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PBRC Case Study ― Implementing Enterprise Billing

The Peter MacCallum Cancer Centre is Australia’s only public hospital solely dedicated to cancer treatment, research and education. Peter Mac treats more cancer patients each year than any other Australian hospital.


Background

Back in 2013, Peter Mac had five separate billing systems, with the main system over 25 years old. The systems did not communicate effectively with each other, resulting in labour-intensive and unsustainable manual data transcriptions. Peter Mac was losing an estimated $1.4M annually due to rejected claims and uncollected payments.
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Challenge

Peter Mac wanted to stop revenue leakage and improve performance. When external consultants recommended an enterprise billing system, Peter Mac decided on the PowerHealth Solutions (PHS) PowerBilling & Revenue Collection (PBRC) system, based on a similar hospital’s experience of ROI within the first year.
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Solution

1. Assemble the Project Team

Peter Mac engaged an excellent Project Manager who recruited the rest of the project team for their skills in IT, finance, change control, business processes, integration, and testing. They worked closely with PHS and this contributed significantly to the project success.

2. Get Executive Support

Peter Mac Executives were actively involved in the project from the beginning and worked throughout to ensure cooperation from the operational areas.

3. Redesign Business Processes

The project team worked to create departmental organisation change and redesigned their business processes ranging from service data capture to revenue collection. It was crucial to ensure business processes were functioning correctly prior to automation.

4. Define System Requirements

The project team worked closely with the operational areas to understand their business rules and requirements, and put together detailed system requirements. In practice, each hospital has specific business rules that vary from the complex generic industry rules, and these need to be well documented early for the system vendor.

5. Automate Billing

Peter Mac began implementing the PBRC enterprise billing system in 2014 and Phase 1 of the project went live in March 2015. Services included Accommodation, Medical Services, Outpatients, Online Claims, Radiotherapy, Receipting, Allied Health, Online Eligibility, and Simplified Billing.

 

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