Evangelical Community Hospital’s dedicated and skilled Medical Staff, along with more than 1,900 clinical and support professionals, provide personalized, affordable care in the safest possible environment. In addition to inpatient services, Evangelical provides access to a network of specialty services and practices not typically associated with community hospitals. That list includes orthopaedics, surgical care, diabetes care, wound and hyperbaric medicine, pain medicine, physical therapy, a dedicated breast health center, urgent care, primary care, and much more.
The Challenge
- JTS Health Partners (JTS) was retained to perform consulting services within professional coding, education and compliance for 2021 Evaluation & Management (E&M) level coding for Evangelical Community Hospital’s Managed Service Organization (EMSO)
- JTS committed to 80% of physician participants meeting clinical standard in a 12-month period
- JTS was tasked with providing the EMSO a strategic plan for sustainable improvement
The Collaborative Approach
Phase I: JTS Conducted Benchmarking & Data Analysis
- Analyzed 600+ encounters
- Identified processes and procedures causing documentation improvements
- Identified billing discrepancies with physician education opportunities
- Formalized goals per practice; alignment with organizational objectives
- Recommended Pre-Bill coding review to improve Provider accuracy rates
Phase II: JTS Implemented Provider-to-Provider Knowledge Journey Strategy
- Initiated Provider documentation improvement process and metric tracking
- Developed curriculum and tools
- Conducted executive and peer-to-peer education and review
- Provided analytics to measure and communicate progress achievements
Phase III: JTS Implemented Sustainability Framework
- Initiated Pre-Bill coding review applying measured analytics
- Conducted a second, Post-bill coding review providing additional physician education under 2021 E&M guidelines
The Accomplishments
- Met short-term physician documentation improvement goals
- 15% improvement in clinical documentation over a 6-month period
- 12,000 encounters reviewed and educated Providers
- Conducted training, chart review and comparative results on a monthly basis toward organizational goals