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Process‐Mapping Your Way to Reimbursement Efficiency and Business
SuccessEsther Apter, President and CEO
MedForce TechnologiesChestnut Ridge, NY
CE Credit in Four Easy Steps!1. Scan your badge as you enter each session.2. Carry your Evaluation Packet to every session so you can add session evaluation forms to it.3. Track your hours on the “Statement of Session Attendance Form” as you go.4. At your last session, total the hours and sign both pages of your Statement of Session
Attendance Form. Keep the PINK copy for your records. Put the YELLOW and WHITE copies in your Evaluation Packet.
o Make sure a completed Session Evaluation Form is in your Evaluation Packet for each session you attended.
o Miss one? Extras are in a file near Registration. Complete the General Attendance Evaluation Form located in your Evaluation Packet. Fill out the information on the outside of your Evaluation Packet envelope, seal it, and
drop it in the box near Registration. Applying for Pharmacy CPE? If you have not yet registered for an NABP e‐Profile ID,
please visit www.MyCPEmonitor.net to do so before submitting your packet.o You must enter your NABP e‐Profile ID in order to receive CE credit this year!
3/26/2013 2
Speaker Disclosures
Esther Apter has no disclosures or financial conflicts of interest to share.
Clinical trials and off‐label/investigational uses will not be discussed during this presentation.
3/26/2013 3
Learning Objectives
• Your business operates based on a set of rules. How do you manage and control your business processes?– Explore the concept of business process management as it applies to a home infusion provider’s business model.
• Learn about the different types of business rules that make up the complete process needed to run your business from human resources, to purchasing to accounts payable and last but not least customer service and billing.
Learning Objectives
• Learn how Business Process Management (BPM) can help your business.• Stop bottlenecks before they start• Eliminate duplicate steps in processes• Streamline your operation to ensure efficiencies and compliance
• Empower your staff to make decisions based on rules without interrupting you or other managers
• Explore the benefits of process mapping key business functions.
In Order To Survive You Must
– Reduce costs– Improve your ability to support the business
Business Process Management is The Secret to Doing More With Less
Have You Ever Asked Yourself These Questions:
• What are my employees doing every day?• Could my employees do more in less time?• Are processes clearly mapped out to confirm with required
procedures?• Are all task performed consistently?• Are we tracking and eliminating ineffective processes?• Have we defined best practices?• Have we defined priorities for each task within a process?• Have we defined minimum productivity requirements for each task?• Are there functions that could be combined or eliminated?
Process ManagementImagine what the world would look like if Henry Ford had not implemented the assembly line concept in making cars?
End of the Line. The Model T's body is joinedto its chassis at the Highland Park plant
Assembly line
People are ManagedProcesses are Seldom Managed
10 People Handling Exact Same Responsibilities
Guarantee:At least 6 different ways of doing the job
Why??
• Different personalities with different strengths and weaknesses
• Without clear process mapping new employees are trained by someone who might already be performing a “cloned” and diluted process
CSR contacts patient to discuss insurance and co-pay
Send to distribution
Distribution assigns to truck / delivery
Driver calls to schedule time slot to deliver
Deliver
CSR contacts patient to discuss insurance, co-pay and delivery schedule
Send to distribution
Distribution assigns to truck / delivery
Deliver
Before After
Order Process
Misplaced or Lost Files?
I had the patient file on my desk, then Mary took it to copy and Bob took it to fax, and
then I lost track of where it went.
• 2.7 billion sheets of paper are created daily
• 200 million documents are filed daily
• The average document is copied 19 times for faxing, mailing, reviewing by others, etc.
• A typical office worker spends 40% of their time looking for information
So practically speaking what does that do for my business??
How much money can a true Document Management system save?
Why do I need Business Process Management Tools?
10 New Patients a Day Generate a Minimum of 100 Documents Per Day
1 Intake sheet1 Referral form1 Insurance verification form2 medical documents1 Assignment of benefits form1 Supplier standards1 Equipment training1 Delivery ticket1 Other (safety hazard, rental agreement, copay agreement)
Let’s Start by Figuring out How to CalculateHow Much Paper You Generate
What Does it Cost to File Documents?Based on 250 work days per year and 25,000 documents per year
PaperFiling time for paper documents: 40 minutes per day for 100 documentsCost per Year $2,000• 5 minutes to alphabetize 100 documents • 15 minutes to create 100 new folders • 15 minutes to put the folders in the cabinet for the new patients • 5 minutes to put the documents in the folders40 minutes per day x 250 workdays /60 x 12 per hour (includes benefits)
ElectronicFiling time for electronic documents: 5 minutes per day for 100 documentsCost per year $250• No alphabetizing • No folders to create• Auto filing eliminates the need to put the files into the file folders5 minutes per day x 250 workdays/60 x 12 per hour (includes benefits)
Savings… $1,750
What Does it Cost to Retrieve Documents?Based on 6 cases worked per hour x 250 work days per year =12,000 documents
PaperRetrieval time for paper documents: 4 minutesCost per Year $9,600• 1 minute to get to the cabinet and locate the document• 2 minutes to get back to desk and copy / fax / review document • 1 minute to refile document 4 minutes x 12,000 /60 x 12 per hour (includes benefits)
ElectronicRetrieval time for electronic documents: 1/2 minuteCost per year $1,200• No getting up from desk• No copying • No refiling 1/2 minute x 12,000/60 x 12 per hour (includes benefits)
Savings… $8,400
Some Signs That You Need Business Process Management Tools (BPM)
• Exceptions to rules result in constant interruptions for assistance
• Lost productivity due to:– Inconsistent prioritization and execution– Inefficient physical work environment
• Inability to chance processes as frequently as business demands change
Intake – Referral
PatientReferal
RPh AssessmentCMW – AC Assessment
Assessment Complete
Care Plan Development
Nursing Agency
Collaboration
Discussion with Patient
Active Care Plan
Patient Assessment
Delivery
Care PlanningTeam
Infusion Patient Management Process
Discussion with Patient CMW‐AC
Patient Calls CMW
Rph & RN AccessFor Change in Care Plan
Weekly Call to Patient
WeeklyStatus Report
Revise Care Plan Discussion with Patient
RevisionDiscussionComplete
End of TherapyPhone Call to Patient
Infusion Patient Management Process
Control Processes.No Unnecessary Moving Around The Officeor Waiting For The Previous or Next Step
in The Workflow.
How BPM pays for itselfCan you put a value on the following?:
• A single lost order or delayed order can ruin a relationship with a referral source resulting in loss of revenue
• A single non compliant order can trigger an audit resulting in thousands of dollars of refunds
Success ‐ PDPT
PeopleRight people in the right jobs
DataMetricsResults used to measure and evaluate processes
ProcessDefined, evaluated and manage
TechnologyTo accomplish all of the above
Do More With Less
• BPM/S isn’t going to cause a massive loss of jobs, replacing people with technology
• Will shift responsibilities and create more knowledgeable workers
• Ensure compliance with business rules