of their role.
Not intended as a substitute for training, these simply
provide users with exposure to Epic before class.
2
Next is class time. Learners see
demonstrations, participate in followalong activities, and learn the
essential workflows for their role.
20
Training Next Steps
• Vacation considerations
• Role analysis underway – please respond to Liz or
Richard! (due 2/5)
• Critical for appropriate level of training for each user
• Liz Tagen and Richard Cerminara available to answer questions
afterwards
21
Readiness Activities
• Epic Application Subject Matter Expert (SME) meetings
(e.g., Cadence, Professional Billing, Ambulatory,
Orthopedics)
• Smaller group of individuals representing a core focus area
• Used to make decisions, validate build, standardize content, etc.
• Readiness Owners
• Individual owners/contacts for a particular practice, location,
department, etc.
• The Epic teams need your help collecting information
used for build
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Access
Cadence & Prelude
Cadence & Prelude Features
Functionality
Definition
Integrated Registration
Once a patient is registered within MAH, MAPS, and MACIPA,
their demographic, guarantor, and coverage registration
information will be accessible in these encompassed areas.
Scheduling Flexibility
Cadence provides a robust framework to fit your practice’s
scheduling needs and preferences. It utilizes a variety of
scheduling tools to aid schedulers and make workflows simpler
and more efficient.
Real-Time Eligibility
(for coverages)
Electronic verification of coverages within Epic increases prompt
claims submissions and gives organizations time to make selfpay arrangements for non-covered patients. Performing the
verification electronically provides registrars and billing staff with
fast, consistent workflows to document their results.
Referrals
Referrals within Epic are used to easily track authorizations for
outpatient appointments or procedures and document physician
to physician referrals for scheduling and tracking. Authorization
information flows from MACIPA/MAPS to the hospital and across
practices, eliminating the need for dual entry.
24
Cadence & Prelude Features
Functionality
Definition
Schedule Orders
Allows scheduling based on a procedure order entered in Epic.
The order is then linked to the appointment for easy tracking of
results.
Reporting
The Cogito application within Epic provides not only
customizable reports to run your practice from day to day, but
larger reports that can help monitor and manage the health of
your practices.
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DEMO
Key Decisions
Decision
Impact
Cross Department /
Practice Scheduling
Schedulers will be able to directly schedule appointments into other
areas within Mount Auburn and MACIPA. Within Epic there are many
tools and safeguards to make this work, and scheduling remains
essentially decentralized.
MSPQ
Epic can prompt an end user for The Medicare as a Secondary Payor
Questionnaire in a number of ways, but a standard MSPQ will be used
across MAH, MAPS, and MACIPA.
ABNs
Forms the patient signs acknowledging notification (whether they
accept or decline) that Medicare likely won’t cover the service being
rendered. Users will be prompted at scheduling and check in for the
ABN, but providers should also be prompted when placing an order.
Referrals
Sending departments are responsible for acquiring authorizations and
scheduling. Schedulers should be prompted to collect authorization for
a referral at the time of scheduling, to be completed by check-in. If
schedulers continue without authorization, Epic has safety nets that can
be used to catch appointments missing authorization.
MyChart
MyChart direct scheduling allows patients to directly schedule
appointments for themselves in Cadence using the auto scheduler.
Patients can be allowed to only schedule certain visit types through
MyChart.
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Outstanding Scoping Decisions
Topic
Explanation and Questions
Devices
The devices you utilize in your practices today will need to be
incorporated within Epic, and will affect build time and strategy.
- What devices, i.e. scanning or e-sig, do you use in your practice
today?
Patient Communication
Many patient communication tools are optional and we will need to get a
sense of how your practice will utilize them. For example, how do you
reach out to patients with an upcoming appointment?
- Will you use auto-appointment reminders?
Guarantor Account
Types
A guarantor account in Epic stores demographic information about the
person/entity as well as billing information. The Guarantor Account Type
describes the purpose of the account or who is represented by the
guarantor information and are service area specific.
Vendor Selection
We need to verify the vendors and third party services you use as
practices, or what your future vendor plans will be with Epic.
- Will you use third party vendors other than Televox for patient
communication and Emdeon for RTE?
28
Practice Scheduling Strategy
• Kick-Off and Introduction
• Today: Practice Manager Summit
• Visit Type Strategy Sessions
• Two hour long meetings by specialty
• Demo functionality
• Consolidate visit types across organization
• Interview Strategy Sessions
• Meetings grouped by specialty
• Determine practice scheduling build and preferences
29
Next Steps
• Practice Scheduling Customization
• Compile visit types used today by your practice
• Send to OneIS Team by February 19
• Look out for visit type consolidation sessions
• Operational Workgroups
• Referrals
• Cross-Department Scheduling
30
Professional Billing
Professional Billing
Resolute Professional
Billing
• Integrated with patient
access and clinical
applications
• Targeted to specialized
users through the revenue
cycle
• Worklists to identify and
prioritize charges
• Robust functionality to
handle complex specialty
billing scenarios
PB for Community
Practices
• Integrated with patient
access and clinical
applications
• Streamlined workflows for
smaller billing offices
• My Practice dashboard as
single-entry point for all
follow-up
• Shared/standardized
functionality allows smaller
practices to benefit
32
Benefits of Resolute PB
Functionality
Definition
Practice Mode
Streamlined workflows to make the system easier to use at practices with fewer than 10
clinicians and/or fewer than 3 billing staff
• Simplified manual charge entry
• Efficient payment posting
• Slimmed down account maintenance
• My Practice dashboard for revenue cycle follow-up
Benefits Engine
The Benefits Engine is Epic's tool for calculating patient liability. It can be used to
prompt warnings in Cadence, calculate copays in registration, determine whether a
charge is covered in billing, and a variety of other functions. If your organization
decides to use Benefits Engine you must clearly define which pieces of Benefits Engine
you will install.
Front-End Cash Collection and
Reconciliation
Payments can be collected seamlessly in Epic during check-in or check-out. The billing
system uses logic to match the copays to appropriate charges so they do not stay as
credits on your accounts.
The enterprise Cash Drawer module and Deposit Tool allow staff to record information
related to money they collect from patients and reconcile that money against
information received from your bank.
Robust Edit Checking
(including CCI/LCD and Medical
Necessity)
Edits checks can be triggered during order entry, charge entry, charge review and claim
edits to prevent billing of charges that are likely to be denied.
Visit Filing
Order/Retroadjudication
Visit Filing Order allows you to control coverage filing order per visit.
Retroadjudication is the process of automatically voiding and reposting charges
correctly adjudicated based on a coverage change made within the system. All
coverage changes occur automatically and are not routed to retroadjudication
workqueues.
33
33
Benefits of Resolute PB
Functionality
Definition
Payment Posting
Manual payment posting allows staff to specify how to distribute payments on an
account.
Electronic Remittance allows you to receive electronic payments, automatically apply
payments to appropriate charges, and perform payor-specific actions. You can also
access a variety of standard remittance reports that will help you with remittance
processing and following up on the causes for rejected claims.
Statement Design and
Processing
Statements can be generated directly out of Epic and either printed in-house or sent to
a statement vendor.
• SmartText Statements-Designed and maintained by the OneIS team allowing more
flexibility, visual appeal, ad-hoc changes.
• Delimited Statement File-Send a programmatic file to a vendor to input into a
design and print.
• Plain Text Statement-Print on preprinted forms in your office.
Reporting Tools
Epic offers several standard tools designed to facilitate different types of reporting
 Reporting Workbench-Reporting Workbench reports typically have shorter time
frames and fill operational needs on a day-to-day basis
 Clarity/Crystal-Clarity reports typically have longer time frames than Reporting
Workbench reports and involve more complex logic
 Radar-Radar dashboards and reporting homes provide a central hub for reporting
content in Hyperspace. These pages can include sections that highlight important
metrics, link to favorite reports, or open activities such as In Basket.
 Application Reports-Application reports vary a lot in look and feel, because they
are designed for specialized tasks. They are more common in the revenue and
access areas
34
DEMO
Decisions Made
Area
Impact
Facility Structure
One service area will be created for each financially independent practice.
This will ensure financial data is restricted to selected staff.
Payor/Plan structure
Financial classes, payors and plans will be shared between the hospital and
all practices.
MyChart Billing
Ability to pay bills, view statements, set up paperless billing, send customer
service messages.
Benefits Engine
Benefit packages, which control what/how certain services will be covered.
These will be shared between the hospital and all practices.
Workqueue Structure
Private practices using practice mode will use standard workqueue structure
to integrate with the My Practice dashboard.
36
Standardization Needed
Area
Statement Format and
Processing
Impact
Will use a standardized statement template that is approved with the
statement printing vendor. Private practices can customize certain details
such as the logo.
Statement processing will also need to be standardized with the hospital for
MAPS, and is strongly recommended to standardize for private practices.
Payment Posting Options
Payment Posting options, such as small balance write-off and payment
application policies, will need to be standardized with the hospital for MAPS,
and is strongly recommended to standardize for private practices.
Expected Reimbursement
Contracts
Currently, MACIPA manages contracts, therefore these will continue to be
standardized.
Epic Expected Reimbursement Contracts allow you to calculate expected
reimbursement, which can be used to report on underpayments or even net
down AR.
AR Codes
AR Codes are used to track different types of payments and adjustments for
reporting purposes.
These will be shared between the hospital and all practices.
Financial Assistance
Financial assistance options, such as discounts and payment plan policies,
will need to be standardized with the hospital for MAPS and is strongly
recommended to standardize for private practices.
37
Vendor Selections
Area
Vendor
CCI/LCD/Medical Necessity Checks
3M
Claims Scrubber/Clearinghouse
Emdeon
Payment Processing Gateway
Instamed
Statement Printing
SmartSource
Collections Agency
Various
38
Outstanding Topics
Topic
Explanation
Outsourcing –
Scope of
workflows?
Will you outsource any revenue cycle processes? Determine
whether outside users will need access to Epic or if information
will be exchanged through extracts. Vendor access to Epic will
require a nondisclosure agreement and additional training for
third-party staff. Extracts require additional build and testing.
My Practice
If using Epic, will you use the My Practice functionality?
Extracts
Do you require extracts to send any of the following:
• Bad Debt (to collection agency)
• Decision Support (to decision support system/data
warehouse)
• General Ledger (to accounting system)
• Outsourced Active AR (to billing vendor for certain revenue
cycle processes)
• Refunds (to accounts payable system)?
39
Outstanding Topics
Topic
Explanation
Specialty Billing
Scenarios
Do you have any billing scenarios that require special
handling?
Already in scope for certain practices:
• OB Billing (fee for service and global option)
• Global Billing (post-operative services)
• Cosmetic/Elective Billing (non-covered services)
Users & Security
How will we collect user role and user security information from
your practice?
We strongly recommend standardizing user templates as much
as possible across both the hospital, MAPS, and private
practices.
Revenue and KPI
Management
If using Epic, how will you monitor and manage your metrics?
What are your financial goals and how will you maintain
revenue integrity through the install?
40
Next Steps
• Determine if you will utilize Epic’s Professional Billing
module.
• Provide practice contact to work with the Epic billing team
• Complete practice questionnaires and submit to the build
team.
• Engage with the build team for additional system build
requirements, design and testing.
42
Questions/Concerns
• If you have concerns about decisions presented today, or
ones that are being standardized, reach out to:
• Bernadette McCarthy ([email protected])
• Layna Chuter ([email protected])
Deadline: Friday, February 12
43
Health Information Management
Decisions Made
Area
Impact
MyChart
Patients will be able to request records via MyChart and releasing records to
patients via MyChart will not involve a fee.
Legal Medical Record
There will be a standard inpatient summary and standard ambulatory
summary that will constitute the legal medical record.
Chart Correction
There will be a standard written policy for end-user chart correction in Epic.
Scanning
OnBase will be the standard vendor for our Document Management System.
45
Outstanding Scoping Decisions
Topic
Explanation
Release of Information
Will all practices be able to see and release information associated with
encounters across all locations?
Scanning
Mount Auburn Hospital and practice providers will standardize Hyland
OnBase as their Document Management System. Will scanning be
centralized through HIM?
Chart Correction
Will you handle your own patient merging and chart correction cases or will
you centralize through HIM?
Legal Medical Record
Will all practices use the standardized MAH Ambulatory Encounter Report as
their LMR?
46
Release of Information
DEMO
Release of Information
• Release Ownership
• Will practices be able to view and release information from Mount
Auburn Hospital and vice versa?
48
Release of Information
• Billing
• Will each practice manage its own ROI Billing?
49
Scanning
• Centralization
• Will you continue scanning documentation at each individual
location or will you consolidate scanning duties by moving to
centralized locations?
50
Scanning
• Document Management System
• Mount Auburn Hospital and practice providers will standardize
Hyland OnBase as their Document Management System.
51
Chart Correction
• Managing Duplicate Patients
• Will individual practices be responsible for analyzing potential
duplicate patients and merging?
52
Legal Medical Record
• Standardizing the Ambulatory Legal Medical Record
(LMR)
• Will all practices utilize the same standard Ambulatory Legal
Medical Record?
53
3rd Party Vendor Overview
Clinical Impact
Name
Description
Vendor Choice
Drug Database
Provides medications data including drug names, pricing, interactions,
and default prescriptions, including: NDDF Medication files, Dosage
Range Check Module, Drug Interactions Module, and Pharmaceuticals
listing for EpicCare.
Provides mapping between Medispan/Multum and First Databank code
sets, which is required for MU.
Electronic prescription gateway. Also provides patient medication
histories based on patient's pharmacy and prescription benefit manager
responses
Integration of Spirometry and ECG device results into EHR.
First Databank
RxNorm Content
E-prescribing
Devices for ECG
& Spirometry
Clinical Content
Evidence-based clinical decision support to improve quality across the
continuum of care; includes inpatient physician, nursing, and
interdisciplinary content.
Order Sets
Evidence-based order set and decision support content can be provided
directly by vendors.
Medication Reference Medication reference information links that are visible in order entry or in
Information
the MAR.
Patient Education and A wide variety of patient education and discharge reference materials
Discharge Materials
that provide consumer-level education.
Reference Lab
3rd party specimen and pathology laboratories.
First Databank
SureScripts
Midmark
Zynx
Zynx
Lexicomp (Wolters
Kluwer)
Lexicomp (Wolters
Kluwer)
Quest
Quest Chantilly
Ameripath
Converge (Acquired by
Quest)
55
Coding Impact
Name
Medical Necessity
Guidelines
Encoder
Description
Vendor Choice
Real-time edit checks applied by your Medicare payors against 3M
LCD/CCI guidelines
Module that finds and pulls codes such as CPT, ICD-10,
3M
HCPCS, DRG, etc.
APC Core
Provides Claim level APC values on outpatient account claims 3M
Grouping Software and is required if you plan to calculate OP expected
reimbursement through Epic via APCs. It also provides an
additional level of OCE/CCI editing on these claims and routes
them to Epic claim edit work queues.
DRG and APC Pricer Provides Claim level APGS values on outpatient account
3M
claims and is required if you plan to calculate OP expected
reimbursement through Epic via DRGs
Coding Cross
Matches non-coded charges (such as operating room time) to 3M
Reference Table
CPT coding done by coders. The matched codes are used for
claims and reporting.
NUBC (UB-04)
UB-04 codes are NUBC-standardized values used to convey Health Language
Codes
specific information related to the claim. Examples include
(Wolters Kluwer)
value, occurrence, span, condition and revenue codes.
Medical Necessity Real-time edit checks applied by your Medicare payors against 3M
Guidelines
LCD/CCI guidelines
Encoder
Module that finds and pulls codes such as CPT, ICD-10,
3M
56
HCPCS, DRG, etc.
56
Revenue Cycle Impact
Name
Description
Vendor Choice
Real Time Eligibility Automated verification of patient insurance eligibility
Claims Scrubber
Claims
Clearinghouse
Statement Print
Vendor
Emdeon
(Has rebranded as
Change Healthcare)
Automatically analyzes and edits claims based on defined
Emdeon
rules provided by vendor or developed in house to reduce
(Has rebranded as
denials.
Change Healthcare)
Allows for claim transmission to multiple payors that is
Emdeon
maintained by the third party. Vendor provides claim status
(Has rebranded as
files and are able to send us claim error and claim acceptance Change Healthcare)
info back into Epic.
Epic produces rich text formatted statements as PDFs. Most SmartSource
customers choose to send the PDF statements to a vendor for Epic Patient
printing and processing.
Statements
Used to integrate credit card payments via swipe devices and InstaMed
patient portal (MyChart) with EHR.
Payment
Processing
Gateway
Collections Agency Epic can be used for some in-office collections, but customers Various
typically have a separate, outsourced collections agency for
their bad debt accounts.
57
Technology Impact
Name
Description
Vendor Choice
Faxing solution
In-EHR faxing capabilities
Biscom
Document
Management
System (DMS)
Learning
Management
System (LMS)
Issue Tracking
System
Capture content like paper forms, faxes, graphics, photos,
videos and clinical images and makes them available through
a hyperlink within the appropriate Epic application.
Learning Management System Common Learning
Management Systems (LMS) can distribute and track elearnings and other training completion milestones.
System to track issues from testing, Go-Live, and ongoing
support. Improved methods for end users to communicate
issues. Enhanced ability for directors to monitor help desk
performance and efficiency.
Patient Appointment Provides automated appointment reminders for proactive
Reminders
patient outreach.
Epic Media Manager
OnBase
HealthStream
ServiceNow
Televox
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Wrap Up & Next Steps
Handouts
• Data conversion summary
• MACIPA 3rd party billing summary
• Epic workstation purchasing guidelines
• 3rd party vendor matrix
• Epic playbook
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Next Steps
• Training
• Send role analysis information to Liz Tagen ([email protected]) or
Richard Cerminara ([email protected]) by 2/5
• Access, Cadence & Prelude
• Send visit types used today by your practice to OneIS team by 2/19
• Professional Billing
• Determine and communicate plans for future state professional billing
(using Epic’s PB module or a 3rd party) to Layna Chuter
([email protected]) by 2/29
• Complete practice questionnaire and identify point people to
work with the OneIS team during the transition to Epic by 2/5
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Key Contacts
• Training
• Liz Tagen ([email protected])
• Richard Cerminara ([email protected])
• Registration and Scheduling
• Suzanne McHale ([email protected])
• Bernadette McCarthy ([email protected])
• Professional Billing
• Layna Chuter ([email protected])
• Bernadette McCarthy ([email protected])
• HIM
• Bernadette McCarthy ([email protected])
• Ambulatory (Clinical)
• Debi Glasheen ([email protected])
• David Rodriguez ([email protected])
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Questions?