With a patient population that is more than 65 percent Medicare, Boca Raton receives an enormous volume of audit and information requests requiring the hospital to submit additional documentation in support of Medicare claims. Boca Raton’s paper process for audit responses presented significant financial and operational challenges for the hospital.

Boca Raton’s paper process for audit requests presented significant financial and operational challenges for the hospital, including:

• Hard costs of paper, toner, shredding, storage and postage
• Labor costs associated with manual data gathering efforts
• Costs related to untimely submissions and lack of response to audits

Objectives for esMD Implementation

Boca Raton implemented esMD (Electronic Submission of Medical Documentation) to facilitate faster processing of audits by accomplishing the following:

• Ensure efficiency when responding to time-sensitive audits versus sending records through the mail
• Ease administrative burden audits cause for hospital staff
• Increase quality assurance and compliance of business office and other revenue-driven departments
• Integrate information from different systems, such as lab and billing, helping the hospital ready itself for future revenue-reporting activities related to quality, efficiency and claims-based programs
• Ensure that physical records never leave the hospital