As labor shortages in RCM departments continue to make things difficult for home-based care providers, many providers are turning to modern workflow solutions to help their front and back offices. In the last of our series on modern workflow management solutions, we turn our focus to common WIP (work-in-progress) setups.
What is a common front-office WIP setup or RCM workflow queue? We touched on this in our last blog about revenue cycle workflow systems, but now, we’ll dive deeper into tips on setting up a queue that will work for you, as well as the common WIP states involved.
When it comes to your front office and common WIP states, a WIP state has three data elements. There is the WIP state itself, the owner who is responsible for it, and the follow-up date. These three elements will help your intelligent workflow system show the right work in the right person's inbox at the right time.
Example of a common front-office RCM workflow queue
This is a simple setup, but Prochant doesn’t recommend you make a setup much more complex than this. Too many WIP states become hard to manage quickly.
- 1.0 New Intake
- 1.1 Missing Information
- 1.2 Qualification Issue
- 2.0 Benefits Verification
- 2.1 Benefits Issue
- 3.0 Prior Authorization
- 3.1 PA Requested
- 3.2 PA Denied
- 4.0 Scheduling
- 4.1 Scheduling Issue
- 5.0 Out for Fulfillment
- 5.1 Fulfillment Issue
- 6.0 Ready for Billing
- 6.1 Billing Issue
Number Your WIP States
Taking a look at the example above, it’s important to number the WIP states in your workflow. This way, when they show up in your list, they show up in a logical order. Otherwise, they are going to get alphabetized and be out of your intended order. The logical order in our simple setup example above is that the workflow queue first starts with New Intake, then goes to Benefits Verification, then Prior Authorization, and so on.
Interim WIP States
There are also interim WIP states for issues, like Missing Information and Qualification Issue for New Intake. This way, when you might be missing information on a new intake, the intake can “park” in the Missing Information parking lot. Anyone who clicks on the intake in that parking lot knows why that intake is sitting there.
Don’t Include Too Many Interim WIP States
Notice, our example doesn’t include a parking lot for every potential issue that may occur. This is done on purpose. The longer your list is, the more difficult it is to scroll through and can become inaccurate. Instead, for example, you can park the new intake in Missing Information with a custom note field to explain why it’s there and what’s wrong.
Having a simple WIP setup like this also allows you to see very quickly what issues you are having in your intake cycle, prior authorizations cycle, and more. When designing your own front-office RCM workflow, it’s important to make sure no gaps are left to let work fall through the cracks.
Have questions on WIP setups or how to create intelligent workflow queues for your own office? To explore modern billing and reimbursement solutions, contact us today or you can reach out to Prochant’s Chief Revenue Officer Joey Graham directly at (980) 999-4293 or email email@example.com.
In this difficult time of high turnover, rising labor rates, and more, find out how Prochant can help simplify your business! Solutions are out there to support you and your staff.
Prochant has DME/HME and pharmacy clients from all over the country and handles front-end and back-end billing functions. Our scalable solutions, years of experience, and advanced technology provide best-in-class results to the healthcare community. Headquartered in Charlotte, North Carolina, our client base includes national HME and pharmacy providers and health systems.