For example, if a claim requires a referring provider, and that piece of information is captured at registration, it should be reflected in both your patient workqueues as well as your claim edit workqueues.Īssign an owner to every workqueue – Accountability is key. Any revisions you have on claim edit or account workqueues should also be captured on pre-registration and registration workqueues since they are worked and owned by different sets of users. Make sure that you include negative results testing as well as positive results testing and ensure that your back-end and front-end edits are in-sync. Test your build– A reminder to test might sound unnecessary, but when rolling out a new build, testing is crucial. Trainers can use this information as they develop training criteria. ![]() ![]() Credit, Adjustment Review and Follow-up WQ – Once the claim is processed, billing may need to follow-up on credits, adjustments, or denialsĮnsure that the criteria for why accounts hit a workqueue and why they fall off is clear and well understood – This must be well-defined for testing and support.Account, Claim Edits WQ – Coding and Billing would need to review any coding edits or claim edits that were triggered prior to the claim dropping.Patient and Account WQ – After pre-registration you might have someone review the patient’s benefit information, create an estimate for a patient and determine a pre-payment.Patient WQ – Drive the future encounter to a pre-registration workqueue or capture any missed information for a current encounter.Schedule Order WQ- Capture the order for scheduling the test and then schedule it.In this situation, you might implement the following workqueues: Let’s take an example of a patient who comes in with an order for an imaging procedure. Ensure that every workflow is accounted for in your build. Use a mix of very common (diagnostic imaging, etc.) and complex workflows (workers comp, case management, etc.). Use claims from your legacy system to reproduce accounts. This will ensure the flow from workqueue to workqueue is intuitive and that stakeholders have a workflow to follow. Workqueues should mimic your workflows – Take your workflows and map out a life of an account across your workqueues. ![]() Here are a few things to keep in mind as you start your build or look at optimizing workqueues: It is much more difficult to correct and clean-up workqueue build once Epic is live than it is to take the initial effort to carefully design, build and test your workflows right at the start. Building anything properly the first time always makes life easier, and building workqueues in Epic is no different. However, it is not uncommon for organizations with Epic’s Foundation system to struggle at go-live and thereafter, when team members do not know how to properly and efficiently utilize workqueues.Īt no fault of their own, Application Teams work in silos on their build in trying to meet “build bucket deadlines” and as a result, an opportunity to build based on your organizational workflows is lost. Workqueues are a cornerstone of Revenue Cycle management in Epic they can provide powerful functionality to keep business operations running smoothly.
0 Comments
Leave a Reply. |