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Empire Home Infusion Services Streamlines Intake and Documentation

For more than 13 years, Empire Home Infusion Services, part of the St. Peter’s Health Partners system, has relied on Mediware’s team of home infusion billing and collections experts to manage its accounts. Recently, after evaluating internal processes, the Empire team realized that some additional training and guidance from Mediware Reimbursement Services (MRS) would enable a more efficient front-end intake operation and a more effective collaboration with the infusion billing experts.

To facilitate the training and consultation process, MRS scheduled a two-day on-site visit. During that time, the MRS team identified several areas for improvement, all of which would streamline Empire’s front-end processes.

Seeing results with Mediware

“The training we received was phenomenal, and we are already seeing results.”

Michelle Mazzacco,
Vice President of Community Services,
St. Peter’s Health Partners

 

In the weeks since the training, Empire has implemented MRS’s recommendations and has been able to:

  • Implement additional “best practices”
  • Respond to all referral sources within 30 minutes
  • Eliminate over-processing and duplication of efforts which improves productivity
  • Use Mediware software to ensure maximum efficiency

Implementing best practices

Following the on-site visit, Mediware Reimbursement Services provided the Empire Home Infusion team with a comprehensive list of recommendations. These included the incorporation of some “best practices” into the workflow. Among the most important were ways to streamline the insurance verification process. Implementing the recommendations has enabled the Empire team to ensure they have confirmed coverage for all services before care is provided. This minimizes the risk of bad debt.
Another critical suggestion was that Empire determine coverage for the Part D drugs that are being dispensed before the medication is compounded. “These strategies are helping us reduce risk and avoid bad debt,” says Michelle Mazzacco, vice president of the community services division of St. Peter’s Health Partners. In addition, MRS provided some tools for Empire’s staff to utilize as it continues to implement additional recommendations. “We really appreciate the Medicare manual and helpful per diem code tip cheats that the MRS team put together for us,” says Mazzacco. “These resources help eliminate the guesswork and create a common process that we can follow, so errors are reduced,” she adds.

Positive response with referrals

Prior to the training, one specific area targeted for improvement was the referral process. Empire had a goal of responding to referrals within 30 minutes, but that wasn’t always met. However, as a result of the newly implemented insurance verification practices, as well as some additional recommendations, Empire can now achieve its goal. “By following the MRS guidance, we are now confident that we can always respond to incoming referrals within 30 minutes, which allows us to treat more patients every day,” says Mazzacco.

Driving productivity

The Empire staff also expressed concern about “overprocessing”—or requiring extra or duplicative steps in other areas of the intake process. MRS identified several areas of over-processing, especially in intake and referrals; test claim processing; and managing required documentation. “After working with the reimbursement team, we came up with several solutions to avoid multiple staff working on the same tasks often because they were scrambling to complete all aspects of the new patient referral process with our realization of what another staff member may be working on. Thus, we also more clearly defined job roles to help make each staff member more productive,” Mazzacco explains.

Using software to its fullest extent

MRS also helped the Empire staff identify reimbursement-critical tasks that were being completed manually rather than within the Mediware software systems the organization already had in place. These tasks included tracking of authorizations; tracking of written orders and other documentation; and producing reports with key metrics. In addition, the Empire team learned how to rely more on the Mediware software for workflow management, inventory maintenance, pricing codes, and managing new payers and patients. As a result, the Empire and MRS team can bill more efficiently and effectively, which will lead to optimal reimbursement and profitability.

About Empire Home Infusion Services

Empire Home Infusion Services is a New-York-based not-for-profit provider of customized home infusion pharmacy services. The organization specializes in coordinating care and educating patients and families about antibiotics, nutritional therapy, chemotherapy, catheter care, and vascular access placement.

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