The team at St. Joseph’s Health in NJ implemented computer assisted professional coding (CAPC) to streamline their revenue cycle management processes. The resulting improvements are helping the organization be more resilient in these challenging times.

Dr. Beth Kushner, Chief Medical Information Officer at St. Joseph’s, recently sat down with Healthcare IT Today to discuss the revenue cycle management (RCM) improvements her team has made.

Efficient RCM Processes are Critical

Dr. Kushner has a passion for RCM. She strongly believes that having efficient RCM processes are critical in these tight economic times or as she calls it “a time of price compression”.

What Dr. Kushner is referring to is the margin pressure that healthcare organizations are facing due to increased labor and other operating costs. Reimbursement rates have remained relatively constant over the past several years, yet in that same time span, staffing costs has skyrocketed. Implementing technology to minimize the demand for labor is one the best strategies to be more financially robust and resilient.

“If you inject technology in a smart way, you can have better outcomes and more efficiency while spending fewer dollars,” said Dr. Kushner. “You can then re-inject that money where you need it, like removing menial tasks, which again improves your efficiency.”

Computer Assisted Professional Coding

One of the tasks that Dr. Kushner and her team looked to eliminate at St. Joseph’s, was clinicians and support staff doing their own billing and coding.

“I don’t want providers Googling CPT codes,” stated Dr. Kushner. “I want them spending more time with patients. So, when we looked to see how we were going to do that, we saw that computer assisted coding could take a big burden away. With the aid of CAPC, our coding team can be quicker and process our charts as well as CPT codes in a more reliable way.”

St. Joseph’s chose to partner with AGS Health and implement their computer assisted professional coding solution which helps clinical staff by predicting appropriate medical codes and identifying missed documentation. Part of what appealed to Dr. Kushner about this solution was not only its capability, but that it did not completely remove people from the process.

“What attracted me to this product was the partnership that AGS Health offered,” explained Dr. Kushner. “They have proven over and over that this is a true partnership.”

It is important to note that not all CAPC solutions are the same. Careful consideration must be given to the current features as well as the future roadmap. AGS Health’s CAPC solution checked both boxes for St. Joseph’s. Their solution had strong capabilities and the company has a plan for many additional features in the years ahead.

CAPC is Meant to Help not Replace Staff

Dr. Kushner emphasizes that reducing headcount was not a goal of implementing CAPC. The primary goal was to reduce or eliminate tasks that were standing in the way of delivering better care and that no one wanted to do. When staff do not feel that their jobs are threatened, it helps with buy-in for new technologies.

CAPC is an assistive technology that gets rid of a task that clinicians and most staff prefer not to do.

Benefits of CAPC

There have been many benefits to CAPC at St. Joseph’s:

• An improved clean claim rate which improved realized revenue
• Faster reimbursement
• Increased revenue certainty
• Reduced staff workload
• Less screen time and more patient-facing time

Watch the interview with Dr. Beth Kushner to learn:

• How preparing for the implementation of CAPC helped identify other opportunities for improvement
• How to win over colleagues who may be skeptical of AI-based technologies, like CAPC

Learn more about St. Joseph’s at https://www.stjosephshealth.org/

Learn more about AGS Health at https://www.agshealth.com/

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