University Physician Associates of New Jersey (UPA) is the Faculty Practice Plan of Rutgers Biomedical and Health sciences (Rutgers) / New Jersey Medical School (NJMS). The Faculty Practice Plan is the organization that bills for, collects, and distributes the clinical receipts, and provides additional administrative support to the practice of the faculty of NJMS.
The mission of UPA is to promote and foster the clinical activities of the Faculty of Rutgers-NJMS, to use the revenue that such activity generates to:
• Support the missions of NJMS in post-graduate, undergraduate and public education
• Advance the body of knowledge in both the clinical and basic science of medicine through research
• Offer the school's patients state-of-the-art, competent, compassionate and cost-effective medical care
UPA physicians bill for more than 500,000 patient visits per year, which amounts to over $325,000,000 in charges.
Many years ago, UPA executives recognized the need to decrease administrative costs for billing and coding, while still maintaining excellence in its compliance efforts. This led UPA to seek a solution that would help its physicians make more informed and accurate coding decisions – proactively – in order to improve compliance, yet also create a more efficient revenue cycle.
After deciding that mobile charge capture was the needed solution, UPA set-out to find the right vendor. The organization reviewed six different products, but ultimately selected MedAptus’ Professional Charge Capture due to its flexibility and powerful coding logic and rules.
UPA next identified about 30 physicians to participate in a pilot program. After only three months of charge capture usage, UPA experienced a 13.9 percent increase in gross charges per encounter and was able to reduce days-to-bill by 15 days. A sampling of the physician-users determined that the average physician captured an additional $38,000 in gross charges during the three-month study period.
Given the positive results from the pilot group, UPA decided to further its roll-out of charge capture to physicians via an incremental approach. These efforts were guided by department physician champions who participated in both system set-up and training to help maximize adoption. The organization also negotiated with its outsourced billing vendor that for every department demonstrating a 75 percent system throughput, the vendor would offer a discount on fees that UPA passes along to physicians (yielding over $400,000 in savings).
"Our organization provides all billing and administrative support to nearly 400 providers. We utilize MedAptus Pro Charge to process and manage data for 99% of physician billable activity. We are big believers in the power of insight and have come to rely on MedAptus' standard reporting suite for ongoing improvement of our revenue cycle processes. But we know that the full MedAptus dataset can provide deeper insight and allow us to execute special analyses such as the impact of the ACA on the setting of care for visits as just one example," said David Haier, chief operating officer for UPA.
Over two years later, with almost 300 full-time MedAptus users, UPA completed another analysis which revealed that days-to-billing decreased by over 50 percent and total charges increased by 25 percent. The net result of these changes was a one-time cash infusion of over $13 million from the charge lag reduction and an ongoing annual benefit of nearly $7 million.
Not surprisingly, UPA's use of the MedAptus solution has evolved significantly over the course of the past decade. A key advantage for UPA has been MedAptus' continuous innovation related to system integration. MedAptus currently integrates inbound visit, demographic and ancillary charge data from five different source systems that include offerings from McKesson, Epic, GE Healthcare and Cerner. This hub-based approach which combines MedAptus’ unique Operational Charge Management with native charge capture gives the complex system complete control of and transparency into its entire professional coding and billing operation.
UPA additionally was an early adopter of MedAptus’ expanded analytics platform offering access to the full MedAptus repository of transactional data within customer Charge Capture databases, as well as a set of tools to create on-demand custom reports and real-time dashboards to review and trend that data over time.