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University of Iowa News Release

 

Dec. 24, 2008

UI Health Care revenue process achieves impressive results, wins awards

Leaders of University of Iowa Health Care announced today that their unique, integrated approach to revenue management is leading to unprecedented financial efficiencies and garnering national recognition.

Beginning in November, UI Health Care adopted an integrated structure for revenue management that encompassed the entire enterprise. The innovative effort allowed closer collaboration and a more seamless flow among finance specialists in the UI Roy J. and Lucille A. Carver College of Medicine, UI Physicians, and UI Hospitals and Clinics.

The project is paying large dividends. The Joint Office of Revenue Integrity reports that it has recovered more than $20 million in hospital payments from insurers that UI Health Care would not have received otherwise in the past four years.

"I would say that 98 to 99 percent of the time our payors do a great job of providing us correct and accurate payments," said Tom Mentz, director of revenue integrity for UI Health Care. "Our integrated structure, sophisticated tools and dedicated team allow us to find those few needles in the haystack and to recover all the payments we are entitled to receive."

"Our new unified financial structure gives us more confidence that both we as a health care provider and our third-party insurers are complying with those contracts," said Ken Fisher, associate vice president of finance for UI Health Care. "The basic principle of the whole dynamic is 'Trust, yet verify.'"

Revenue Integrity staff continuously design and develop their own software tool set to help monitor hospital payments, which is a key element in the office's success.

Mentz said another critical success factor is the team's identification and recovery of more than $1 million in physician payments. Following that achievement, the Joint Office of Revenue Integrity recently won the national "Best Practice" award in the field, presented by Medical Present Value, creators of the software used by the team to audit physician reimbursement.

"It is very impressive to see these high-functioning teams in action," added Mentz. "Their successes are making important contributions to the overall success of the entire enterprise, especially in this very challenging economy."

Another important component in the integrated structure is assigning the correct codes to patient care activities. Ingenix, a leading national health information technology consulting service and coding reference publisher, recently announced UI Hospitals and Clinics as one of the "Top 200 Coding Hospitals" in the United States. Of 4,607 hospitals analyzed by Ingenix, UI Hospitals and Clinics placed eighth out of 233 major teaching hospitals.

"When the process begins correctly with proper documentation and accurate assignment of the patient care codes, there are fewer problems down the line, which makes the whole process flow much more smoothly," said Tammi Craft, director of health information management.

STORY SOURCE: University of Iowa Health Care Media Relations, 200 Hawkins Drive, Room E110 GH, Iowa City, Iowa 52242-1009

MEDIA CONTACT: Tom Moore, 319-356-3945, thomas-moore@uiowa.edu