"The Toothaches" Increase Revenue for Dental Services

Summary

Impact Statement: 
By using the Six Sigma DMAIC method, Lake County Health Department streamlined their billing process for the Dental Program. This change resulted in a significant decrease in lost revenue, from an average of $5,354 per quarter down to an average of $2,076. The quarterly losses decreased steadily once improvements were instituted, to a low of $1,700 in the final quarter of the QI project period.
Summary: 

During fiscal year (FY) 2014–2015, Lake County Health Department's dental program lost approximately $21,000 in revenue, most of which was due to denied claims. "The Toothaches" QI team, comprising the entire dental staff (from the dentist to front-line staff), was formed to address this issue.

The Toothaches used the Six Sigma DMAIC methodology to improve the billing process and decrease the number of denied claims. The goal was to increase revenue by reducing denied claims from an average of $5,354 per quarter to $2,500 per quarter by September 30, 2016. The Toothaches exceeded their goal by bringing the average down to $2,076 per quarter, with a low in the final quarter of the QI project period of $1,700.

This Six Sigma Green Belt project used many different QI tools, including cost of poor quality, flowcharts, a waste matrix, a Pareto chart, and many others (see the attached PowerPoint presentation and storyboard for the completed tools). The team continues to monitor the claims denied for dental services on a quarterly basis.

Organization that conducted the QI initiative: 
Lake County Health Department
Citation: 

Mehta, U. Public Health Quality Improvement Exchange. "The Toothaches" Increase Revenue for Dental Services. Thu, 06/15/2017 - 13:02. Available at https://www.phqix.org/content/toothaches-increase-revenue-dental-services. Accessed October 19, 2018.

Submission Status: 
Completed
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