Death, taxes and paperwork. To paraphrase Benjamin Franklin, these are some of the few certainties in life. Graham Healthcare Group’s work in automating the pre-claim review process for the Review Choice Demonstration earned it Gold in the Innovator of the Year category in the Home Care track of the 2022 McKnight’s Excellence in Technology Awards.
Review Choice Demonstration, from the Centers for Medicare & Medicaid Services, aims to protect Medicare funds and ensure Medicare requirements are being met. Graham automated the burdensome pre-claim process with help from Element5, an automation-as-a-service solutions provider for post-acute care.
After enlisting the help of Element5, Graham Healthcare Group was able to implement a pre-built workflow that automates the pre-claim review submission process. Staff no longer had to manually collate the documents and submit pre-claim reviews to Palmetto GBA, wait for the approvals, and then upload the approval documentation back to their EHR. On average, the pre-claim Review process takes 30 minutes per submission with data entry and transfer being the most labor-intensive aspect of the process.
Thanks to Element5, “at GHG we were projected to spend upwards of 175-200 hours a week supporting the process from beginning to end,” said Kristin Hellebuyck, director of health information management at Graham Healthcare Group.
Graham Healthcare Group is currently reporting pre-claim review affirmation rates in the 98th to 99th percentile across multiple states. Automating the process meant that Graham Healthcare Group staff could focus on attending to business-critical tasks, work at the top of their licenses and ensure better patient outcomes.
Other winners in the Innovator of the Year category in the Home Care track.
Silver: Integrated Home Care Services, of Miramar, FL, won for MedTrac digital home care platform.
See a list of all the McKnight’s Home Care winners. Read about the Quality category winners in the Skilled Nursing track on the McKnight’s Long-Term Care News. See a list of all 2022 McKnight’s Excellence in Technology Awards Senior Living track winners here.
The Platinum sponsor of the 2022 McKnight’s Tech Awards + Summit is KARE. Gold sponsors are iN2L + LifeLoop, IntelyCare and Saiva.To view the virtual awards presentation and recordings of the Summit webinars, visit mcknights.com/100422techawards.