case study


A Complex CPTII Coding Automation Solution


The Jackson Clinic

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BACKGROUND

Founded in 1950
Jackson, TN


First Multispecialty Clinic
in the State of Tennessee


145 Providers
25 Specialties
12 Outreach Locations


Implemented Keena’s
CPTII Coding Automation
Solution: Q4, 2018

THE CHALLENGE

Managing Insurance Carrier Requirement to Submit Appropriate CPTII Codes with Visit Charges


Major insurance carries in Tennessee were increasing pressure on provider organizations to link CPTII codes to certain visit charges in order to improve their quality scores and reimbursement levels.

The Jackson Clinic’s coding and clinical teams were frustrated with extra chart look-ups and manual tasks required to meet the new submission requirements. With a thorough understanding of the workflow and data management needs for this project, their Medical Directors and Population Health teams shifted their focus from trying to streamline new manual workflows to looking for a data solution to automate and improve the process.

Since they weren’t aware of any automated CPTII coding systems available to meet their specific reporting requirements, they looked for a 3rd party resource with the experience and expertise to create a custom automation solution.

Collaborated with a Trusted Vendor to Create an Automated Solution

THE SOLUTION


The Jackson Clinic and Keena have had a long-standing and trusted relationship. For years they have collaborated on dozens of data integration projects, implemented workflow applications and custom script projects all with a focus on improving efficiency and the quality of care delivered.

 

THE RESULTS



Keena’s deep understanding of Jackson’s needs and IT systems challenges lead the entire CPTII coding automation project to be completed and implemented in a little over 4-months time!
  • Speedy and accurate quality reporting.
  • Improved quality performance and reimbursement levels.
  • Access to CPTII coding automation library of quality measures that are adjusted as needed.

What Our Customers Are Saying About Us


We turned to Keena as we've done in the past to help us solve an organizational workflow problem - in this case, managing expanded CPTII coding requirements.

Keena delivered an automated solution to meet our needs in 4 months! The solution significantly reduced our time to manage new requirements, improved our quality scores, and resulted in an increase reimbursement levels for the organization.

It's certainly one of the contributing factors to the Jackson Clinic achieving its 5 Star Quality rating with BC/BS of Tennessee.”

— JAN MATTHEWS

Director of Information Systems, The Jackson Clinic

BENEFIT TO

Organization


The Jackson Clinic saw a dramatic decrease in the time required to accurately submit new CPTII coding requirements through the Allscripts Touchworks EHR/PM system, and a resulting improvement in quality scores.

  • Improved quality reporting contributed to the Jackson Clinic receiving a 5 Star Rating from BC/BS of Tennessee’s Commercial Plan.
  • Insurance reimbursement levels rose consistently as their quality reporting accuracy and BC/BS scores improved over time.

 

BENEFIT TO

Coding Staff


The coding staff recognized significant time-savings, eliminating previously required chart pulls, record look-ups and error tracking/ corrections related to CPTII Coding submission.

These changes resulted in:

  • Significant reduction in CPTII coding submission errors.
  • Increased productivity enabled staff to be redeployed onto other organizational coding priorities that had previously been delayed, improving departmental productivity and performance.

 

BENEFIT TO

Providers & Staff


Keena’s CPTII coding automation allowed providers more time to focus on patients and quality of care processes rather than chasing down patient chart information required for compliance.

These changes resulted in:

  • Consistent incremental improvements in patient care and quality scores.
  • Compliance reports were generated for use by clinical department stakeholders to maintain quality performance over time.

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