At a Glance

The team delivered! We were able to make tremendous progress in a relatively short amount of time. UCHealth will be able to take the foundation that Tegria put in place for us to continue to automate more of our patient estimates.

Jenny Eno, Senior Director, Epic Revenue Cycle Applications

Background and Challenge  

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. 

Results  

UCHealth advanced its price transparency and patient estimates goals by implementing the new automated functionality. The system achieved dramatic results that earned an Epic trophy for Estimates Automation Creation Percentage. UCHealth is now a leader in leveraging Epic’s automated estimates functionality to deliver accurate price estimates to patients.  

• 6,000% increase in estimates created 
• 30% increase in accuracy for all estimates 
• 98% of scheduled surgical cases have an estimate