A single-site hospital with approximately 200 beds that is looking to build an additional campus in Texas.
After implementing Epic Systems more than 15 years ago, the new CFO observed that the hospital had been undercharging medications for some payors related to 340B compliance. As a temporary response, a unique markup table was put in place and used for payors observed as undercharged. To address these concerns and provide a permanent solution, the client contacted Baker Tilly to:
After a thorough assessment of their electronic health records (EHR) build and claim details, Baker Tilly identified opportunities to update the build to meet the client's initial request. Baker Tilly also provided a unique dynamic tool using client specific medication usage and payors. The tool allowed revenue leadership to immediately visualize and project the impact of changes to markup tables based on medication and payor and implement strategic pricing to improve ROI.
Baker Tilly was able to ensure all payors were charged consistently with appropriate modifiers and improve 340B program compliance. In addition, Baker Tilly using strategic modeling tools helped the client identify an additional $11.3 million in annual gross charges with significant anticipated increase in claims paid.