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Nicklaus Children's Hospital

Bridging clinical and financial data: Early successes with a clinically driven revenue cycle™

"This is one of the most successful implementations that I personally have been part of or seen nationally,” said Edward Martinez, senior vice president and chief information officer, Miami Children’s Health System. “Cerner’s Patient Accounting solution was another step closer in achieving a clinically driven revenue cycle for Miami Children’s.” Martinez recently presented on this topic at the 2015 HIMSS Conference.

This past July, South Florida’s only licensed specialty children’s hospital, Nicklaus Children’s Hospital, formerly known as Miami Children’s Hospital got closer to completing their clinically driven Revenue Cycle journey on time with the successful launch of Cerner Patient Accounting. The organization was also able to implement interfaces between three pre-collection agencies and one collection agency.

The solution enables Nicklaus Children’s Hospital to bridge the gap between clinical data with the appropriate financial information to better manage patient accounting across the entire continuum of care. Electronic transmission of data helps reduce manual interventions and consolidate patient data into a single bill, which leads to fewer errors and quicker payment closing times.

As a result, Nicklaus Children’s Hospital met AR days goal and showed substantial financial improvements, such as higher clean claims rate and improved cash collection numbers.

Within five days of go-live, Nicklaus Children’s Hospital was submitting claims again, and by the end of that first week, saw their clean claims rate improve from an average of 78 percent to 87 percent.

By September 2014, just three months after go-live Nicklaus Children’s Hospital surpassed cash collection goals by 15 percent and recorded October 2014 as one of the highest cash collection months in its history.

Nicklaus Children’s Hospital also noted a three percent net cash collections increase during the six months after go-live, over the same period from 2013. The increased cash collection rate translates to a total of $6,354,331.

Addressing the slow reimbursement cycle that result in potential revenue loss is a concern for all hospitals, but in particular, children’s hospitals. Medicaid patients are a demographic that accounts for a little over half of all pediatric patients according to the Children’s Hospital Association. An average adult hospital’s revenue from Medicaid funding is between five to ten percent. Changes and cuts to Medicaid funding have left children’s hospitals with inadequate reimbursements.

Nicklaus Children’s Hospital invested time, leadership and resources into this project so they could sustain their organization’s operations and keep their focus on their first purpose — serving the health needs of their young patients.

Back in 2012, Nicklaus Children’s Hospital started their journey to improve their financial management and create a more integrated system with the implementation of Cerner’s registration and scheduling, charge services and eligibility verification solutions to help mitigate front-end errors.

Now with this final piece in place, Nicklaus Children’s Hospital can go back and work to optimize their system and continue to advance their revenue cycle effectiveness.

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.