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Holistic Health Systems ( HHS ) operates 3 9 hospital facilities and clinics. The executive team has been reviewing key metrics over the last year
Holistic Health Systems HHS operates hospital facilities and clinics. The
executive team has been reviewing key metrics over the last year and identified a
need to improve Point of Service Collections, or simply known as POS
pronounced POS POS is a patient payment that is received within days of
discharge. Increasing POS is important for HHS because hospitals are less
likely to receive payment once the patient leaves the hospital. The cost of
collecting on the patients account continues to go up while the chance of actually
collecting payment goes down if there is a delay in collecting the payment after
the patients discharge. Therefore, it is better to not delay collecting the payment.
Increasing POS reduces bad debts, provides a better cash position, reduces
expenses, and increases patient satisfaction when conducted properly.
POS is calculated by dividing POS payments by the total patient cash collected.
HHS has identified the industry median benchmark for POS as and the top
POS benchmark as HHSs current POS performance is and the
executive team has determined that a percentage point increase is needed to
stay competitive target A Lean Six Sigma team was formed.
POS is a metric that heavily relies on the Patient Access team, or PA PA is
responsible for several taskspatient scheduling, registration, and financial
clearance. The "scheduling" tasks are typically completed by a centralized PA
team for multiple hospital facilities. During scheduling, PA reps receive a doctors
order for a patient. The order is like a permission slip for specific medical services
the doctor deems necessary. The doctor or even the patient related to the order
can call scheduling to reserve an appointment for the services that correspond to
what is written in the order. PA reps need to verify that the order is complete and
accurate, coordinate time for services, and provide patients with preservice
instructions. After the patients information is logged into the scheduling system, it will be queued up for the PA registration team to complete the registration
process. The PA will call the patient and confirm their identity and collect
demographics such as address, family, emergency contact, etc. The patient's
health insurance providers will also be confirmed as part of the PA registration
process. PA registration can be completed at a hospital facility or by a centralized
team. Lastly, PA Financial Clearance will verify patient health benefits to ensure
they exist and to determine if the procedure or service for the patient is covered.
If authorization is required, the PA Financial Clearance will request authorization
for services from the patients health insurance provider. Services performed
without authorization lead to rejected claims. Also, during PA Financial Clearance,
the PA rep will counsel the patient about their liability how much their insurance
provider says they need to pay for the services and collect the payment. Any
payment received is considered POS since its before days post discharge.
Financial clearance can also be performed at the hospital facilities or by a
centralized team.
Summary patient cash data for HHSs hospital facilities for a year is presented
in Table The table also indicates if the PA team for each facility is centralized or
not.
Table provides an overall monthly trend for POS performance.
The team identified the facilities with POS performance above the target and
researched the activities they have in place, hoping to find commonalities or key
drivers. They are:
ensure proper patient education on benefits and liability
ask for payment
have a financial counseling policy
reduce number of patients that leave without financial clearance
have accurate tools to help estimate patient liability or responsibility
utilize devices that allow patient collections at the patients bedside
Exercise
Process Stability
Using the data given in Table determine if the POS performance is stable using a
control chart.
Explain why you used the type of control chart you selected.
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