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Trinity Health of Novi, Michigan, is the fourth largest Catholic health system in the country with revenues equaling $6.1 billion annually. The company owns and/or manages 45 facilities and employs more than 44,000 people across seven states.

At Trinity Health, like most hospital systems, collecting payments is an ongoing challenge, especially considering the system’s size. Typically, coding and billing processes are time-consuming and require manual searching of desk references. This cumbersome process often means the staff is pressed for time and cannot possibly collect all potential revenue.

In the past, Trinity Health turned to outside consulting firms to evaluate revenue codes and run reports. Though the system successfully recovered additional revenue with external vendors, it often paid commissions up to 20 percent of collected payments.

In 2003, Trinity Health appointed Brian Smit, a former consultant, who helped identify opportunities to re-bill and collect revenue, to be responsible for service documentation and chargemasters, and to optimize revenue for three Trinity Health hospitals with more than $1 billion in charges.

The hospital had MedAssets’ KnowledgeSource® tool, an extensive knowledge base that helps healthcare providers capture the correct revenue to ensure appropriate reimbursement and receipt of rightful revenue. However, with few staff members in finance using the tool, the hospital wasn’t taking full advantage of the application’s revenue-enhancing capabilities. Smit estimated that Trinity Health missed millions of dollars in potential reimbursements and revenue. He sought to reduce the time and costs to identify correct codes.

Smit quickly learned the MedAssets application himself, and with support from his MedAssets account manager, he began implementing the software in a number of outpatient departments including medical records, health information management, patient accounts as well as with other clinical managers. New users easily picked up the application and rely on it as their onestop information source. Today, an average of 50 people at each of the three locations access KnowledgeSource.

With quick access to information in the tool, Trinity Health reduces the time it takes to determine coding in each case, allowing staff to move quickly to the next case. Such benefits have led new users to embrace KnowledgeSource rapidly, with the application becoming the “go-to” resource. “MedAssets is becoming almost a household name among employees who use the tools regularly,” said Smit. “This tool more than pays for itself,” he said. “The more you use it the more you become proficient in extracting everything that’s there and recovering revenue.”

MedAssets’ products have been instrumental in helping Trinity Health collect rightful revenue. Since Smit joined Trinity Health and expanded the coding application to more users throughout the hospital system, it has re-billed and collected more than $3 million in revenue.

In the case of several medical oncology drugs, the facility used the coding tool to identify incorrect coding information, which netted $880,000 after re-billing. Additionally, Trinity Health has reduced its costs by bringing coding review in-house, rather than relying on external consultants. “After using MedAssets for two years, we have recovered over $3 million in additional revenue that would otherwise have fallen off the table,” said Smit.

At the various hospital sites, users can rapidly identify the correct codes for billing or respond to internal questions about appropriate coding. Staff can refer to CodeCheck within KnowledgeSource to find any Current Procedural Terminology (CPT®) or CCI edits based on the code pair in question and look up whether other facilities are successfully charging with the code pair. Staff members can then create a charge for the service and report results back to the physician. With KnowledgeSource, users can find the answers they need much more quickly and have a greater degree of certainty about the information.

Smit continues to utilize MedAssets to find opportunities to re-bill and collect lost revenue. Depending on the question, within KnowledgeSource, he can consult either CodeBase for applicable codes or the tool’s KnowledgeBase, which contains resources such as national publications and forums of questions and answers posted by other hospitals. “The ability to get immediate access to revenue codes, code pairs, reimbursement information and notes, as well as reviewing questions and answers posted by other facilities, is extremely helpful,” said Smit.

Users can access coding information within minutes on MedAssets’ website, whereas before, it might have taken closer to an hour. A welcome alternative to exhaustive manual searching, the software has become an integral part of Smit’s daily workflow.
“I log onto the application every single day,” he said. “I’ll have maybe 30 projects going on at any given time, and in each case, I’m going to use this product in some way. It’s literally my first login when I boot up my computer in the morning. It offers much more information than you get from any other source.”

Additionally, as an ASP, KnowledgeSource is continuously updated automatically, ensuring that Smit and users at the various hospitals have the most current coding and reimbursement information.

Smit also appreciates the level of support he receives from his MedAssets account manager. “I definitely like having a designated account manager,” he said. “We’re on a first-name basis, which adds a certain level of comfort. Our account manager does a super job and is always willing to get new staff up to speed on the product.”