CEO Message: June 2017

Dear Colleagues:

Last week, we celebrated the opening of the new NEMG Multispecialty Center at 4A Devine Street in North Haven. Attendees' spirits were high and the weather was perfect for our ribbon-cutting ceremony. The facility brings together primary, specialty and walk-in care to better coordinate our patients' care and provide added convenience. Please read more about the ribbon-cutting event here.

This new model of care is one way we are working smarter at NEMG. On June 10, we hosted a Spring Working Retreat for our clinicians centered on this theme of working smarter and the non-clinical functions and processes to help us meet this goal.

Revenue cycle management is the financial process for managing all of the billable services a clinician provides to a patient during a single encounter. The cycle begins with the scheduling of the patient's appointment and concludes with reimbursement for the rendered services from the payer. With the goal of working smarter, we have undertaken some key initiatives to better stabilize revenue cycle management.

Registration, charge capture and coding are significantly important when working with a multitude of payers, each with its own claims policies and requirements. We strive to have each claim paid upon its first submission, so we have to be sure it is coded properly to meet the needs of the particular payer. That is why our coding team reviews all the clinical documentation to ensure all procedures and diagnoses appear in the claim before it is sent to the payer. To better realize efficiencies, align workflow processes and ensure consistent results, we combined New Haven, Bridgeport and New London coding teams to cross cover for each other and reduce redundancies.

To streamline billing, we moved to a single vendor. On April 1, the legacy L+M Medical Group central business office staff were on-boarded as employees of Corporate Professional Business Services (CPBS). This new internal entity was created by Yale New Haven Health to support Professional Billing Services. It is continuously hiring and training new employees and has already doubled in size since being formed. This team is currently working to improve pre-billing and claims review.

Additionally, our Operations team is placing an increased focus on timely and correct patient registration, check-in processes and time-of-service collections. In fact, during Q3 of 2017, nearly 92 percent of copays were received. That group is also piloting a centralized authorization team to improve the patient experience and decrease authorization denials.

Our revenue cycle management programs are being spearheaded by two newly formed groups within NEMG – the Revenue Cycle Taskforce and Professional Revenue Oversight Committee. I would like to thank them for their efforts, which have already yielded positive results. Most of them are at or above industry standards, as shown below.

Metric Comparison
NEMG Average Top Quartile
Accounts Receivable Days (of Revenue) 29.4 39.4 30.9
Charge Review Days (of Revenue) 3.4 2.8 1.1
Claim Edit Days (of Revenue) 0.3 1.3 0.4
Outstanding Denial Days (of Revenue) 2.9 6.4 3.7
Undistributed Days (of Payments) 2.0 3.5 1.3

Many thanks to Christine Hines, Jennifer Wooley and their teams for the significant work around these services this past year.

My many thanks to all of you for your dedication, expertise and leadership in enhancing the health of our communities and making our work environment more joyful and efficient.

Best wishes,

Prathibha Varkey, MBBS, MPH, MHPE, MBA
President and Chief Executive Officer
Northeast Medical Group