As the organization grew, the medical coding team at CalvertHealth struggled to keep up with its coding backlog. With these coding issues and a slow denial, revenue started to get held up. “The team didn’t always understand what they needed to do,” says Jerron Brown, coding manager at CalvertHealth. “Some issues and denials were placed on logs for weeks, or sometimes months, after coders touched the record.”
Even as the leadership team worked to identify patterns in the process breakdowns, and provide education and guidance on how to correct them, the same issues returned over time.
Because CalvertHealth already used 3M technologies and services, including the 3M™ 360 Encompass™ System, the team explored solutions that would provide a seamless integration. CalvertHealth chose to implement the 3M™ Ambulatory Revenue Management Software (ARMS) to help connect the missing dots in its processes.
When CalvertHealth decided to make 3M ARMS a part of its everyday process, the teams worked together to create a road map of the “as-is” status and the “should-be” status to get the results necessary. “The CDI, HIM and business office teams met every two weeks during the implementation process,” says Brown.
The group discussed its high-volume issues, met with clinical department leaders and educated providers on the transition process. By shining a light on where the organization could improve, and by focusing on three key specialties—infusion, radiology and laboratory—CalvertHealth set the stage for success using 3M ARMS.
Since going live with 3M ARMS in 2018, CalvertHealth experienced quick success. “The results have been really significant—especially with medical necessity denials. We went from about 15 to 20 denials per week to only four medical necessity denials,” says Brown.
The workflow changes that Brown and her team established in the implementation process cascaded through the organization, leading to a solid foundation for better agility and response time in coding, documentation and reporting. “We are able to start up directly from the 3M 360 Encompass and complete all our coding using that and 3M ARMS. So, all of our abstract information is actually done on the same screen, which really helps with production,” says Brown. “We’ve actually been able to run customized reports that help us pinpoint hospital- specific problem areas that we need to focus on.”
With the significant drop in denials, the financial implications were quick to follow. “It’s had a big financial impact on us—a positive financial impact. Considering we area small, 74-bed hospital, having denials reduced from 15 to 20 patients a week to about four has been a big help for us financially,” says Brown.
While CalvertHealth’s results reveal the potential of using 3M ARMS, the response from those who use it daily highlight the power of the solution. “3M is the foundation for my job, really. It’s the reason I’m able to perform my job on a daily basis,” says Brown. “It simplifies the workflow for me and my team, and I really like working with the 3M team because they are always able and willing to assist whenever issues arise.”
The enthusiasm for 3M ARMS stretches throughout CalvertHealth. “I actually had one of my coders, my lead coder, tell me she was really impressed with 3M 360 Encompass and 3M ARMS, and that she feels like she’s able to improve her productivity,” says Brown.
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