Revenue cycle management: HL7 interface
You own or manage a physician owned Management Company, medical coding company or medical billing company. Chances are you have heard of HL7 integration. HL7 integration is an important data source for streamlining your practice’s revenue cycle management. Automating data delivery through HL7 interfaces provides your organization accurate and reliable information to get patients claim coded and billed. Internally, we have hundreds of facilities that have HL7 interfaces, and I want to tell you the most important takeaways.
Understand your data needs.
Create an HL7 specification guide for the segments your organization needs. Segments for an outsourced physician staffing group may include:
PID: Patient Information
PV1: Visit Information (DOS)
IN1: Insurance Information
IN2: Additional Insurance Information
IN3: Additional Insurance Info, Certification
GT1: Guarantor
Your organization may require additional or even entirely different segments from what I have listed above.
Talk the talk, walk the walk. After all, HL7 is just structured data. Make sure you have the right team and security layers in place to digest the data.
Hospital IT, your new best friends.
Hospital IT is responsible for granting access to the facilities registration and charting systems. More likely than not, hospital IT may recommend remote access to capture the necessary data. It is not ideal for any efficient and quality driven organization. Hospital IT is more likely to work with your medical practice when you know what you need, and communicate that well.
When we onboard a facility I like to think of it as a negotiation session. We know what we need, that includes patient demographics and the coinciding medical records. You must be well versed with how to ask for it and what systems are all involved. Registration and medical record systems may not always be compatible to export HL7 structured data. We will leverage HL7 if possible, but every organization should aim to work with what you get. An essential point that has helped drive our success when negotiating facility integration.
Test, test and test.
Before implementing an HL7 interface test it. It is important to test before your facility goes into production with an HL7 interface. Work out any potential issues and establish guidelines for testing.
Be systematic.
Our clients are outsourced physician staffing groups, medical coding companies, and medical billing companies. Whatever the specialty is, we intake HL7 in a systematic and reliable manner. HL7 integration may be used for compiling medical records, ADT or patient demographics, or a combination thereof. When we approach our clients facility IT departments, there is a systematic approach used to capture the data needed, the file transport methods, and the security surrounding the interface. This increases the likelihood that we will get the data we need.
Check out an example of an HL7 segment below!
Ben Bohlen is the operations/client lead at LightSpeed Technology Group, makers of VeriDOCS coding and revenue cycle workflow system. LightSpeed works with coding, billing and physician groups throughout the US and abroad. Handling emergency, hospital, anesthesia medicine, and other specialties. He is driven to provide clients with meaningful and relevant results.
