Implementing Arbograph's Healthcare Payment Automation Center at South Nassau Communities Hospital

Table of Contents

• South Nassau Communities Hospital's Revenue Cycle Challenges
• Arbograph's Healthcare Payment Automation Center (HPAC) Solution
• Benefits of HPAC at South Nassau Communities Hospital
• HPAC's Integration with South Nassau's Systems
• Maintaining HIPAA Compliance with HPAC
• Conclusion: HPAC's Impact on South Nassau's Revenue Cycle

South Nassau Communities Hospital's Revenue Cycle Challenges

South Nassau Communities Hospital, a community hospital located in Oceanside, New York, faced several challenges in its revenue cycle process, similar to many other healthcare facilities. Abdul Razak, the senior director of patient financial services at South Nassau, highlighted two key issues that the hospital grappled with.

Firstly, the hospital had been heavily reliant on manual payment posting, a laborious and error-prone process. Despite submitting 95% of their claims electronically, only around 55% of the payments were posted electronically. The remaining 45% required manual intervention, which was both time-consuming and prone to human errors.

Manual Payment Posting

Prior to partnering with Arbograph, South Nassau Communities Hospital had been relying on manual payment posting, a tedious and error-prone process. Despite submitting 95% of their claims electronically, only around 55% of the payments were posted electronically, leaving a significant portion to be processed manually. This manual process was not only time-consuming but also increased the risk of errors, which could lead to inaccurate patient accounts and potential revenue leakage. The hospital recognized the need to automate payment posting to improve accuracy, timeliness, and overall efficiency.

Inefficient Correspondence Management

The second major challenge faced by South Nassau Communities Hospital was inefficient correspondence management. The hospital received thousands of correspondence documents on a daily basis, ranging from rejections to requests for medical records and coverage notifications. Manually sorting and routing these documents to the appropriate departments was a daunting task, often leading to backlogs and delays in processing. Timely handling of correspondence is crucial in the revenue cycle, as delays can result in lost revenue opportunities and hinder effective denial management.

Arbograph's Healthcare Payment Automation Center (HPAC) Solution

To address these challenges, South Nassau Communities Hospital partnered with Arbograph and implemented their Healthcare Payment Automation Center (HPAC) solution. HPAC is a cloud-based platform that automates the processing of explanation of benefit (EOB) forms, EDI 835 payments, correspondence processing, and denials management.

Christine Kasuvzkoler, the financial information systems manager at South Nassau, explained that HPAC is an electronic content management system that allows users to access EOB images, 835 files, denials, and correspondence securely in the cloud. The integration of HPAC with South Nassau's existing systems, such as Tripwire, was seamless, enabling easy implementation and secure access for authorized users.

Benefits of HPAC at South Nassau Communities Hospital

The implementation of HPAC at South Nassau Communities Hospital brought about several significant benefits, streamlining the revenue cycle process and improving overall efficiency.

Julie Huppert, the supervisor of cash management and correspondence at South Nassau, highlighted the positive impact of HPAC on the cash posting and correspondence units. By electronically posting remittances into the hospital's system, HPAC reduced keying errors, improved posting accuracy, and ensured timely processing. Additionally, HPAC's electronic notes posting feature benefited the payment adjudication area, reducing backlogs from three weeks to just one day.

Improved Payment Posting Accuracy and Timeliness

One of the primary benefits of HPAC was the improvement in payment posting accuracy and timeliness. By automating the process of converting paper EOBs into electronic 835 files, HPAC eliminated the need for manual data entry, reducing the risk of errors and ensuring more accurate patient accounts. The electronic posting of remittances through HPAC allowed South Nassau to post payments accurately and promptly, cutting down the time required for posting and freeing up resources for other critical tasks.

Enhanced Correspondence Management

HPAC's electronic content management capabilities significantly enhanced South Nassau's correspondence management process. By converting correspondence documents into electronic formats, HPAC enabled quick and efficient routing of information to the appropriate departments. This streamlined process reduced backlogs, allowing the hospital to address correspondence, such as denials, in a timely manner. Iris Rodriguez, the supervisor of the denial management department, emphasized the impact of HPAC on their workflow, stating that they could now address denials more efficiently and effectively, as the system automatically posted notes into their system.

Increased Denial Management Efficiency

HPAC's integration with South Nassau's systems, coupled with its electronic content management capabilities, significantly improved the hospital's denial management process. By automating the posting of notes and providing easy access to correspondence related to denials, HPAC reduced the time required to retrieve and process this information. As a result, the denial management team at South Nassau could address denials more promptly, leading to fewer denials and improved revenue capture. The efficiency gains allowed the hospital to reallocate resources previously dedicated to manual processes, further enhancing overall productivity.

HPAC's Integration with South Nassau's Systems

The successful implementation of HPAC at South Nassau Communities Hospital was facilitated by its seamless integration with the hospital's existing systems. Christine Kasuvzkoler highlighted that HPAC worked well with their Tripwire system, which controls secure access to various sites.

HPAC's cloud-based architecture and secure access protocols allowed authorized users to access the platform seamlessly, ensuring compliance with the hospital's security protocols. This integration enabled a smooth transition to the HPAC solution, minimizing disruptions to the hospital's operations.

Maintaining HIPAA Compliance with HPAC

As a healthcare provider, South Nassau Communities Hospital is subject to strict regulations regarding the protection of patient data and compliance with the Health Insurance Portability and Accountability Act (HIPAA). HPAC's robust security measures and compliance with HIPAA standards were crucial factors in South Nassau's decision to partner with Arbograph.

Christine Kasuvzkoler emphasized the importance of HIPAA compliance for South Nassau, as the hospital undergoes annual audits, particularly in the IT department. HPAC's secure file management and robust auditing capabilities provided assurance that patient information was safeguarded, and access could be tracked and monitored effectively.

Conclusion: HPAC's Impact on South Nassau's Revenue Cycle

The implementation of Arbograph's Healthcare Payment Automation Center (HPAC) at South Nassau Communities Hospital has had a transformative impact on the hospital's revenue cycle processes. By addressing the challenges of manual payment posting and inefficient correspondence management, HPAC has streamlined operations, improved accuracy, and increased overall efficiency.

Through its seamless integration with South Nassau's existing systems and robust security measures, HPAC has provided a secure and compliant solution for automating various aspects of the revenue cycle. The hospital has realized significant benefits, including improved payment posting timeliness, enhanced correspondence management, increased denial management efficiency, and the ability to reallocate resources to more critical areas.

As Abdul Razak, the senior director of patient financial services, stated, the Arbograph technology has benefited South Nassau tremendously, enabling the hospital to work more effectively and efficiently while decreasing paper usage, creating more electronic 835 files, and streamlining the denial process. Overall, HPAC has played a pivotal role in enhancing South Nassau's revenue cycle, contributing to the hospital's financial sustainability and ability to provide quality healthcare services to its community.

FAQ

Q: What were the main challenges South Nassau Communities Hospital faced in their revenue cycle process?
A: South Nassau faced challenges with manual payment posting, inefficient correspondence management, and a backlog in denial processing.

Q: What is Arbograph's Healthcare Payment Automation Center (HPAC)?
A: HPAC is a cloud-based solution that converts paper EOBs into electronic 835s, manages electronic correspondence, and automates payment posting and denial management.

Q: How did HPAC benefit South Nassau's payment posting process?
A: HPAC allowed for electronic payment posting, reducing keying errors and ensuring accurate and timely posting of remittances.

Q: How did HPAC improve correspondence management at South Nassau?
A: HPAC automatically posted correspondence notes into South Nassau's system, reducing the backlog from three weeks to one day and improving timeliness.

Q: How did HPAC enhance denial management at South Nassau?
A: HPAC's automated note posting allowed the denial management team to access and address denials more efficiently, reducing the time required to process denials.

Q: How did HPAC integrate with South Nassau's existing systems?
A: HPAC worked well with South Nassau's Tripwire system, allowing secure access for users. It also exported data into South Nassau's HIS system for reporting purposes.

Q: How did HPAC help South Nassau maintain HIPAA compliance?
A: HPAC's secure cloud-based system and auditing capabilities helped South Nassau meet HIPAA compliance requirements and perform internal audits for corporate compliance.

Q: What was the overall impact of HPAC on South Nassau's revenue cycle?
A: HPAC helped South Nassau work more effectively and efficiently, reducing paper usage, reallocating resources, streamlining denial processing, and receiving fewer denials due to timely submissions.

Q: How did HPAC affect South Nassau's electronic payment posting capabilities?
A: HPAC enabled South Nassau to convert more paper EOBs into electronic 835s, increasing the percentage of payments posted electronically.

Q: What were some of the specific roles and responsibilities of South Nassau employees in relation to HPAC?
A: Roles included the Senior Director of Patient Financial Services, Financial Information Systems Manager, Supervisor of Cash Management and Correspondence, and Supervisor of the Payment Adjudication Department.