GRM recently developed a dynamic healthcare patient coding solution for Hospital Corporation of America–a national healthcare organization with over 150 hospital facilities, over 100 surgery centers, close to 200,000 employees and a network that spans throughout the United States and England. Records from these practices arrive at the company’s main offices via fax of through the mail. Upon receipt, documents are compiled and reviewed to make certain all of the necessary information has been received. Coding is then assigned to internal employees or outside contract coders, who receive their assignments based on medical specialty expertise.
What prompted GRM’s involvement were a number of growing challenges within the healthcare organization’s in-place coding process. They included a heavy reliance on the manual handling of paper and frequently receiving patient paperwork that was incomplete. These issues led to a high incidence of information error, process interruption and lengthy delays that negatively impacted productivity and overhead costs. Errors and incomplete records required representatives of the healthcare organization to frequently contact physician practices multiple times to resolve discrepancies. This, combined with the sheer volume of claims (several hundred per week) only aggravated the delays and contributed to a growing backlog in coding, which in turn translated into longer wait times for physician practices to be paid.
GRM and HCA launched a test pilot program for 15 practices, which took only two weeks to implement. Using electronic forms, GRM created a digital claim submission process that could be easily accessed and completed through the GRM Online Record Center–a flexible, Cloud-based, digital repository. This system enabled the capture and accounting of all necessary physical information on the very first attempt. It also ensured the electronic attaching and archiving of any required paperwork (whether physical or residing on a computer or other digital device) through Kofax scanning and file uploads.