The Cerner  Experts

®

Helping our clients
save 
millions

$19.2 Million Found

Challenge

One large Southeast Hospital noticed its revenue was millions of dollars less than expected three months following a complete implementation of Cerner® Millennium, including Patient Accounting. No one could find what caused the dip and the revenue team was losing trust in the newly implemented EMR system.

 

Discovery

Using the Charge Integrity Control inside our proprietary Panther technology, Softek’s Revenue Consulting team had instant visibility into missing charges. The Control instantly identified nearly $4.8 million in lost revenue that other analysts had missed for three months, including:

 

  • $3.8 million in 16 different orderables in Blood Bank and General Lab that never posted a charge. One lab test was ordered – and not charged – nearly 20,000 times.

  • $1 million in General Lab and Anatomic Pathology orders that sometimes charged, but not always. Our Control showed that all the missing charges came from the same location.

 

By drilling into the data, our Revenue Consulting team discovered that the no-charge orderables were the result of build issues and the inconsistent charging was caused by a workflow design issue.

Results

Correcting the build and workflow issues stopped revenue leakage that would have totaled $19.2 million annually.

Client:

Large Southeast healthcare organization

When Softek Engaged:

3 months post-conversion

Technology Used:

Panther’s Charge Integrity Control

Issues Fixed:

Application build and workflow design

$3 Million Found

Client:

Southern academic medical center

 

When Softek Engaged:

6 months post-conversion

 

Technology Used:

Panther’s Charge Services Reports

 

Issues Fixed:

Application build

 

 

Challenge

Revenue at one Southern academic medical center was down six months after going live with Cerner® clinical applications. No one could find the source of the drop.

 

Discovery

Softek’s Revenue Consulting team used reports within our Panther Charge Capture technology to quickly locate the source of this six-month-old problem. Among them, the Pharmacy No-Cost Ingredients Report showed 30 days of data and identified 17 pharmacy ingredients that did not have costs defined but were being ordered on a pricing tier that referenced specific costs.

Results

The client corrected its system build to add in costs for these ingredients and allow them to begin charging. The correction of just 17 charge items stopped revenue leakage that would have totaled nearly $3 million annually. The client also manually corrected these charges for the previous 30 days and was able to recover $250,000.

$2.5 Million Found

Challenge

Revenue at one Midwest regional medical center was down six months after going live with Cerner® clinical applications. No one could find the source of the drop.

 

Discovery

Using the Charge Integrity Control inside our proprietary Panther technology, Softek’s Revenue Consulting team had instant visibility into charging gaps within each department. In Radiology, our team noticed that even though all procedures had charges, some were much lower than the expected average price. Drilling into the data revealed that the procedures with low charges were charging inconsistently. The accurate price included two charges, but some orderables were missing their second charge, which was a technical one. Softek identified 10 different orderables with a manual change to the technical tier that had led to this missing technical charge.

Results

The client corrected the build in its technical tier to allow it to post charges. The correction to these 10 orderables stopped revenue leakage that would have totaled nearly $2.5 million annually. The client also manually corrected these orderables for the previous 30 days and was able to recover $206,000.

Client:

Midwest regional medical center

 

When Softek Engaged:

6 months post-conversion

 

Technology Used:

Panther’s Charge Integrity Control

 

Issues Fixed:

Application build

$1 Million Found

Challenge

The charge build for orders at Cerner® clients is very complex. Using charge tier logic, clients must determine how to charge for each orderable which can vary by such factors as locations and encounter types. While most clients and consulting companies believe revenue issues stem from the billing side, Softek understands that most mistakes happen well before charges are sent to billing.

 

Discovery

During our engagement at one health system in Florida, we noticed issues related to orders not posting charges and orderables that sometimes posted charges, while other times did not. Softek classifies these as “No Charge” orderables and “Inconsistent” orderables. Inconsistencies like these will never be seen if you are auditing the billing side, but using our Charge Integrity Control, Softek’s Revenue Consulting team had instant visibility into these charging gaps. Our control helped identify which orderables had missed charges and for which patients they were occurring on.

 

With this control, we identified inconsistent charging within the Gen Lab. One orderable was completed 6,374 times in one month but missing a charge 2,923 times.

 

After meeting with the Lab department, it was determined that this orderable was indeed chargeable. Looking further, it appeared that it classified as “inconsistent” because at the beginning of the month it was charging as expected. However, sometime in the middle of month, a change was made, and it was no longer posting charges. These orders were all missed due to a change in the charge point mid-month.

 

Mid-month, the charge point was changed to “Collected” when it should have been “In-Lab.” The In-Lab status is a mandatory status for an order to be completed, but the “Collected” status is one that can be skipped. Because this orderable was not hitting the “Collected” status, it never was posting charges (nor was it suspending).

Results

With all the no charges, the 3,439 orders led to around $84,600 in missing charges in one month and would continue indefinitely until fixed.

 

The Softek Revenue Consulting team and the Panther Charge Integrity Control identified missing charges that would have totaled over $1 million annually.

 

Our consulting team worked with the client and Cerner® to resolve these issues and confirmed the orderable is now posting to date.

Client:

Health System in Florida

 

When Softek Engaged:

2 years post-EMR conversion

Technology Used:

Panther’s Charge Integrity Control

 

Issues Fixed:

Build/Workflow

 
  • Grey LinkedIn Icon
  • Grey Twitter Icon
  • Grey Facebook Icon
  • CernerUsersIcon

4500 West 89th Street

Prairie Village, KS 66207

Phone: 913.649.1024

© 1995 - 2019 Softek Solutions, Inc.

All rights reserved.