Using Today’s Technology to Increase Efficiency, Accuracy, and Productivity Presented by:
Today’s Presenter Shamel Naguib President of Paperless Productivity, Inc. • 20 years of experience in electronic fax and document workflow for healthcare • ABC News - fax SME (Subject Matter Expert) • “Expert” on American Idol Voting techniques • Connecticut Green Guide – paperless SME • The Guardian – paperless SME • Favorite books • Cheaper by the Dozen - Carey & Gilbreth Jr. • Oh the Places You’ll Go! – Dr. Seuss
Paperless Productivity, Inc. • 15 years of systems integration using best-of-breed OCR, RightFax fax server, and mailroom technology • 9 years as a Senior Consultants with Advantage Technologies, Inc., the # 1 integrator of RightFax in North America • Fax server / software and Fax-over-IP (FoIP) technology experts • Complete Professional Services for • Optical Character Recognition (OCR) experts for fax Implementation, Support, and Training • Automated Prior Authorization, Accounts Payable, Accounts • Representatives in Seattle, Portland, Receivable, Claims, and other Workflow San Francisco, and New York • ClaimsCapture for CMS Claims processing automation using • Mailroom & Outsourced Services on OCR technology 6 Continents, 24x7x365 • Global Mailroom, Business Process Automation, End-to-End Service Provider for Payers and Providers
Some of Our Clients & Friends…
Today’s Focus… Simple, effective, quick-to-market technology solutions that leverage existing technologies along with sophisticated and proven techniques to reengineer Fax- and Scan-centric workflow into fully automated or partially operator-assisted digital transformation. We will discuss real-life examples of how other payer organizations have been able to significantly reduce costs while also increasing SLAs in less than 12 months from project inception to ROI realization. These examples will come from workflows around fax, mailrooms, and other document heavy processes.
Topics include: • Challenges facing healthcare organizations • Issues for payers and providers • Obstacles to interoperability • The problem of paper documents • Existing technology • Solutions to everyday manual processes
Challenges Facing Healthcare Organizations Providers Payers • Health Risk Assessments, Surveys & Questionnaires • Claims Processing • Typically come in via fax Many claim are still received on paper • Measure performance and satisfaction • • Manual data entry for processing • Manual data entry Average annual processing cost: $210 billion • • Inbound fax automation • Prior Authorization Fax Automation Most inbound documents arrive via fax as unintelligent images • Typically come in via paper fax • and require a lot of user intervention Time-sensitive process • Healthcare providers are still exchanging 75% of PHI via fax • Requires manual scanning, data entry, and indexing • • IDC White Paper | Fax Market Pulse: Trends, Growth and Opportunities. • Integration with legacy systems Authors: Ron Glaz, Holly Muscolino. June 2017 • Integration with legacy systems • Many homegrown or custom systems require paper processes and manual data entry Some EMR/EHR implementations are many years old; • tech has changed! Often very big investments • Cloud tools (especially SaaS) growing, but only for certain niches Usually better to refine than to start over • • • HIMSS Analytics 2017 Essentials Brief: Cloud • Need to step outside training/background just to keep things running
Continued Challenges for Payers and Providers Biggest Problems with Fax • Time employees spend sending and receiving paper faxes is wasteful • 42% of organizations say this is their biggest challenge • The cost of paper-based, manual faxing is too high • 39% of organizations say this is their biggest challenge • Mailroom routing often necessary, always painful • Prone to classification errors • Usually reliant on legacy capture software (if any) • Average cost: nearly $20 per document ! Source: Dr. Gerhard Wohland & Matthias Wiemeyer – “How Dynamic - Robust Organizations Create Market Pressure” • Capture automation largely unexplored • Only 45% of organizations use or plan to use capture tools to digitize from paper Source: IDC’s Fax Survey, February 2017
Continued Challenges for Payers and Providers Biggest challenges with manual data capture • Speed is critical • Average payer receives over 1,000,000 CMS-1500 claims per year Source: http://nucc.org/images/stories/PDF/nucc_survey_1500_form_2017_results.pdf • ...but so is accuracy! • 30% of claims denied at first, often due to simple errors Source: https://www.hbma.org/news/public-news/n_where-your-clients-might-be-losing-money-in-their-practices • Scaling is linear and not cost-effective • Handwritten claims forms are still common • Constitute nearly 1/5th of all provider CMS-1500 submissions Source: http://nucc.org/images/stories/PDF/nucc_survey_1500_form_2017_results.pdf • Rapid technical evolution and new buzzwords to track
Obstacles to Interoperability Obstacles Sources for Further Reading • Wide variety of healthcare systems with http://www.managedhealthcareexecutive.com/business- • strategy/six-healthcare-interoperability-barriers-watch/ no link to communication https://www.researchgate.net/profile/Iroju_Olaronke/publication2 • • Each one is (at least) a little bit custom 82322922_Interoperability_in_Healthcare_Benefits_ Challenges_and_Resolutions/links • Architecture and code vary wildly 560bada308ae6de32e9a457a.pdf • Payer and provider communication is challenging • https://heinonline.org/HOL/LandingPage?handle=hein.journals/wa shjolta3&div=21&id=&page= • Lack of seamless integration between • https://www.healthcare-informatics.com/news-item/ehr/survey- workflows and data exchange workflow-design-key-improving-quality-health-it-implementation • Plenty of data exists, but it's hard to use in normal, manual workflows • Over time, orgs get more — not fewer — data sources • Health IT implementations limited by sub-optimal workflows
Paper, Paper & More Paper Most document exchange still via fax or mail, • yielding a baffling amount of paper • Orgs "about to stop" using fax...for 20 years! Meanwhile, usage has grown 25% year-over-year • across all industries Source: IDC’s Fax Survey, February 2017 The big question: how do you keep your head • above the flood of paper? • Can technology squeeze data from paper documents and faxes? Does manual capture/input make sense? • If so, is outsourcing prudent? As one person/org, do you try to stop the deluge? • Do you just try to make it more manageable?
How do we overcome these challenges?
Technology Today • What's in the toolbox? RPA – Robotic Process Automation • • OCR – Optical Character Recognition • Electronic Fax • What can they help you accomplish? • Digital Transformation BPA – Business Process Automation • • Key takeaway: tools already exist to automate manual processes! What will you build with them?
Tactics to Fight the Healthcare Giant: Manual Workflows 1. Eliminate the mailroom • Offload scanning to senders, then it's effectively free to your org 2. Eliminating paper faxing • IDC research: 36% of organizations still use old-fashioned faxing methods, which will barely dwindle in the next two years (to 28%) 3. Eliminate scanning paper into the EMR • Start & stay paperless when possible • Use OCR to digitize effortlessly when paper is inevitable 4. Eliminate data entry • Intelligent data capture tools have made hand-keying unnecessary 5. Eliminate data errors • The sharpest human workers are still human; rules-based tools and RPA end the errors
Reinvent & Reengineer with Exceptional Technologies Our specialty: process automation with fax and OCR • Expertise in RightFax and cloud-based fax technologies • Out-of-the-box OCR solution that automates manual data entry for healthcare claims (CMS 1500, CMS 1450, ADA J430D) • Other prebuilt OCR solutions for: • Health Risk Assessments • Surveys • Biometrics forms • Prior authorizations • EOBs • Any other recurring document types Examples to follow…
Claims Processing
Case Study: County Health Care Agency From 100 paper claims in days to 100s each day ! ISSUE: County was processing over 100,000 paper claims manually each year Before After Processing both CMS 1500 and CMS 1450 Using Paperless’ claims processing solution, the (UB-04) forms and spending hours each day county was able to process over 100 claims in with manual data entry, rule reconciliation two hours when it took them two days prior. and data validation issues. Additionally, all the data is able to be directly exported in their desired EDI 837 format!
Health Assessments
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