Are you considering replacing your EMR system? Before diving into a new installation for your Revenue Cycle, it’s crucial to explore several key prerequisites. While these topics often arise during the implementation process, addressing them beforehand can significantly streamline your EMR transition. While you don’t need to finalize every detail before implementation, having a clear understanding of your current state, payer regulations, revenue cycle pain points due to your existing system, and past decisions can expedite the process. This allows you to focus your implementation time on achieving desired workflows and outcomes.
- Integration Possibilities: Highly integrated EMRs can often replace multiple third-party vendors. To begin, review your current contracts and assess the benefits of integration versus interfacing. Thoroughly research third-party vendors and compare them to your recommended EMR; you might find that some third-party systems can be eliminated, reducing vendor cost, and ultimately improving your bottom line.
- Banking Synergy: Evaluate your current banking relationship with the selected EMR and identify potential workflow benefits. Outline workflows for your current EMR, clearinghouse, payer, accounting, bank, and document management system. Highlight any limitations or areas that require improvement. Explore the use of cash reconciliation tools within the EMR that can seamlessly link with your bank.
- Charge Master and Fee Schedule: Consider consolidating your charge master(s) and fee schedule pricing. At the very least, gather historical information on why specific codes were separated and pricing was segmented. This knowledge will be invaluable if changes are needed in the future. Understanding revenue routing and reconciliation processes in your current state can aid in integrated charging implementation and proactive mitigation of revenue loss.
- Accounting and Reporting: Engage in a dialogue with your accounting team. A new EMR implementation often presents an opportunity to revamp general ledger accounts, enhance reconciliation processes, and adopt a more comprehensive reporting approach with new terminology to distinguish between legacy and the new EMR.
- Billing Requirements: Reassess billing requirements for specific service lines and document current processes. This information will facilitate discussions on facility structure, payer build, and clinical workflows, ultimately impacting the claim’s end result and reporting. Be sure to collect examples of these billing requirements.
- Payer and Plan Volumes: Capture payer and plan volumes for consolidation. Gather historical data and document the reasons for specific plans being carved out. This will help determine if an alternative approach can capture the need without creating a new payer plan.
- Additional Systems: Reflect on any additional systems that will be implemented alongside the new EMR. Consider the impact on resources and the project timeline. Many resources overlap with the new EMR implementation, such as new clearinghouse, document management systems, or credit card integration. Research and create a plan for transitioning from legacy accounts receivable companies.
- Revenue Cycle Restructuring: Assess and optimize current revenue cycle operations before the go-live to avoid bringing suboptimal processes and behaviors into the new build and ensure alignment with new system capabilities. Getting a reset with a new EMR is a once every 20 years or so opportunity to start fresh with a good solution from the beginning. Also begin to think about legacy AR wind down strategy.
- Creative Thinking: Encourage a shift in mindset away from the status quo and embrace a “think outside the box” mentality for desired workflows. Develop integrated build teams to explore the bigger picture and leverage creativity within the system to resolve issues.
A successful EMR implementation requires comprehensive information gathering, assessment, and a clear roadmap from your current state to the desired state. PinnacleHCA has years of experience providing implementation and optimization guidance, helping you prepare for a new EMR while efficiently managing your current business office operations. Contact us today at [email protected] to explore how we can support your future partnership for a seamless transition.
Other relevant topics can be found through the following links: How to Determine if Your Current EHR Platform Can Solve Your Revenue Cycle Challenges. Top 5 Missed Epic Revenue Cycle Optimization Opportunities. Are Your Epic HB Workqueues Broken? Here’s How to Fix Them. Getting More Out of Your Epic Activity Codes. Black Holes the Watchlist Doesn’t Even Know About. Keeping an Eye on the Watch List – Epic Tips & Tricks.
