Bridging the gap: Three steps to integrating EHR reporting for newly acquired facilities

Wednesday, November 28, 2018

Hospitals are merging and acquiring smaller facilities and physician practices at a feverish pace. An April report from Kaufman Hall found that merger and acquisition activity was up 11% in the first quarter of 2018 as compared to 2017. Although mergers and acquisitions can present opportunities to health systems, uniting two or more different facilities under one organization is not a simple feat. Bridging the gap between different facilities’ revenue integrity functions is an endeavor that more and more revenue integrity professionals are called on to engineer.

One of the biggest challenges revenue integrity faces when integrating a newly acquired facility is that it is often on a different EHR and billing system than the rest of the organization. That’s a situation Bruce Preston, CPC, director of revenue integrity at Grady Health System in Atlanta, has faced many times. As most revenue integrity professionals know, switching EHR and billing systems isn’t a walk in the park and can’t be done instantly. It’s likely that the newly acquired facility will remain on its current system while a transition is planned.

Step 1. Revenue integrity’s first step should be to participate in an accounts receivable (A/R) assessment, along with patient financial services, to get an accurate view of the current AR, according to Preston. Look at what kind of reporting can be produced using that facility’s current systems. Then determine how the acquiring organization’s policies and procedures can be applied or tailored to those systems until the facility can be transitioned to the organization’s EHR and billing system.

“So if we’re using Epic and they’re using Cerner, we would go in and get our IT experts to tell us what kind of reporting is available out of Cerner so that we can get an accurate inventory of what our A/R looks like and we can get an idea of how many accounts have discharged not final billed on them or have claim edits or other issues,” he says.

Step 2. Then, revenue integrity, along with other revenue cycle departments, can work with IT staff to potentially create a dashboard that would provide the same type of information that the organization’s billing and EHR system produces. If comparable reporting isn’t available from the newly acquired facility’s current system, revenue integrity will need to work with IT to find a way to create a reporting system.

“That’s really where your partnership with the IT department comes into play because we really rely on those folks to get in there and give us the same level of detail, as much as possible, to let us know what we’re up against with this new system,” Preston says. “If we don’t know how many accounts that currently have billing edits, we don’t know how much money is being held up for those billing edits. We don’t know how much reimbursement we have coming to us if we can’t lay eyes on that.”

Step 3. Once revenue integrity has that information, it can begin to bring the newly acquired facility into step with the rest of the organization. Work with IT, health information management, informatics, and medical staff leaders to develop and plan an EHR transition strategy.