Tracking Denials
The Financial Services department at Halifax Hospital worked with a third-party denial and underpay management group to handle all contract reimbursement calculations as well as denial tracking and managed care contract modeling. The group also tracked Clinical Core Measures in real-time. The hospital required a representative of the vendor to be on-call 24/7 to support the programs. If paged, they would have to dial into the system, document the error, and attempt to diagnose or restart the program and contact the vendor. Many times the vendor would take days or even weeks to resolve an issue.
Because relying on vendor support can cause delays in issue resolution and ultimately more overtime and call-pay-for-support, Halifax decided to internally write and support these programs using Boston WorkStation. By replacing the vendor programs, Halifax was able to significantly decrease their reliance on an outside vendor and save approximately one 8-hour day per week from relying on a posting representative.
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