electronic work queue

The Business Office at the Redwood City Medical Center in Northern California was letting some of their bills slip by.

Specifically those billed to Medi-Cal and the Northern California region asked facility business offices to improve the turnaround time for filing those treatment authorization requests.

They wanted to improve the reimbursement rate for care provided to Medi-Cal patients because that initiated payment to Kaiser Permanente. So, the region asked facilities to file the authorizations within five days from the day a Medi-Cal patient was discharged.

But apart from the one-year time limit on billing, a lot of business departments didn’t monitor the number of days it took to file those requests. Sometimes it might take 30 days, other times perhaps just two days. They needed a consistent turnaround time. 

“A dollar devalues the longer it’s out there,” says Pattie Murphy-Kracht, director of the admitting and business office. “So an outstanding bill loses its value the longer it’s unpaid.”

The Redwood City team decided to monitor the electronic work queue that tracks patient billing to look for Medi-Cal patients. They also monitored the electronic list of Medi-Cal hospital patients, so the team could anticipate their discharge.

In two months, the number of days to file a treatment authorization request dropped from 21 to two days. 

The team said being open to change was a big reason for their success.

“We’re good at trying different ways of doing things,” union co-lead Jessica Garcia says. “Change isn’t always easy, but we’re not stuck on one way.”