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Improving Patient Account Management Processes with EMUE Script Automation

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Title: Improving Patient Account Management Processes with EMUE Script Automation


1
Improving Patient Account Management Processes
with EMUE Script Automation
INVISION RCM1Session 312
  • Carol Maier, Project ManagerRon Powell,
    AnalystSUNY Upstate Medical University,
    Syracuse, NYChristine Bachtel, Director of Rev
    Cycle Support  St. Vincents Hospital, NYC
  • Bridget Palan, Technical Support Manager
  • Aria Health
  • Paul  Martin, VP Rachel Bowles,
    AnalystDatabound Healthcare Solutions

Innovations 09 Siemens Customer Education
Symposium Sharing ideas. Expanding knowledge.
2
What is This Presentation About?
  • Sharing Ideas and Processes
  • EMUE Overview what is it?
  • History, Capabilities, Product Goals Roadmap
  • SUNY Upstate Medical University
  • Discharging and re-registering recurring
    outpatients
  • Bad debt write-off
  • St. Vincents Hospital
  • Translating charges for special billing scenarios
  • Automated Medicaid research and re-billing
  • Frankford Hospital
  • POS system cash posting
  • Medical Record system charge posting with Patient
    Management Updates

3
What is EMUE anyway?
  • What is OLIE?
  • What exactly is the Express Mainframe User
    Emulator?
  • Runs existing OLIE scripts with
  • Complete Automation Scheduling, built-in
    terminal management, password encrypted sign-on
    and file management with email notification of
    success or failure
  • Saves Time.
  • Development Tools OLIE specific editor with
    interactive source-code debugging to create and
    modify scripts on-the-fly.
  • Saves Time and minimizes costly errors.
  • Multiple Sessions Up to 10 simultaneous scripts
    per PC.
  • Saves Time Money
  • New command and functional enhancements
    Automate more processes and automate them more
    completely.
  • Saves Time.
  • Use for ad-hoc functions, scheduled jobs, or as
    an interface
  • OLIE on steroids.

4
(No Transcript)
5
EMUE Overview - History
  • OLIE is a great tool for automating user data
    entry into INVISION and SIGNATURE.
  • EMUE has grown into a full featured process
    automation and data movement tool.
  • OLIE 3270 ? ? text file
  • EMUE

6
How does EMUE Automate Processes?
  • Our development goal with EMUE is to automate all
    activities associated with a script.
  • File polling, file identification, archiving,
    scrubbing, and preparation
  • Connect, Sign-on (dedicated or pooled), and run a
    script
  • Notify appropriate persons upon success and/or
    failure of a script, and include appropriate
    information and/or files.
  • Archive and/or perform additional post processing
    tasks like
  • Time/Date stamping a file.
  • Staging file for another process
  • Starting additional processes.
  • Make it easier to create and debug scripts, and
    help prevent costly errors.
  • EMUE makes it easy to create robust, hands-off
    processes for sharing data between systems.
  • Doesnt require a PhD in Computer Science to
    build robust processes use existing knowledge
    and resources.

7
EMUE Overview - History
  • Statistics
  • First Installation in 2002
  • OLIE has about 35 commands (3270 screen, files,
    and workflow)
  • EMUE has over 90 commands plus 90 configuration
    options
  • Automation (scheduling and polling)
    Notification (email)
  • Enhanced analysis and workflow
  • Database access
  • Running 3rd party programs
  • Date processing, String manipulation,
    Validation
  • Data scrubbing
  • File management
  • Web scripting
  • Archiving
  • Encrypting passwords and other sensitive
    information

8
EMUE Roadmap
  • EMUE 3.1 Progress
  • Beta Spring and Summer of 2009
  • GA Fall 2009
  • Highlights
  • FTP
  • Pooled sign-ons
  • Overnight script suspension
  • Run OLIE scripts by adding one configuration
    option

9
EMUE Roadmap
  • Future Release Feature Options
  • Soarian Interoperability
  • Email as a data source (pop3 message retrieval)
  • File compression (Zip and Unzip) capability
  • Structured Error Handling

10
SUNY Upstate Medical University
  • 378 Licensed Inpatient Beds
  • 18,071 Inpatient Admissions
  • Inpatient Length Of Stay of 6.5 days
  • Adult/Peds Emergency Department
  • 51,262 ED visits
  • 77 Hospital-Based Clinics
  • 202,487 Hospital Clinic Visits
  • 225,000 Referred Ambulatory Visits
  • Only Academic Medical Center in CNY
  • Level 1 Trauma Center
  • Specialty Centers Include
  • Pediatric ED, Pediatric ICU, Clark Burn Center,
    Regional Oncology Center, CNY Gamma Knife Center,
    Joslin Center for Diabetes, Renal/Pancreatic
    Transplant Program, Designated Stroke Center

11
Motivating Factors
  • We were a big OLIE user
  • BUTOLIE needs babysitting
  • SO, When we saw EMUE, we were very excited to get
    a product that would allow us to run OLIE scripts
    at defined times with a tool to manage OLIE

12
Implementation Process
  • EMUE gets installed on a workstation
  • Training sessions were held for 2 days
  • Then we rolled out some simple scripts

13
Problems with Old Process
  • High volume OLIES were effecting CPU
  • Staff Time spent babysitting OLIE
  • Difficulty debugging OLIE

14
How EMUE could help
  • EMUE can be scheduled to run at night and on
    weekends
  • EMUE can kick off other EMUEs
  • EMUE can send email on script status-Success/Failu
    re
  • EMUE includes a tool for debugging OLIE scripts
  • EMUE has all the functionality of OLIE plus lots
    more

15
Discharge and Pre-Registration of Recurring
Outpatient Accounts
  • Previously we had run an OLIE script on the last
    business day of the month. This was both system
    and resource intensive.
  • Initially, we continued to run OLIE/EMUE during
    the day so we could monitor it.
  • Once we gained confidence and knowledge, we
    schedule it to run at 230 a.m.
  • It is completed by 600 a.m. when the system
    usage begins to climb

16
Script to Discharge and Pre-Register Recurring
Outpatients
  • At 130 A.M. on the last business day of the
    month the Windows scheduler kicks off an EMUE
    script that runs six ad hoc reports which
    identify all open (OA) recurring (pt type D)
    accounts with a specific hospital service.

GQ
17
Script to Discharge and Pre-Register Recurring
Outpatients
At 230 A.M on the last business day of the
month, a chain of six EMUE scripts are run, using
the six Ad Hocs produced at 130 as input.
Dsch/Prereg script
GQ
18
Script to Discharge and Pre-Register Recurring
Outpatients
  • Each service specific script passes the name of
    its ad hoc and the name of its successor script
    to the main discharge and prereg script.

19
Script to Discharge and Pre-Register Recurring
Outpatients
  • The main script, DSCHPREALL, searches for the
    newest version of the requested ad hoc. When it
    finds the report it loads account numbers into a
    temporary list. It then processes each account
    through a custom built pathway that discharges
    recurring patients with a month-end date,
    pre-reg's them with a 1st of the next month date,
    then copies orders from the discharged case to
    the pre-reged case

20
Script to Discharge and Pre-Register Recurring
Outpatients
  • After processing all of the accounts loaded from
    the Ad Hoc , email notifications are sent to
    notify of success, or failure with output logs
    attached.

21
Script to Discharge and Pre-Register Recurring
Outpatients
  • As the DSCHPREALL script concludes, it calls the
    next service specific script using the name
    passed to it by the previous service specific
    script and processes the next hospital service
    through the main script.

22
Script to Discharge and Pre-Register Recurring
Outpatients
  • This repeats through six iterations. The last
    service script passes a blank nextscriptname and
    gotoscript which tells the DSCHPREALL script that
    we are finished.

23
SUNY Upstate Medical UniversityBad Debt Write-off
  • Bad Debt accounts need to be identified and zero
    balanced
  • The old process required several manual steps to
    prepare the input files, then additional manual
    intervention to run and monitor the three OLIEs
  • The EMUE process accepts the input on .XLS files
    directly from Finance. It also processes all
    three CDM types without manual intervention.
  • Benefits include the time formerly spent
    preparing input, no tweaking of OLIE scripts, and
    all three CDMs are processed at the same time.
    In addition the EMUE script outputs a detailed
    log file listing bad accounts, accounts that are
    in historical, and recurring accounts.

24
St Vincents HospitalEntering Evaluation and
Management Charges for Clinic Visits
  • Requirement - Automate the posting of clinic
    visit Evaluation and Management charges and still
    be able to identify the visits from the Chinatown
    or Senior Health clinic. The workflow of the
    clinic staff could not be impacted.
  • Old Process - There was an auto-charging process
    based on the Clinic Code. One visit charge per
    clinic. The EM Level was identified by the CPT
    code only. Corporate Compliance mandated that
    the auto-charging process be discontinued.

25
St Vincents HospitalEntering Evaluation and
Management Charges for Clinic Visits
  • EMUE Process - The clinic staff continues to
    enter the EM CPT codes in INVISION Patient
    Management. A Patient Accounting Ad Hoc report
    is scheduled daily for Chinatown and Senior
    Health accounts that had CPT Procedure segment
    created today. The Chinatown EMUE script is
    scheduled thru Windows Scheduler to run at 7 am
    daily. The EMUE script copies the patient
    number, clinic code, CPT code and date of service
    from the Ad Hoc Report, maps the clinic code and
    CPT code to the correct charge code and enters
    the data on the Charge Entry screen in Patient
    Accounting.
  • Benefits - We have been able to discontinue the
    auto-charging as mandated Post charges based on
    EM levels without changing the workflow of the
    clinic staff Reduce the number of incorrectly
    posted charges that need to be manually reversed.

26
St Vincents HospitalAutomated Medicaid
Eligibility Search and Re-billing
  • Requirement - We have a large population of
    patients that are registered as self pay. Many
    of these patients have active Medicaid or are in
    the process of applying for Medicaid. The
    request was made by the VP of Patient Accounting
    to improve the identification of the active
    Medicaid information using HDX Eligibility.
  • Old process - A vendor would do a sweep of the
    New York State Medicaid file and find valid
    Medicaid numbers. This information was returned
    to the hospital to bill. The vendor received a
    percentage of the reimbursed amount.

27
St Vincents HospitalAutomated Medicaid
Eligibility Search and Re-billing
  • EMUE process A query was created in Echo Loader
    to capture the self pay and pending Medicaid
    accounts in the Active and Bad Debt files. The
    EMUE script creates a list by executing the query
    using the command getodbcdata. Using the
    accounts listed, the script pulls and logs data
    from the Patient Accounting screens (Name, Date
    of Service, Date of Birth, SS, Sex, FC, Medical
    Record , Account Type, Hospital Service and
    Insurance Plan 1). If there isnt a SS an HDX
    Equifax inquiry is requested and the results
    logged. EMUE will launch a Medicaid Eligibility
    request and log the results. Comments with the
    results are added to the accounts. There are
    rules for finding Medicare, Medicaid and Medicaid
    Managed Care. Logs are created for Patient
    Access to review the found Social Security number
    and for Billing to review the found insurance
    information. We eliminated the script updating
    and re-billing the accounts because of the risks
    associated in incorrectly updating insurance
    information. We can also exclude accounts from
    qualifying for the script by entering a 28
    record. This is used if a patient has limited
    Medicaid coverage.

28
St Vincents HospitalAutomated Medicaid
Eligibility Search and Re-billing
  • Benefits We have eliminated the dependency on
    the vendor to find active Medicaid. We have been
    able to expand the script to find missing Social
    Security numbers and average about 150 valid
    Social Security numbers per month. We find an
    average of 400 active and billable Medicaid or
    Medicaid Managed Care accounts per month.

29
St Vincents HospitalOther Scripts/Processes on
CD
  • Ad Hoc Script (my favorite) - Did you ever have
    a list of values, patient account numbers or
    medical record numbers that you needed to add to
    an Ad Hoc report? We have a script that takes
    the list and populate the qualifications of an Ad
    Hoc report. This eliminates the need to manually
    enter hundreds of numbers and eliminates
    inaccuracies.
  • High Volume Comments By using the Ad Hoc script
    as a model, we created a script to post High
    Volume Comments. This came in handy when we had
    to post the comments from 10 days of Medicare
    remits that were on the TCEs.

30
Aria HealthPOS System Cash Posting
  • Problem We needed to automate the posting of
    the cash that is collected at the point and time
    of service via our POS Payment System in a
    timely, accurate and efficient manner.

31
Aria HealthPOS System Cash Posting
  • Our POS Payment System generates a file nightly
    of the cash collected that day and transfers the
    file to a network drive. EMUE picks up the file,
    which includes the payments and user comments and
    posts them to the Invision system. This process
    is scheduled to run after day end, this helps to
    ensure that the accounts have passed from the
    Patient Management system to the Patient
    Accounting system. Once the process has been
    completed, EMUE then forwards a script complete
    notification email to our Tech Support team who
    then will settle the input/output data files and
    forward them to our Batch Control area for the
    finalization of the batch.

32
Aria HealthPOS System Cash Posting
  • Benefit This process ensures timely and
    reliable results. There is no need for operator
    intervention to process the job, which reduces
    FTE time necessary. EMUE gives us the ability to
    run the process daily, 7 days a week without 24/7
    FTE coverage. Once the process is completed, an
    email is forwarded to our Tech Support team who
    then settles the input/output data and forwards
    to our Batch Control Department for finalization
    of the payment batch.

33
Aria HealthMR System Charge Posting w/PM Updates
  • Problem ED accounts are coded by our MR
    department. There was a time that these account
    were being sent via batch to our Billing area for
    manual charge entry into both our Invision and
    Signature systems. We are responsible for both
    the facility and professional charge entry for
    the ED, we needed to automate this process.

34
Aria HealthMR System Charge Posting w/PM Updates
  • Old Process Our first automation with this
    process was to create fields in our Signature
    charge entry screen for the billers to manually
    key the Invision patient number, CDM service code
    and any other data that was needed to update the
    charge into Invision while they were entering the
    professional charges into the Signature system.
    We would then run an ad hoc to extract the
    Invision data and run an OLIE script to upload
    the charges.

35
Aria HealthMR System Charge Posting w/PM Updates
  • PFS and MR were able to meet and create a pathway
    within our MR coding system that would generate
    files for both the Invision and the Signature
    system daily for upload. The coder enters all
    the charge information while coding the ED chart,
    this includes CDM service code, DX information
    and ED provider information. The files are
    generated daily and are placed on a network drive
    for pickup. EMUE picks up the file, copies the
    file and creates 3 files for parallel processing.
    2 files created are processed the same day
    received, the third file (diagnosis) is sent to a
    holding directory to be processed on day 2.
  • The first parallel file that EMUE will process is
    the ED Doctor file. This process updates the
    ED provider that was captured by the coder via
    the ED chart review via the Patient Management
    pathways.
  • The second file that is processed is the charge
    entry file.
  • The third file is pulled from the holding
    directory on day 2 and adds the diagnosis to the
    accounts that were charged yesterday. This is
    necessary due to the way our Contract Management
    system is set send allowances to Patient
    Accounting.

36
Aria HealthMR System Charge Posting w/PM Updates
  • Once the files are completed EMUE sends email to
    all responsible team members to alert them that
    EMUE has completed the script.
  • Daily balancing is done and forwarded to our
    Batch Control area for batch closure.

37
Aria HealthMR System Charge Posting w/PM Updates
  • Benefit These processes have saved time and
    are efficient. EMUE is a dependable tool. EMUE
    can be used with existing scripts seamlessly.
    Its easy to debug and modify scripts when needed
    with EMUE. All files are automatically archived
    and easily accessed when needed.

38
Aria HealthOther Scripts/Processes on CD
  • 72 hour ad hoc sent to users via email.

39
Wrap-up
  • CD contains
  • Scripts presented here
  • Additional scripts provided by these sites
  • Adhoc Script
  • High Volume Comments
  • 72 Hour Adhoc Emailed
  • A free license for our OLIE/EMUE script editor.
  • OLIE/EMUE syntax highlighting, parsing, and more!
  • Links to the FREE OLIE/EMUE script library which
    has almost 100 OLIE EMUE Scripts.

40
Questions? Comments? Feedback? THANK YOU!
INVISION RCM1 Session 312Please take a few
moments to complete your evaluation form before
you leave.
  • For more information you can go to
    http//www.databoundhealthcare.com
  • FREE Resources include
  • The scripts mentioned in these presentations
  • Almost 100 more in the community based script
    library
  • Databounds OLIE/EMUE script editing tool
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