Prism has a longstanding partnership with a North Carolina-based academic medical center with $4.2 billion net revenue, over 36,000 staff members and 1,500 physician members. The 1,200+ bed system includes three hospitals, a private diagnostic clinic, university–affiliated physicians and community private diagnostic clinics. The system provides over 60,000 inpatient admissions and over 1.3 million outpatient visits a year.
The AMC manages its revenue cycle through the Patient Revenue Management Organization (PRMO). At the PRMO, revenue cycle leadership oversees many centralized functions for hospital and physician visits, including Pre-Registration, Insurance Verification, HIM/Coding, Billing, Follow-up, Denials and Patient Balances. Most workflows and data are housed in Epic, following AMC’s system-wide conversion to Epic in 2013.
In 2014, one year post-Epic go-live, the AMC was experiencing a growing accounts receivable and identified a need for tools and reporting to effectively manage staff and inventories. Leadership brought in Prism Healthcare Partners for a dedicated A/R clean-up and sustainability engagement.
Prism developed and implemented a unique workqueue (WQ) tool and process to drive real-time performance management and allocation of resources by leveraging Epic data for key insights into revenue cycle work in process. Prism’s Epic experts helped the AMC:
Prism provided training and materials to support WQ management, including how to interpret weeks of inventory backlog, at-risk A/R populations and how to align resources and action plans according to weekly trending.
The WQ tool has been in use on a weekly basis since 2015 and is integrated into the weekly process for the AMC’s entire management staff.