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Learn from the Q&A with Leaders from MercyOne Des Moines Laboratory

  • Product Marketing Manager, XIFIN

We recently had the pleasure of speaking with Mona Dinnauer and Teri Reiff from MercyOne Des Moines. Mona Dinnauer, MHA, MLS (ASCP)CM is the director of outreach services, and Teri Reiff, MHA, MLS (ASCP)CM is the market director for laboratory services at MercyOne Des Moines. Below is a summary of some of the key questions they addressed during the XIFIN webinar, “MercyOne Des Moines Laboratory’s Innovation Leads to Outreach Financial Optimization.”

Question #1: Can you tell us a little about MercyOne Des Moines and the Laboratory Outreach Program?

MercyOne Des Moines has a full-service reference laboratory. Our mission is “To provide accurate, accessible, and timely laboratory results to healthcare providers and patients.” For the past 30 years, we have offered full-service hospital outreach laboratory services and currently have 200 FTE and 400 active clinic clients. We are a 24/7 operation with three draw stations. We serve a large part of the state of Iowa.

Question #2: Can you describe at a high level your infrastructure program and the IT systems specific to the laboratory that you have in place and how it has evolved?

Our hospital embarked on the EHR journey back in 2006. For the outreach lab, we implemented Atlas about ten years ago. Then we did a number of integrations with it, including Salesforce, a document management system, and other Atlas optimizations. In 2018, we started working on revenue cycle management (RCM) with XIFIN, and that was completed and live in 2019. Now we are working on eligibility checks and front-end payor rules. Working on the client manifest is next. There is always something to work on, and we typically focus on one area at a time.

As I mentioned, the core of our laboratory IT system is Atlas, which is an integrated order and results application that is connected via web portals to our clients. About 95% of our orders are now received electronically. There are multiple interfaces between Atlas, the client EMR/LIS, the hospital financial system, EHR/database, and instrument interfaces. They output to our outreach operations systems and our outreach revenue cycle management solution, XIFIN RPM. We have it set up so that the requisition scanning system feeds XIFIN as it does Atlas via the demographic information.

Question #3: Would you please elaborate on the specific challenges the outreach program was facing, what you decided to change, and why?

A few years ago, we found that we lacked the visibility we needed to understand what was happening with the outreach laboratory billing, such as, what was getting paid, what was not, and what the reimbursement was compared to what we were expecting. We didn’t have the business intelligence (BI) capabilities we needed to get reports at the level of detail to understand which clients were profitable and which were past due.

We also knew that there were inefficiencies in our manual processes, and we wanted to increase the automation in these processes. We are continually seeking better outcomes at a lower cost.

In the last couple of years, we have made some significant changes to our revenue cycle management process, including:

  • Using client and patient portals to make invoicing a lot easier; now 80 - 90% of clients are using portals to communicate with us
  • All processes are now automated, including sending out exception/error processing letters
  • Changing bill types with just a click in the system, which has eliminated a lot of rework
  • Account bill changes are now streamlined
  • Having flexibility in creating rules and placing a hold on accounts
  • Making updates to payor rules and limited and national coverage logic
  • Having end-to-end visibility and understanding of reimbursements and profitability

These improvements led to a 15% increase in cash collections.

Question #4: What was the process for gaining approval for an RCM system change? Who needed to get on board, and how did you go about getting them on board?

We needed to get a lot of our senior leadership on board, including our CEO and CFO. We explained the issues and difficulties we were experiencing. We had multiple discussions about RCM capabilities, and everyone came around to where we needed to go. Our CEO understands outreach and its revenue potential. One of the hardest parts was getting the CFO on board because they were concerned about routing revenue through another system.

We were able to build trust with the corporate executives that this change would result in higher revenue and profitability. We also emphasized that they would be able to have more focus on the hospital accounts with the lab out of the mix. It took about a year to build the case and two years to complete implementation. They are now pleasantly surprised to see month-end reports available within a day.

Question #5: Why did you decide to outsource to XIFIN?

We have experience with many of the different RCM options from doing it ourselves to through the hospital outsource service provider. We knew we needed a solution designed for laboratories that could be customized to our needs.

We liked the differences we could get in terms of the relationship, system, knowledge, and support via outsourcing with XIFIN. We didn’t just want the software; we wanted feet on the ground communicating with us and helping us improve our financial results. We also knew we needed the flexibility to drive different actions with clients or payors, as well as the ability to look into finer details of our performance and how we can improve through automation. We wanted a partner, rather than going at it alone.

We wanted a complete solution to manage our business, including write-offs, researching denials, and understanding trends. XIFIN has the expertise we were looking for, and we know we have the option to transition to in-house in the future if that makes sense.

For more of the discussion between XIFIN and MercyOne Des Moines listen to our on demand webinar "MercyOne Des Moines Laboratory’s Innovation Leads to Outreach Financial Optimization." 
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Published by XIFIN
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