Anticlue

Exception Workflow Applications Needed

Interfacing data from one system to another always needs to include some type of exception and comparison reporting. This reporting however really needs to be closely examined. What value is there in generating a paper report that states out of 245 inpatient cases, 237 were successfully interfaced? These 8 accounts need to be identified as to why they are on the exception list. Here is where in some places the drill down stops, and what I’m proposing should change.

In reality exception reports are just a worklist for someone to go digging in the various systems to find which information is missing. But what if instead of having an individual go digging, we actually created a systematic system to do the digging? What I am referring to is this, imagine a situation with ed charge capture. Have a tool that always multiple people to work the exception list, probably web based. But let the tool be all financial exceptions to the final completion of this account. First there is the screen listing the exception accounts, then you can categorize the exceptions to the missing inforamtion, and drilling down on the exception account yields the missing information to fully completing the account.

For example with treat and release patients, there will need to be information from patient access or registration, coding and abstracting, and charges for supplies, level of service, procedures, labs, and drugs. So the exception tool may report off of all items preventing this case from properly billing. For example let’s say in the billing system the insurance information didn’t interface properly, but it exists in the registration system. This would place the account on the exception report, categorize it as an interface issue, and maybe even try resending the info once automatically. Or for example let’s say the coding wasn’t completed, and this was one of the items in the drill down. When querying the in coding db, it is noticed that the chart has not been received yet. New category for the error, and everyone can track.

With this manner of managing by expections for the total account, it would be easier to identify trends and issues, which hopefully would improve workflow.