Automation Increases Cost Estimate Efficiency By 6,000%

Background and Challenge  

University of Colorado Health (UCHealth), a Colorado-based network of hospitals, clinics, and providers that serves patients throughout the Rocky Mountain region, wanted to advance its use of Epic’s patient estimates functionality to provide more of its patient population with a cost estimate without manual intervention. They also needed to meet government regulations related to the No Surprises Act.

UCHealth had already implemented estimates functionality, but the current workflow was manual and didn’t leverage Epic’s automated options. The system also struggled to produce accurate estimates for certain visits, requiring a complex solution.  

Solution

The engagement began with an assessment to determine the areas of focus with the greatest impact for the patient population. Execution then focused on three deliverables:  

1. Update the charge router: Tegria designed a reporting workbench extract to route charges differently and removed the build that was negatively impacting accuracy. The solution is easier to maintain and aligned third-party vendors to one method rather than supporting multiple processes. 
2. Create estimates and gather data: Tegria enabled the system to create pending estimates and provide accuracy data. Then, Tegria helped UCHealth design a solution pulling information from various Epic master files and translating it to an automatic estimate creation build. 
3. Finalize estimates with high accuracy: As the team gathered data, Tegria refined the automation to ensure that finalized estimates were submitted to MyChart with a high level of accuracy.