I have serveral ideas that would take time to implement, but would yield valuable results from a cost savings perspective and a patient satisfaction/customer service perspective.

Now that the UCSF has one system (EPIC/APEX) and the current "Funds Flow" model is changing , I would consoliate the following units:

1.  Consolidate the payment posting units associated with the Hospital (PFS) and the Medical Group (MGBS).  Currently both units are sending information back and forth to each other in attempts to balance ERAs (Electronic Remittance Advices) and bank lockbox payments.  Having both units under one roof improves communication, reduces posting errors, reduces the need to post to undistributed/unidentified Work-queues and ultimately can reduce staffing levels through economies of scale.

2.  Consolidate the Package/Transplant billing units associated with PFS and MGBS.  Currently both units shuffle paper back and forth via campus mail.  When MGBS has a global type transplant bill, they have to print the claim forms and send them to PFS.  Consolidating both units would improve on communication and would improve billing by at least one or two days.  The sooner the claims go out the sooner payment can come in.

3.  Centralize registration.  Today our registration process is decentralized and when there are changes due to payors (Covered-California rings a bell), training these changes is extremely difficult because the training has to be coordinated with hundreds of registration staff at various clinics.  Attempting to decipher insurance cards today requires an indepth knowledge of insurance acronyms and sending a bill to an incorrect insurance address will delay payment and causing much back-end work to correct.  Reimbursement rates are continuing their downward spiral, so getting it right the first time is imperative.   Having a centralized registration unit improves on having staff that specialize in registraion only that have time to ask the right questions and gather accurate information.  Today our clinic staff are burdened with collecting co-pays, posting money in the system, answering phones, answering nursing and/or physician quesitons, dealing with unruly patients and/or a long line of patients.  The front end staff, although do a good job, UCSF needs to understand that we need to do a great job.  We must do better to improve the "Patient Experience".  When incorrect information is in the system, things go wrong and ultimately the patient experience suffers and all the apologies and letters of apology just can't heal the bad experience.

4.  The following is extremely futuristic.  Since many of the UC Medical Centers have or are jumping onto the same system (EPIC), the consolidation of various departments/units can drive endless economies of scales.  Imagine one massive billing entity for two or three or five UC Medical Centers (this particular entity could perform these services anywhere).  Also, imagine one reimbursement contracting body for all UC's

Thank you for listening....Lupe Galvan 415-353-3816