[ ] According to the electronic health records (EHR) totals provided by the finance department and billing department, they are missing $257,000 in billable services, over the last month, compared to last years numbers.

[ ] The agency states that employees daily productivity should be 80% of daily time should be providing Face-To-Face Services to clients This benchmark ensures a break even or slight surplus, since non-profit agencies can only carry limited funding with this corporate structure.

[ ] According to the IT Dept EHR records, the agency productivity numbers show only 57% of F2F Service records available for billing. Data specialist confirmed that the total number is 57%.

[ ] Data Reports showing the low EHR records entered have been provided weekly to program managers, yet program managers cant explain why.

[ ] The QA Manager for the agency doesnt have any oversight of this process, and no answers to the record shortage.

[ ] No red flags were raised based on the $257,000 monthly funding shortfall (compared to year to year stats), because no reporting captures submitted activity logs for services to the final billing submitted monthly to the state.

[ ] Program managers claim staff are busy all day long, yet activity logs submitted per day within the EHR system, dont line up with payroll dollars spent per week.

[ ] Client no call/no shows for scheduled appointments are higher than last few months of this fiscal year. _____________________________________________________ QUESTIONS TO RESPOND TO:

1) What procedures should be implemented to provide weekly follow-up, when staff misses the 80% daily productivity?

2) What oversight procedure would you consider providing adequate weekly oversight?

3) What could the agency do to reduce bottlenecks and inefficiencies in billing processes, such as claim submission, reimbursement, and revenue cycle management?