With the launch of the Review Choice Demonstration (RCD) in 2019, came an added, labor-intensive process for Home Health agencies. Including both a clinical review portion and an administrative submission portion, agencies needed time to acclimate themselves to determine how to best manage the new CMS requirement. Graham Healthcare Group quickly recognized the need to stay ahead of the curve by simplifying the pre-claim review process and turned to technology to effectively manage this change.
With the Review Choice Demonstration in place, Graham Healthcare Group (GHG) saw that their staff was spending an inordinate amount of time supporting the pre-claim review process. Each submission into Palmetto GBA took about 30 minutes when performed manually. The team at GHG was clear, they wanted to find a more efficient system to solve this problem.
Element5 collaborated with GHG to deploy a fully-managed, automated workflow for the pre-claim review submission process. This pre-built automation, designed by Element5, efficiently handled document collation, submission to Palmetto GBA, approval waiting, and documentation upload into the EHR. GHG staff saw reduced manual tasks, enabling them to focus on exception handling and higher-value responsibilities.
GHG teams gained visibility through the Element5 Automation Hub, allowing monitoring, manual intervention, and corrections as needed. Over time, the tangible benefits of the automation became evident, with teams focusing on critical tasks while Element5's automation acted as digital assistants, expediting the pre-claim review process.
