The Quality Improvement Committee at the Sedgwick County Health Department (SCHD) in Kansas identified improving the efficiency in their billing process as one of the eight improvement areas to address in an effort to
develop a culture of QI at the agency.
SCHD sought to improve the efficiency in their billing process by reducing the most common data entry errors. The billing department reports, encountering an average of 45 insurance errors each month, were related to incorrect or incomplete data entry. These errors resulted in insurance denials, decrease reimbursement time, and inefficient use of billing staff time. It was determined that the insurance error rate could be reduced either by complete information being entered into the “Notes” section or by scanning the insurance card.
AIM Statement
To improve the efficiency in the billing process by reducing the most common data entry errors of incorrect/incomplete insurance information.
Plan
Data entry errors and efficiency of billing process was identified as a possible area for improvement. An informational meeting was conducted with the billing staff to determine the top billing errors. The top two errors identified were incomplete and inaccurate insurance information entered in the data system (KIPHS).
Do
One training session occurred with Preventive Health and Healthy Babies Fiscal Associates in October of 2010 to review types of insurance and information needed for each field in the Preventive Health (PH) Clinic. During the discussion, it was determined that an upgrade was needed to KIPHS to help reduce insurance entry error and PH initiated modification.
Study
Sedgwick County anticipated that the error rates would decrease as of 2011. They had a baseline and intended to update results of the graph after the 1st Quarter of 2011.
Act
Based on the results of the study, it was determined that standardized training on insurance data entry along with the modifications made to the Preventive Health Clinic will result in a reduction of data entry errors related to missing or inaccurate insurance information. All data entry staff must receive the same training.
Establish Future Plans
The new theory will be tested during the first quarter of 2011.