Not just a bill...
Payment Posting Lean Implementation Team improves Professional Fee Billing at UMHS
The appointment is over. Or the patient has left the hospital. Now, the billing process begins, as the Health System aims to get paid for the service we have provided.
"It's very important that we as a Health System are able to collect all the money for the work our faculty does," says Senior Director of Revenue Cycle Benjie Johnson. "One big factor is how quickly we post the payments we receive from third-party payers."
When Johnson and Operations Manager Pamela Britz realized that their payment posting results and unit morale could be better, they volunteered with Britz's Payment Posting group to pilot the Michigan Quality System's "lean in daily work" model.
"Much of our work is manual," Britz explains. "So we needed to standardize our work, find a way to track the issues, monitor our progress, and let our customers know where we were with posting."
Faculty Group Practice (FGP) Professional Fee Billing Payment Posting posts all information received from third-party payers to the billing system. Information is received both via paper and electronically and includes payments for patient services, claim denials, claim status and requests for refunds.
"Once the staff started sharing their issues, submitting ELIs, or everyday lean idea suggestions for improvement, and implementing their improvement suggestions, they became very engaged," Britz says.
As a result of the lean work, there are now three teams within Payment Posting: Tape Posters (who handle electronic postings from big payers such as Blue Cross Blue Shield, Medicare and Medicaid), Commercial Posters (who post from smaller, non-government payors) and Core Specialists (miscellaneous postings and refunds).
Breaking into concentrated, specialized teams with team leaders has enabled staff to know immediately where postings stand, how to resolve issues, and who to go to for help. Visual boards in each area are updated daily, as needed, so that the freshest information is right at hand.
"Lean has given us the tools to be more organized and thorough in our problem solving," Britz says.
As a result of their work, commercial postings that once took an average of 12 days now take five days or less, and electronic postings from large organizations only take an average of three days. The group has seen an overall 75 percent improvement rate and implemented 43 lean solutions, with more on the way.
Executive Medical Director of the Faculty Group Practice David Spahlinger, M.D., was the administrative sponsor of this lean team.
"What impressed me even more than the improvements was the engagement of the staff," he says.
"As a director, you want to engage staff, but you don't always know how," Johnson adds, "Lean makes it easier. I love it!"
Payment Posting Lean Implementation Team Participants
Pamela Britz, operations manager
Benjie Johnson, senior director, revenue cycle
Tami Samborski, project manager
Kevin DeHority, lean coach
Brendon Weil, lean coach
Inside View Editorial Advisory Group
Constance Bridges, Office of the Dean, Medical School
Teri Grieb, MSA Office of Research
Judy Hallberg, S.P.H.R., UMMS Human Resources
Kelly, UMHS Human Resources
Mark A. Kempton, UMHS Human Resources
Erin Koenigsknecht, UMHS Marketing Communications
Allison Krieger, Office of the EVPMA
Rick Krupinski, Editor, Medicine at Michigan
Alisa Morningstar, UMHS, MFit Health Promotion
Sara Stephens, Safety Management Services
Tammy Nipper, UMMS Human Resources
Juanita Parry, Nurse Recruitment & Retention
Steve Raymond, UMHHC Leadership & Staff Development
Karen Schlueter, Livonia Health Center
Connie Standiford, Medical School Administration
Carole Strong, House Officers Association
Quinta Vreede, Office of the EVPMA
Public Relations & Marketing Communications Staff
Michael Harrison, chief public relations and marketing officer
Kara Gavin, director of public relations
Beth Johnson, editor and senior writer
Geoff O'Connor, senior Web developer
Michael Steigmeyer, assistant editor
Juliet Fuller, photography coordinator
Heather Guenther, contributing writer
Cathy Mellett, contributing writer
Bruce Spiher, contributing writer