The Department of Defense integrated electronic health record MHS GENESIS is being upgraded at Puget Sound Military Health System military treatment facilities.
Just as Madigan Army Medical Center, Naval Health Clinic Oak Harbor, the Air Force’s 62nd Medical Squadron and Naval Hospital Bremerton were the first to deploy MHS GENESIS in 2017, they are now amongst initial sites to implement MHS GENESIS Revenue Cycle Expansion (RevX) in 2022.
RevX is specifically designed with new features, functionalities and capabilities as a crucial next step for Defense Health Agency commands such as NHB to increase their efficiency in managing resources when meeting patient demand.
“RevX went live April 1, 2022. Business and clinical champions came together to identify the need for a “clinically driven revenue cycle” that ties what we do in the clinic to what the coders and billers are able to capture. This ensures that the work we are doing in the clinic is being accounted for and also ensures that we are capturing potential revenue from beneficiaries who might have other health insurance,” said Lt. Cmdr. Paul Flood, NHB chief medical informatics officer, staff physician, and Urgent Care Clinic department head.
RevX is designed as the the next step to hone efficiency in such administrative and management areas as meeting patient demands, managing patient records, and detailing patient accounting.
Above all, insists Flood, RevX introduces a cultural shift towards a clinically driven revenue cycle culture which will optimize decision-making for leadership at NHB. It’s designed to integrate and standardize clinical and business workflow processes in delivering positive patient outcomes. RevX will improve operational efficiency for the business communities, as well as provide predictability and accuracy of supply and logistics for the command.
What does all this mean for an eligible beneficiary?
RevX will streamline the administrative workload typically associated with every appointment so clinicians can focus on patient care. It will be part of every patient appointment, which starts with scheduling that appointment, which then leads to the Patient Identification Process, one of the focal points of the RevX training.
“PIP allows the selection of a patient profile and health plan based on eligibility for the care and reason for their visit,” explained Flood. “PIP will improve upon patient information collection, simplify the check-in process and lead to collection accurate and detailed financial data, from which a bill can be generated.”
After a patient’s registration, enrollment and eligibility details are given the pre-authorized thumbs-up, the patient will again go through the patient identification validation process when checking in for the actual appointment. The administration trail continues with any information collected during the provider and patient interaction such as clinic notes, laboratory orders and pharmaceutical prescriptions. At that point, the workload is summarized, along with any charges noted and if a referral is needed. Upon discharge, all the charges are recorded, followed by billing and a coding review.
“The staff most affected with RevX going live are our front desk clerks, our coders and our billers in the Uniform Business Office. To a small extent our clinical staff are also impacted as we need to ensure we are documenting and placing charges for all the little things we are doing in clinic,” said Flood.
NHB billing and coding team, although not directly involved in providing patient care, are intricately engaged in every patient encounter. Every time a NHB provider, nurse, corpsman sees a patient, there’s a specific code assigned to each diagnosis and procedure. That coded data is used to be reimbursed by insurance companies and/or federal government coverage such as Medicare or Medicaid. Increased billing accuracy is a crucial part of NHB’s business operations working with and supporting clinical operations.
For patients, Flood attests that the new and enhanced MHS GENESIS tools allow for better understanding the reason for the appointment, as well as accurately verifying the health care coverage information.
There are a few tips which are recommended for all patients in the military health system and using MHS GENESIS.
Arrive Early: follow the standard military logic of ‘early is on time.’ It’s recommended to give yourself an extra 10 or 15 minutes before appointment check-in.
Let it be Known: Be sure to share the reason why you have an appointment to help ensure staff have the right information.
Current Health Care Coverage Comms: Make sure your insurance coverage is up to date. Have there been any modifications? Is your personal contact information accurate? Share all pertinent details to make all future visits and pending appointments not spent on paperwork and red tape.
RevX is expected to benefit clinical staff by increasing their emphasis on patient care due to streamlined administrative capability. The Resource Management team benefits by enhanced operations, such as improved check-in efficiency and patient experience through better identification of the patient’s other health insurance information. Supply and Material Management benefits with increased logistical predictability which include being able to anticipate when to order medical supplies and prevent any shortages of vital supplies to have on hand.
“In terms of how has this improved since MHS GENEIS go live in 2017, we are better adapted at identifying issues as they develop and implementing fixes. Training has also become more targeted so that we are getting training to those who need it to ensure that this project is successful,” stated Flood.