Case Study

Standardization, Reimbursement Management & Government Reporting


SITUATION

HFS was approached by a large hospital system that needed to create consistent, accurate government programs reporting across all of its locations. The hospital system’s objectives were to:

  • Demonstrate an effective compliance program in its government programs reporting
  • Consolidate overlapping reimbursement functions
  • Reduce program specific costs
  • Eliminate manual processes
  • Improve use and cost of external vendors
  • Improve revenue
  • Create organizational, structural and people development plan
  • Leverage an operating model that serves to eliminate duplicated responsibilities
  • Better use resources through identification of best practice models and skills

SOLUTIONS

The health system’s reporting was inconsistent from one hospital to the next. Its documentation was insufficient, and, in many cases, simply not appropriate to support requests for reimbursement. These problems were resulting in numerous audit adjustments, causing losses in both time and money at all of its locations.

RESULTS

HFS’s compliance-driven approach to standardization of the reporting of all information to state and federal agencies eliminated the inconsistent handling of issues within and between facilities, and the numerous lack of documentation adjustments. It has provided the system with the ability to demonstrate an effective compliance program in its government reporting functions.