In the fall of 2019, during the Tableau Conference in Las Vegas, Claire Phillips and I challenged ourselves to watch at least 12 Tableau Sessions by the next conference. In my blog, ‘What’s the #Data19Challenge?’ I explain this challenge and why I took that goal a step further by writing about each session I watch.
For my third session, I watched ‘Leveraging Tableau to Drive Bottom Line Improvements for Healthcare Providers’ by Michael Duke, Baker Tilly. Since I’ve been in healthcare for over 15 years, this was of great interest to me. In Healthcare, there are many challenges related to billing claims and reimbursement from payers. Knowing that Baker Tilly is an accounting firm, I was very curious on how they were using Tableau to improve the bottom line for healthcare organizations.
In this session, Michael Duke reviews how Baker Tilly uses 835 and 837 claims data to develop dashboards around the following topics for their clients: first pass rejections, unbilled claims, adjustment analysis, accounts receivable analysis, and FTE analysis. The detail contained in the industry standard 835 and 837 files for billing and reimbursement of healthcare claims is vast. Individual 837 claims contain a wealth of information about the type of services and price paid for each line item of service, diagnosis, insurance information, who provided the service, when the event occurred, etc. Once a payer receives the claim, they return the reimbursement results with a Healthcare Claim Payment and Remittance Advice 835 file. This file contains information about how much each line of service was reimbursed or denied with CARC (Claim Adjustment Reason Codes) codes explaining the reasons for the adjustment. There are over 100 CARC codes.
Knowing the complexity of billing claims, sometimes more than once, Baker Tilly’s dashboard review is impressive. Mr. Duke reviews how tracking rejection rates by CARC codes and payer can drive insight into the reasons for a denial. Below is an image of the Patient Access Process Rejection Analysis Dashboard. What I like about this dashboard, is it’s simplistic layout containing a few graphs with detailed explanation below the graphs to make it easy for the user to understand the information. This is a common theme in several dashboards demonstrated during the 30 minute session.
If you are interested in developing dashboards for tracking medical necessity, coding and provider denials, tracking accounts receivable with targets to calculated opportunity costs, this session is for you. Click on link to the session to start watching now: https://www.youtube.com/watch?v=feltaBq4owo
To learn more about the #Data19Challenge and participate, please visit https://analyticswithlohr.com/2019/12/03/whats-the-data19challenge/