Using Six Sigma Principles to Reduce Billing Errors

View Paper

View Presentation

Financial/Human Resource Performance

Cassandra Murphy
Functional Analysis and Process Improvement
The Methodist Hospital

Hanie Abdul Sathar
Commercial Manager
Patient Accounting
The Methodist Hospital

The session will describe key Six Sigma techniques used to decrease billing errors at The Methodist Hospital, TX. This particular session will provide ideas on optimization of claims throughput, streamlining processes that impact claims processing and reimbursement and the use of six sigma principles to achieve success.

Due to rising healthcare costs, hospitals across the nation are placing a strong emphasis on streamlining & improving operational efficiencies. In the first quarter of 2007, thirty-six percent of claims at The Methodist Hospital did not produce a clean bill, on first pass into Claims Administrator (C.A.), due to failing billing edits. This resulted in inaccurate and incomplete bills, rework, increased costs, delays in reimbursement, and decreased cash flow. As a result of failed claims on first pass, an estimated $9.4 Million per day is delayed for at least one day. This presentation will present some of the key lean/six sigma techniques used to establish processes to streamline operations, and hence, facilitate improved claims processing and reimbursement.