Jeanne Crockett

Results-driven Revenue Integrity Supervisor with a strong focus on data analytics and process improvement. Expertise in monitoring processes and enhancing operational efficiency to drive impactful outcomes.

I began my career with St. Luke's Hospital in 1995 as a PRN employee in the Health Information Services department filing loose sheets and assisting physicians with their deficiencies while attending college. I very quickly realized I had found my forever home at St. Luke's.

During this time all documentation was on paper and many duties were manually performed. I spent the next couple of years learning the hospital and department and transitioned into a new role of abstracting the coding as well as completing Birth Certificates.

During 1998, the hospital transitioned their network from PCS to Star. I took a new role and became involved in the transition to the new Star System. I played a key role in training staff and became what was then called a Super User. This was during a time when St. Luke's was part of the Unity Network of hospitals.

With the new Star system and the Unity network, I held a position that was part of a Unity wide team who collaborated together in order to provide consistency throughout the multi-facility network.

There were many process improvement initiatives during this transition and with the new Star program came many advancements in collecting data related to charges, edits and workflow. I began working closely at this time with the PFS department related to many of these spreadsheets and edits.

I took on a new position of APC Coordinator and was the first of many to be added to form a team. During this time there were changes happening with the Medicare Payment system around this time and the APC or Outpatient Prospective Payment System was implemented. I was part of a large team to learn more regarding these changes and attended many outside meeting regarding the OPPS updates.

This was really when my skills became much more defined as I began researching more regarding coding/billing guidelines and identifying areas for improvement in their charge capture.

There was an initiative at one point for every department to "find" an additional 25K in charges/coding or other opportunities for the hospital to obtain the appropriate reimbursement. With the new APC payment systems, there were multiple edits that applied to Medicare. I worked for Bonnie Lehman at the time and we began pulling Medicare edits which would be appropriate for all payers and not just Medicare. Within the first month, I personally identified several Cardiac Cath encounters where a pacemaker procedure was performed but the device for the pacemaker was missing. After reviewing these with the department, they were able to add the missing charges. We rebilled these encounters and recouped over 125K in reimbursment.

As the years went by, I began working closely with the departments regarding charging and coding guidelines related to their area. I have built many relationships within St. Luke's and have become a dependable team member and resource for many throught the facility.

Over the years, several other employees were added to our staff and thus began the team I supervise to this day. As each staff member was added to the Revenue Integrity Team, I provided the bulk of the training and direction. I am proud to say that I have had a significant impact in building our team as it is today and moving up to the position of Supervisor of this team.

Some of my accomplishements while on this team are listed below.

• Collaboration and team building which involved multiple facilities during the Unity timeframe
• Played a key team roll in system transitions....PCS to Star, HPF system, Cerner.
• Member of a Focused APC Team with Dr. Thompson, HIM, PFS, Risk Management and other departments
• Identified automatic write offs for Medical Necessity and began audits which resulted in reviewing encounters prior to write off. This continues to this day and while I do not have a specific dollar associated with this project, it began in the early 2000's and has a positive financial impact to this day.
• I have been on countless teams regarding charge and compliance issues.
• Member of the Chargemaster Team since 2000.
• Participate in resolving insurance denials and gather data for repeat denials. After study of insurance policies and procedures, I have been able to team with the Billing and Collection Teams to implement edits or CDM changes to prevent future denials.
• One such process change is related to Devices and Implants. After review, we found certain payers denied implants that did not meet the FDA definition for reporting. I was able to identify and update the CDM to report those items as surgical devices instead of implants which resulted in a significant decrease in denials related to implants thereby eliminating the need for back end adjustments and denial reviews.
• CDM updates - play a key roll in quarterly and annual updates for CPT/HCPCS codes.
• Helped to identify a missing charge in Radiology and lead the process to identify claims affected, add the missing charges and educate the department moving forward. This was an estimated 100K in additional reimbursement for these claims and moving forward having a possitive impact on future reimbursement.
• Key player in the build of new departments related to their CDM. Including the charge on documentation, charge on orders or manual charging depending on the situation and departmental process.