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With 424 inpatient beds, Firelands Regional Medical Center in Sandusky, Ohio, is the area’s largest and most comprehensive resource for quality medical care. Established by the consolidation of three separate hospitals, the not-for-profit facility is locally managed and is the only full-service medical center in Erie County.

Challenge

In a not-for-profit hospital environment focused on delivering high quality care to patients, all departments at Firelands Regional Medical Center were seeking ways to save money and optimize revenue. Because its chargemaster was out-of-date, the pharmacy struggled to make significant changes because there was no efficient way to verify whether charges were accurate. Like many health care facilities, prices were adjusted by across-the-board percentage increases rather than based on actual costs. Progress was further inhibited because the pharmacy and revenue cycle management lacked a shared platform to address cross-departmental issues.

Solution

Pharmacy ChargeLink®, Chargemaster Toolkit®, Bill Analyzer, Online Reference Toolkit

 

Results

  • Identified net revenue of $2 million ($6 million gross) in uncaptured charges over an 18-month period with a focus on pharmacy and oncology.
  • Identified net revenue of $850,000 ($2.2 million gross) after a cost-to-charge review, removing outdated drug acquisition costs and updating to actual costs and markup.
  • Addressed incorrect multipliers and HCPCS coding issues, identified missing charges, and deactivated out-of-date charges.
  • Aligned consistent pricing to decrease disparities in drug charging between inpatient units and cancer center, increasing patient satisfaction.
  • Helped the hospital form a cross-functional team that continues to improve revenue integrity and compliance across pharmacy and finance.

“We’ve all learned how important it is for pharmacy and revenue cycle to have the relationship that we now have – that’s what makes us so successful.”

Tracey Moyer, Pharmacy Analyst and Buyer

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