Radiology Call Center
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Brief Descriptions of project
Hospital services are involved with varied procedure deemed to evaluate the precise clinical decision to be implemented. History taking and laboratory examinations alone are not sufficient to arrive at a most appropriate decision, in some cases. Radiology is a crucial department in the hospital, especially in detecting brain tumors, cancers, spinal injuries, and fractures among others. Physicians order these exams based off signs and symptoms that are expressed from their patients. Some of examination requests that can be ordered in an attempt to supplement the available information and data include Computer Tomographic scan, Magnetic Resonance Imaging, Nuclear Medicine, or even a basic x-ray. Insurance companies based on medical necessity or preventative care cover most of the exams. My project proposal is to design a Radiology Call Center within a hospital setting that offers a scheduling department, which will schedule and authorize exams on behalf of ordering physicians.
History and Rationale
Radiology services have primarily been offered at free-standing facilities for outpatients. Most inpatients procedures are performed in a hospital setting depending on what equipment is available and do not require prior authorization. With the latest innovations in technology, not all free-standing facilities have the budget or funds to update equipment as much as thriving organizations. Historically, referring or requesting physicians’ offices would obtain outpatient authorizations and fax or call their order into the different department of radiology to obtain a scheduled appointment date and time. In most cases, preparations and other guidelines such as no food or drink are given to the caller to relay that message to the patient. All these preparation and precautions are vital in the process of radiology. It is essential that the client observe the precautions to facilitate correct results.
Goals and Outcome in relation to strategic focus
The goal of a radiology call center is to increase patient satisfaction, customer service, and revenue generation. At time exams that have been denied by insurance because they do not meet medical necessity are sometimes scanned by accident. This can occur if the registration or patient checks in the process are not completed properly. Enabling the call center to obtain prior authorization and schedule the patients ensures efficiency since all exams will be approved and for the correct procedure/CPT code. In addition to this process, the organization will focus strategically on elements such as the values, mission, vision, and other goals that can inspire and motivate staff (Strategic Focus, 2013). It also shows patients that their care is valued and that the care and treatment services they receive is the best.
Structure of the project
This organization will contract with alliances that are willing to care for patients just as much as the organization. Reimbursement rates will need to be suitable enough to cover costs and other expenses. Being a hospital setting ensures that radiologists are already on the lookout and available for radiology readings. Office space and exam rooms will need to be considered with the future expansion of the radiology department. A center that is dedicated to scheduling their own exams and submitting for authorization approvals is looking to expand and compete with other imaging centers.
Competition is soaring in radiology, and it is imperative that each department or facility remains up-to-date with the latest improvements in order to remain as a competitor. Insurance companies are also looking to imaging centers that provide quality service at a lower price. Each facility or organization contracts with insurance companies based on certain reimbursement rates. In contrasting between free-standing and hospital, most free-standing facilities do not have the capability of inserting intravenous fluid for sedation or administering general anesthesia since nursing and anesthesiologist coverage are required. Therefore, market scenario will be a key consideration in this project.
Financial Data Overview
An analysis of the data overview will include a balance sheet showing the details of assets and liabilities, an income statement to state revenues, a statement of retained earnings projecting the amount of income reinvested in the company and a statement of cash flows assisting with the cash necessary to meet current debts (Moseley, 2009).
Personnel and staffing
Technologists and Radiologists already exist within a hospital organization so in this case we would have to prepare for the expansion of technical space as well as for scheduling. Staff or schedulers from each modality will need to be trained on how each exam is scheduled such as allotted time, preparations needed and guidelines. Marketing department will need to be present to convince hospital physicians to refer to the marketing department not only for revenue, but convenience in hopes of increase patient satisfaction and meeting all needs.
The implementation of the call center can begin once the project has been approved. A payoff matrix may be a vital issue to considering what works and what does not. It is designed to judge strategic ideas to observe any difficulties and what the possible benefits are. A timeline will need to be design to measure any progress along the way and view if things are looking positive, before implementing any changes or if adjustments need to be made.
Evaluation criteria and monitoring plan
The business plan gives hospital setting organizations the opportunity to grow from many aspects. Evaluations can be completed to collect data that can be reviewed by strategic teams with the aim of monitoring for increment in revenue, patient satisfaction, and the amount of radiology exams performed. The success of the program will be a considerable benefit to the hospital; hence profound efforts are needed from all the stakeholders.
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