HIM Case Study
THE CASE: Chatham Hospital, Siler City, NC
The Challenge:
When the HIM director suddenly took medical leave, CEO Woody Hathaway turned to QHR for support. The interim director arrives the next week - bringing 25 years experience and was quick to resume efforts already underway and find other opportunities for improvement:
- The prior director had begun a process to engage department managers in the revenue cycle
- Staff needed training on new PCs and software
- Billing was backlogged; discharged not billed (DNB) accounts topped $1.2 million
- Poor cash flow had forced the hospital to borrow $100,000 on its line of credit
- The upcoming construction project added expenses – and pressure to perform
Q Solutions
Meeting with departments to understand their issues, QHR’s HIM consultant worked with CFO Bert Barnette to simplify processes. “She got our managers to see their role in the revenue cycle,” explains Barnette, “and how important it is.”
Why were so many accounts in limbo? The interim took the team into ancillary departments like radiology, respiratory therapy, lab, dietary and physical therapy. They found that accounts remained open for repeat patients – those who returned for weekly or monthly tests or services; bills weren’t generated on a schedule.
The team implemented a process of repeated discharge, billing, and generating a new account to restart the cycle by training departments show to work with registration staff.“QHR’s interim HIM director got people communicating and updated our processes,” relates Hathaway. “The result is better cash flow. And that keeps everything moving.”
QHR supported the team’s efforts with a chargemaster review, while the interim director managed other initiatives to move the hospital forward: new registration software to reduce denials by prompting for medical necessity information; off-site archiving of old records to make current ones easier to manage; and computer training to enable HIM staff to retrieve archived records via secure internet connection.
“Without QHR, we would never have found someone so quickly… or so qualified,” adds Barnett. Finding a permanent director is the next challenge. “She did more than bridge the gap: she made progress. And now, by helping us interview for her replacement, she’ll help us keep it going.”
The Outcome
- In two months, DNB was reduced by 50%, to $600,000
- Better cash flow enabled the hospital to pay off its credit line
- Stronger financials keep the building project on track
”When our HIM director took medical leave, QHR found an interim for us the same day. That’s the way it is with QHR: when I have a need, I pick up the phone, and QHR meets that need, whatever it is.”
