Developing a Best-In-Class Quality Review Program
Variation in revenue cycle quality leads to issues with denials, delays and increased costs. Methods are needed to ensure consistency so that efficient and effective billing can occur. Moffitt Cancer Center launched a quality department to conduct consistent, unbiased quality assurance in the revenue cycle. Quality auditors oversee training and system support for the revenue cycle’s five key departments and 700+ team members. Moffitt implemented the Trace platform from Vyne Medical and leverage scorecards, reporting and dashboards to track and trend quality performance over time. The review process provides a controlled base to reinforce efficiency, accuracy and accountability across teams. By catching and correcting errors before they move downstream, Moffitt can send claims out cleaner, reduce denials and bring in more cash.
- Describe the structure and role of a revenue cycle quality review department.
- List performance measures and metrics used to calculate quality scores.
- Assess frequency of quality reviews and strategies to incentivize team members.
- Discuss key capabilities of a quality review system, from scorecards to dashboards.
- Identify outcomes resulting from a quality review process in the revenue cycle.
- Lynn Ansley, Senior Director, Revenue Cycle, Moffitt Cancer Center
- Rebecca Ashe, Manager, Revenue Cycle Quality and Training, Moffitt Cancer Center
- Scott Overholt, Chief Business Officer, Vyne Medical