Larry Bronikowski is the business office director of the Florida Orthopaedic Institute in Tampa. The institute, which employs 600 staff to serve 1,250 patients on a daily basis, implemented a predictive rules engine platform from RCxRules to enhance its RCM processes.
What was the impetus for implementing a new predictive rules engine platform?
Prior to implementing RCx Rules, Hosted Claims Management (HCM) was the claims scrubbing solution. For a while, it served the practice well. As the practice grew, the need for more rules also increased. HCM could no longer support the addition of rules once maximum capacity was reached. The practice needed a new solution that offered unlimited rule writing that was also highly customizable. We have been very satisfied with RCx Rules. The product is user friendly, and the support team has been responsive to our needs.
How do you hope the new technology will benefit the practice?
The solution is seamless and has little to no impact on the patient. RCx allows for claim scrubbing prior to pushing the charges to GE Centricity. Scrubbing charges and making changes to codes and modifiers outside of Centricity significantly reduces the number of time-consuming charge corrections that would have otherwise been posted to the ledgers. In addition, fewer adjustments and corrections to the ledgers reduce the complexities of account analysis.
Is the Institute working on any other healthcare IT implementations? What timelines have been established?
FOI is currently in due diligence, reviewing multiple fully integrated EHR/PM solutions. With full integration, we hope to sunset as many bolt-on systems as possible. Full integration will revolutionize the revenue cycle from end to end. The target is 2017. Since we are participating in the Bundled Payments for Care Improvement Initiative, we are evaluating our current tools and will make a decision on how to proceed with procuring BPCI-dedicated software. In addition, we are currently implementing single sign on and content management software (utilizing tap-and-go technology). The go-live target is March 2016. Prior to the ICD-10 conversion, FOI implemented an electronic charge ticket solution. With any technology change, there are challenges.
What coordinated care initiatives are currently underway?
FOI has been participating in the CMS Bundled Payment for Care Improvement for lower extremity joint replacement since Jan. 1, 2015. We have been doing bundled outpatient joints with Blue Cross for several years. We have been developing a multi-specialty clinically integrated network in Tampa and an orthopedic clinically integrated network across the state.
What tips do you have for orthopedic practices looking to implement new healthcare technologies?
With any implementation, the practice should complete a robust due diligence process. Select vendors and solutions that are highly experienced in the practice’s specialty. View and try the product. Ask in-depth questions. Request to interview and/or tour other client installs. Form a steering committee with the proper stakeholders including an executive and physician champion. Dedicate a fulltime project manager to provide the administrative oversight. Allow for ample training in advance. Lastly, allow a generous timeline to complete the project so as not to jeopardize a successful install.