South Florida Hospital News
Saturday January 18, 2020

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November 2006 - Volume 3 - Issue 5




ORHS's Efforts to Improve Patient Access Work Quality and Accuracy

What essentially began as a schematic on a napkin at a medical industry conference is now providing 99% billing accuracy for one of the largest healthcare systems in the South East U.S., Orlando Regional Healthcare System (ORHS).

Composed of Orlando Regional Medical Center, Orlando Regional Lucerne Hospital, M.D. Anderson Cancer Center Orlando hospital-based services, Arnold Palmer Hospital for Children, Winnie Palmer Hospital for Women & Babies, Orlando Regional Sand Lake Hospital and Orlando Regional South Seminole Hospital, ORHS records 50,000 registrations per month and one day AR of $2.6 million annualized.

ORHS Director of Patient Business Craig Pergrem and Chuck Kramer, CEO and President of The Kramer Group, hashed out the details of what would become Registration Quality Improvement (RQi) on a napkin.

"We knew we needed something and The Kramer Group (TKG) has worked with ORHS over the years on so many projects in our Patient Accounting area." Pergrem said. "What TKG offered was a solution that would allow us to build the rules and to control what we needed on each account. With that much flexibility, we knew it was going to be a success."

"With RQi we are able to look at the account in two ways: Discharged (D) and Billed (B). With our manual process that was showing us 10% of accounts registered, we were usually in the 83-85% range," said Pergrem.

"When we went live with RQi our scores were at 93% and we now hover at the 96-97% score for "D" status accounts. One of the beauties of RQi is you can make the correction before it hits a "B" status and we can score that as well."

"As a corporation, we stand at 99% and have not been lower than that since May 2005. Several of our facilities maintain a score of 100% at "B" status, as well as, many of our representatives maintain 100% in both "D" and "B" accounts."

May of 2005 marked the debut of RQi to ORHS’s management team. For a month, management was able to learn about the system in a live environment. The following month, RQi was rolled out to staff with a 30-day grace period to familiarize themselves with the system without having it impact their coaching plan score.

"RQi is a continuous education tool that each staff member receives daily." Pergrem said. "They are able to look at their errors on a daily basis and not only see what they did wrong, but get a chance to correct it themselves and know why the error was made. That also teaches them at the same time and the next time they register a patient they will remember that error."

"We also utilize a six-month coaching plan with our staff. With RQi we have the ability to keep a running QA score on their home page of RQi so they know where they stand for that period. They can view their score daily, monthly and coaching period to date, which means there are no surprises when they meet with their Supervisor and discuss their quality."

"The reporting capabilities in RQi allow us to pull reports on individuals for that period and break it down by error and the total account dollars that could be or were impacted with those errors."

RQi is web-based allowing for ease of implementation and access.

"I give TKG a lot of credit for making us think out of the box too." Pergrem said. "Our QA Manager, Kristy Summers, took charge of the implementation and her QA team wrote rules, tested and tried every possible way to break the system before we went live."

ORHS has been working to improve patient access professionalism, accuracy and accountability for years. By implementing RQi, ORHS has implemented the newest most cutting edge and cost effective way to review and account for 100% registration and information accuracy while achieving a level of employee training and accountability never accomplished before.

For more information on Registration Quality Improvement, contact Chuck Kramer at (407) 872-7969, or visit
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