Making complex government reporting scalable – yet customizable
EXL Health makes complex government reporting scalable – yet customizable
Government reporting challenges
Government reporting is a herculean task for healthcare systems. Consider the following: To stay in compliance with regulations and optimize revenue, healthcare systems typically are responsible for completing and submitting hundreds of government reports – some on a yearly basis, others quarterly, monthly, or even weekly.
Reports required by Medicare and state Medicaid programs are required to be produced by a variety of facilities ranging from free-standing rural health clinics to critical access hospitals to community hospitals to large academic medical centers and more. Knowledge and expertise related to home office reporting, provider-based billing, 340B drug discount programs, and state-specific Medicaid reporting requirements leads to issues with a one-size-fits-all reporting solution. Making government reporting even more difficult is the changing requirements and ability to extract these in an automated manner from various websites.
Healthcare systems must also ensure accuracy and be on time when producing government reports. The submission of inaccurate reports can create substantial financial losses due to non-compliance. In addition, health systems need to submit reports on time to avoid penalties as well. These challenges are further complicated because many healthcare systems do not have the solid standard and integrated data foundation needed to support government reporting. Because data often resides in silos, health systems specifically struggle to provide integrated clinical and financial data to the government.
Health systems need to find an efficient way to innovatively build and maintain data structures to keep up with myriad, evolving reporting requirements without experiencing significant business interruptions.
The EXL Health government reporting solution
EXL Health Data & Analytics Team provides the analytics, data foundation, subject matter expertise, reporting, and automation. This makes it easy for health systems to construct a real-world framework that can empower them to comply with government reporting requirements accurately.
To start, EXL scrapes the web to extract regulation reporting guidelines, ensuring that health systems are working with the most current rules. The EXL team then leverages known best practices to build an efficient, scalable, and repeatable data framework that can be implemented by an array of health systems. The team then customizes the data framework, making it possible to meet the specific needs of each health system or provider organization.
In a typical scenario, EXL Health helps a health system meet government reporting requirements by:
- Integrating and standardizing data sources required for government reporting
- Creating standard metrics and their definitions that can be used consistently across the organization
- Building data cubes that manage the information needed for specific reports
- Creating a reporting framework that automates report generation, thus driving efficiency and accuracy
- Supporting automated quality assurance (QA) processes
Hospital cost reporting
- Medicare Cost Report (MCR) provides facility characteristics, utilization data, total and Medicare costs, inpatient and outpatient charges, Medicare Payment Data and Financial Statement Data
- Summary of Uncompensated care – biweekly reporting
- Facility adhoc reporting
- Daily cash handling of inflows/ outflows
- Medicare bad debts reporting
- Hospital Outpatient Prospective Payment System (OPPS) rates updates to accrue professional base payments to offset lump sum payments
- Physician/App Time studies
- Annual reports consists of year end closing reviews
- It provides the cost report booking and budgeting
- Base rates updates for physician fee schedule and Inpatient prospective Payment System (IPPS)updates
- Geographical Review of Inpatient Rehabilitation Facility(IRF)
- Finance Monthly reporting – reconciliation and validation of supplement payments
- DSRIP, UC LPPF Entries – To accrue revenue based out of payments
- Medicare and Medicaid Rate change Updates
- Journal Entries Verification
- Scheduling of cash inflows and outflows accrual or due in current or past financial year
- Reporting of un-recoverable income/expenses incurred
- Summary of all details such as Bad debts and General Reserve
Real results with EXL Health government reporting
By working with the EXL Health Data & Analytics team, health systems can improve government reporting processes without experiencing any business interruptions. EXL works with health systems to help them experience:
- Optimal efficiency: Health systems can reduce the time required for reporting, including peak report submission times using EXL Health Government Reporting capabilities
- Significant savings: With the help of the EXL team, health systems can improve the delivery of on-time government reports – thereby averting substantial penalties.
- Unsurpassed effectiveness: By relying on advanced government reporting capabilities, health systems can reduce the number of manual reports and out-of-period adjustments
- Improved reporting accuracy: With EXL at the helm, reports are produced from an integrated source, implementing the checks and balances needed to ensure accuracy– and avoid additional penalties.
- Enhanced productivity: With an automated regulatory reporting framework in place, health systems can streamline processes and, thereby, reduce the number of full-time employees dedicated to government reporting.
- Adaptability to meet future needs: EXL creates data structures that can scale for the future.