Lower Sioux's TMG Project to Increase Efficiency of Health Services Billing - Abstract Applicant: Lower Sioux Indian Community (federally recognized tribe) P.O. Box 308, 39527 Reservation Highway 1 Morton, MN 56270 (507) 697-6185 Contact Person: Loretta Dixon, Grants Management , Ext. 2522 Application type: TMG Priority II Health Management Structure Time Frame: One-year funding request commencing on March 1, 2025 through February 28, 2026. Amount Requested: Year One (7/1/2025-6/30/2026) - $150,000 Total Amount Requested: $150,000 All TMG project activities will take place on the Lower Sioux Indian Community Reservation. The proposed TMG Project will enable the LSIC to sustain the medical, dental, optical, pharmacy and community health services to the community and its members through moving from AllScripts to EPIC electronic health record and building out the billing module to increase billing efficiency and accuracy. The project goal and objectives are: Goal: Enhance the operational capacity of the Lower Sioux Health Care Center to transition back to a sustainable billing model, focusing on increasing revenue generation, improving billing efficiency, and achieving full financial self-sufficiency within 3 years, while maintaining high-quality care and service delivery. Objective 1: By March 30, 2026, successfully complete the design, development, and implementation of the EPIC billing module to streamline and automate the generation of accurate billing claims, ensuring compliance with industry standards, reducing claim processing time, and increasing operational efficiency. Objective 2: Achieve successful credentialing of Lower Sioux Health Care Center with the Centers for Medicare & Medicaid Services (CMS) to qualify for Medicare and Medicaid funding, ensuring compliance with all regulatory requirements and facilitating access to critical funding for enhanced patient care and services by March 30, 2026. Objective 3: Develop and implement comprehensive billing policies and procedures for Lower Sioux Health Care Center that ensure full compliance with applicable healthcare billing regulations and best practices, streamline billing processes, and reduce errors, with a target completion date of April 30, 2026. Objective 4: Develop and implement a comprehensive Clinic Charge Master for Lower Sioux Health Care Center, ensuring accurate and standardized pricing for all services, alignment with industry standards, and integration with the billing system to optimize revenue cycle management by April 30, 2026. Objective 5: Design, develop, and implement a comprehensive Billing Audit Tool for Lower Sioux Health Care Center that enhances the accuracy of billing processes, identifies discrepancies, and ensures compliance with regulatory requirements, with the goal of reducing billing errors by 75% and improving overall revenue cycle efficiency by June 30, 2026.
