Coding and Reconciliation Enhancements Bring Madison Memorial Immediate Return on Investment
St. Louis and Atlanta, January 28, 2014 – Amerinet, a leading national healthcare solutions organization, recently partnered with Craneware, the revenue integrity software market leader, to help member Madison Memorial Hospital overcome financial performance challenges by optimizing reimbursement, increasing operational efficiency and mitigating compliance risk. As a result, the 69-bed hospital identified a yearly return on investment (ROI) opportunity of $327,658.
Like many healthcare facilities, Madison had been struggling with financial challenges, including how to keep the chargemaster updated with the most recent codes and descriptions. According to Dorsie Sullenger, director of Pharmacy for Madison Memorial Hospital, there were hundreds of items in the chargemaster that did not contain current information. The facility was writing off thousands of dollars due to issues with coding and unit descriptions. It had turned into a situation in which the facility was struggling to keep the chargemaster current, rather than being proactive.
Following a full briefing on the situation, Amerinet recommended a consultation with Craneware, a member of the Amerinet Strategic Alliance for Financial Efficiency (SAFE) and partner that specializes in all aspects of revenue integrity including chargemaster management and control processes. Recognizing a good fit and the potential for significant return on investment, the facility implemented Cranewares Chargemaster Toolkit® and Pharmacy ChargeLink®. Chargemaster Toolkit is a flexible, easy-to-use solution for continually updating chargemaster data in order to ensure ongoing charge accuracy and consistency. Chargemaster Toolkit is packaged with Craneware’s Online Reference Toolkit®, a browser-based tool that provides instant access to the most current clinical, financial, coding and regulatory information. More than one in four U.S. hospitals and healthcare organizations rely on Chargemaster Toolkit to:
- Optimize reimbursement by identifying chargemaster issues and incompleteness
- Increase operational efficiency by automating chargemaster management
- Manage workflow based on the organization’s control processes
- Track interdepartmental routing, approvals and communication to support an accurate audit trail
Almost immediately following the implementation, a large number of pharmacy items were found in the chargemaster without current HCPCS codes assigned, which prevented reimbursement. Based on this alone, the immediate anticipated yearly potential ROI opportunity was $327,658. In addition, pricing issues discovered included 140 items in which the unit cost was greater than the amount charged. In terms of volume reconciliation, there were 647 line items in the chargemaster that had never been used.
“It was quite unique how the Craneware software was able to take the purchase files from the pharmacy department and compare this to the revenue files from our information services vendor”, said Dorsie Sullenger, director of Pharmacy for Madison Memorial Hospital. “This comparison showed the flaws in our previous manual system and allowed us to see that we had billable items that we thought were being billed out, but they were not.”
The Craneware solution also allowed Madison Memorial to benchmark, by seeing how pricing on certain medications compared to other hospitals in the state or local area. This comparative data highlighted significant changes the hospital could implement into their current pricing, a significant advantage in a highly competitive environment.
Craneware’s Chargemaster Toolkit®ranks No. 1 in the Revenue Cycle Chargemaster Management market category in the “2012 Best in KLAS Awards: Software & Services” report, published December 2012. Data 2012 KLAS Enterprises, LLC. All rights reserved. www.KLASresearch.com.
About Madison Memorial Hospital
Madison Memorial Hospital is a nationally recognized, nonprofit, full-service facility with 69 beds. In Idaho, Madison Memorial Hospital is the only county-owned, non-critical access hospital.
Craneware (AIM: CRW.L) is the leader in automated revenue integrity solutions that improve financial performance for healthcare organizations. Craneware’s market-driven, SaaS solutions help hospitals and other healthcare providers more effectively price, charge, code and retain earned revenue for patient care services and supplies. This helps customers optimize reimbursement, increase operational efficiency, minimize compliance risk, and retain more earned revenue. By partnering with Craneware, clients achieve the visibility required to identify, address and prevent revenue leakage. To learn more, visit craneware.com.
As a leading national healthcare solutions organization, Amerinet collaborates with acute and alternate care providers to create and deliver unique solutions through performance improvement resources, guidance and ongoing support. With better product standardization and utilization, new financial tools beyond contracting and alliances that help lower costs, raise revenue and champion quality, Amerinet enriches healthcare delivery for its members and the communities they serve. To learn more about how Amerinet can help you successfully navigate the future of healthcare reform, visit www.amerinet-gpo.com.
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