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Challenge: Standardize and automate the charge capture process to create consistent cash flow and protect Medicare reimbursement across acquired hospitals.

For any hospital, careful management of revenue capture processes helps mitigate cash flow interruptions and capture every earned dollar. For Meridian Health, one of the largest providers serving coastal New Jersey, the addition of six hospitals in less than four years made managing revenue capture more challenging.

“We were particularly challenged and motivated to implement a standardized charge master and claims management systems, with a goal of collecting 100 percent of net patient revenue,” says Marilyn Koczan, vice president of patient financial services operations for Meridian Health. “We also wanted to keep our collection costs as low as possible for our health system.”

Bringing together six hospitals, Meridian Health set out to connect, aggregate and convert billing data generated by four different patient financial systems and teams. Every facility needed to access the same data for transparency. However, the patient financial services teams worked in silos, independently from one another. Existing revenue cycle technology did not completely automate processes, track claims and billing errors, or identify areas for process improvements.

Meridian Health’s main facility, Jersey Shore University Medical Center, already used MedAssets technology for both supply chain and revenue cycle for years.

Identify Errors, Drive the Most Value
Meridian Health implemented MedAssets charge master and claims management systems to standardize workflow and access trend monitoring reports for claims processing. “We realized that you can’t manage well without tracking revenue trends, knowing what’s working in your revenue cycle and identifying your problem areas,” says Koczan. Trend monitoring reports pinpointed errors such as incorrect patient addresses, insurance claim codes, reimbursement codes and other essential claims data elements to correct and include on a uniform charge description master.

“With MedAssets, we now can trend billing data and perform root-cause analyses for missed information or mistakes that impact revenue capture across the system,” adds Koczan. “We started with identifying errors and process improvement requirements on the front end of the revenue capture process in patient registration and coding. Then we trended the back end of the revenue cycle to address cash posting and bad-debt management findings.”

Meridian Health now trends system-wide billing data following Medicare and related medical-necessity and coding guidelines. For example, Meridian Health uses a standard template of processes that pertains to Medicare for reconciling cash remittances. That template is adjusted and applied to all patients. Koczan notes that “Medicare reimburses 50 percent of our patient services. If it’s happening with Medicare, it’s only a matter of time before it will happen with other payors.”

Captured More Net Revenue
Since implementing MedAssets chargemaster and claims management technology, Meridian Health has achieved a 3.6 percent increase in annual net patient revenue, including a one-time gain of $20 million from more accurate claims.

Improved Communications, System-wide
Koczan and her team’s commitment to standardized and automated revenue capture processes have helped improve communications with clinical departments. “We started quarterly revenue-integrity meetings with different clinical specialty areas to review charge issues and revenue capture successes uncovered from trend reporting,” she says. “If we have a problem, we meet more often. For example, we meet frequently with our oncology group on how to bill for infusion services and obtain certifications on drugs. These meetings are collaborative. We review lists of denied claims. Both financial and clinical teams leave with valuable information.”

Increased Best Practices, System-wide
Data automatically generated from MedAssets solutions are updated on Meridian Health’s Outpatient Prospective Payment System performance, making it easier for Koczan and her teams to disseminate change information to clinical departments.

“Everything we do – including the chargemaster, coding, claims management, charge integration into preference cards and trend reporting – is efficiently standardized so all our facilities are working together as one cohesive system,” Koczan says. “Many, many pressure points exist to jeopardize capturing all the revenue we’ve generated. We must analyze and trend charge capture data and correct actions that are contributing to errors. We don’t have to accept revenue capture errors. MedAssets helps us capture more.”

As a result, Meridian maintains a strong, consistent cash flow. And with profitability comes the flexibility to upgrade facilities, add patient programs and further investment in innovative technology for their hospitals.

AHA’s Hospitals & Health Networks magazine recognized Meridian Health’s use of innovative technology by including the system among the nation’s Top 100 Most-wired Hospitals. Modern Healthcare also named Meridian Health among the Top 100 Integrated Health Networks (the only New Jersey health system recognized in 2011).