Increasing Audit Processing Throughput by Over 100%

Valle Del Sol is experiencing rapid growth while resources stay constant. This has led to late deliverables, changing standards and outdated reports. Internal medical charts do not meet external standards and have limited improvement. Voided claims, violations and monetary sanctions have increased. If this continues, compliance scores may decline and lead to additional loss in revenue and impact patient care.

Solutions Implemented:

  • Steps were removed from the audit process
  • Excel formulas, macros, and templates were created for every audit
  • QM Department metrics were identified and monitored for QI needs
  • Agency QI projects are tracked and monitored for effectiveness
  • SOLAR reports now include links (job aids, PPP’s) and practical data
  • VdS Staff are coordinating with other agencies to save costs in EMR
  • Increase customer surveys
  • “You asked, QM Heard” emails when solutions are implemented

Project Results:

  • QM audits on average decreased from 12.4 hours to 4 hours to complete
  • With savings of 17 hrs/wk QM implemented 7 new audits, increased the frequency of 7 audits and produced 8 customer improvements
  • This led to a total savings of $30,768 in paid wages and increased employee satisfaction.

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