Payment Personalization, Charge Capture Analytics, and CAC at Virtual AHIMA 2020

As you’ve seen from my previous coverage, I had an enjoyable week attending the AHIMA Virtual Conference.  While it’s not the same as in person, AHIMA did a nice job allowing us to connect with HIM professionals and be able to learn from each other.  As I went through the virtual event, I gathered a potpurri of insights and perspectives that I wanted to share with you

First up was a conversation I had with Doxim around patient payments.  They highlighted to me a number of efforts they’re making to personalize the patient payment experience based upon a patient rating.  You may remember that I’ve covered the idea of patient payment classification by Patient Matters before and customizing the payment plan offered to the patient based upon that classification or rating.  I still think this is a great idea and smart given the growth of payments from patients thanks to high deductible plans.

What made Doxim especially interesting was that not only were they offering payment options based on payment rating, but they are also adjusting the statement based on the rating.  We didn’t have time to dive into all the details of how they’re able to adjust the statement based on patient rating, but this felt like the next evolution of personalizing the patient payment experience.  To be honest, this type of personalization is starting to happen all across healthcare and so it’s no surprise that the same is happening with patient payments too.  This is a smart move and it’s great to see them already starting to do this type of personalization of statements based on each unique patient.

Next up was a visit to Patient Keeper.  I enjoyed the conversation and have always been impressed with their charge capture tool.  However, it was interesting to see them offering a new analytics tool that would talk an organizations schedule feed and then evaluate the organization’s billing to see if there were potential gaps.  Sounds like a simple solution and in theory it is, but it really takes someone understanding the nuances of charge capture the way Patient Keeper understands it to be able to do this really well.  You can see how this simple analytic solution could be valuable to an organization that wants to make sure they’re getting paid appropriately for all the visits they do.

Of course, Patient Keeper is taking their analytics one step further by also providing a communication channel to be able to inform and educate the clinician of any issues that were found.  Assuming you’re using Patient Keeper, the nice thing is that the secure message will be alongside the record.  So, it’s easy for a clinician to correct a mistake.  A great reminder that analytics is great, but communicating the results of those analytics back to the clinician is important as well.  It is interesting that Patient Keeper was moving towards analytics since one could see the day that ambient clinical voice and other technologies could eventually replace a lot of the charge capture that is being done today.

I had a great conversation with Dolbey about Computer Assisted Coding (CAC) as well.  When I asked them how far we’d come with CAC, it was interesting to hear them talk about how it really depended on how far an organization had gone in creating a workflow that had CAC or not.  Kind of reminds me what it was like having someone go from one EMR to another EMR vs going from paper to EMR.  There’s something to say about those who understand what the workflow should look like already.  That said, I’m sure the good people at Dolbey are having to battle with those who have been burnt by CAC in the past and are now interested to see if CAC is ready for prime time.

Finally, I was quite impressed with the work MDaudit was doing to help E&M auditors do their job.  I’ll admit, when they first started demoing the product, I felt like their solution was just slightly better than Excel.  Ok, that might be a little harsh since it had a better workflow and process, but it was a pretty standard workflow and audit documentation tool.  Although, they did have an education piece that was much better and was certainly much better than Excel.

However, once I started asking them about how a healthcare organization could better identify who and what to audit, I started to see the real magic behind MDaudit.  Sure, every healthcare organization needs a regular E&M audit of each of their providers, but knowing who the outliers are that may need a little extra audit attention is where the magic happens.

This was best illustrated by the E&M Outliers Bubble Chart they showed me:

Obviously, this is worth a full demo of MDaudit to understand it fully, but it’s pretty easy to see how this identifies which clinicians in your organization are possibly under coding (ie. bottom left circles that are possibly a revenue risk for your organization) and those that could be up coding (ie. top right circles that are possibly a liability risk for your organization).

You can see on the right side that you can also filter by a wide variety of options including taking a look at national norms to compare your organization against national benchmarks.  Here’s an example of a chart that dives into just internal medicine/cardiovascular disease:

Needless to say I love this type of analysis and use of data in healthcare.  The reality is that no one has the time to audit every chart, so tools like what MDAudit are offering can help a healthcare organization prioritize who, what, and when they audit.

Those are just a few of the things I saw that stood out to me.  What did you think of AHIMA 2020?  What did you learn or see that got you excited?  What did you think of the virtual event?  Let us know in the comments or online with @hcittoday on Twitter.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

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