A Calif.-based non-profit community clinic sets out to prevent repetitive-motion injuries and ends up dramatically reducing costs and increasing revenue.
Today’s computerized practice management (PM) and claims coding systems revolutionized healthcare. Though much of the claims process is electronic, the coding and input of patient data is still a highly manual process. For those occupying such positions, repetitive-motion injuries can be the result. When a Calif.-based community health clinic purchased an automated charge capture and coding solution to help protect staffers from repetitive-motion injuries, it was stunned by a substantial and unforeseen benefit.
A Calif.-based non-profit community clinic sets out to prevent repetitive-motion injuries and ends up dramatically reducing costs and increasing revenue.
Mike Hull is chief information officer at Livingston Medical Group, Livingston, Calif. Contact him at mike.hull@livingstonmedical.org.
Today’s computerized practice management (PM) and claims coding systems revolutionized healthcare. Though much of the claims process is electronic, the coding and input of patient data is still a highly manual process. For those occupying such positions, repetitive-motion injuries can be the result. When a Calif.-based community health clinic purchased an automated charge capture and coding solution to help protect staffers from repetitive-motion injuries, it was stunned by a substantial and unforeseen benefit.
Livingston Medical Group is a non-profit community clinic in Livingston, Calif., that provides comprehensive ambulatory, educational and preventive health services using a fee-for-service reimbursement method. Livingston has the equivalent of nine full-time providers, including physicians, physician assistants and nurse practitioners. Prior to January 2006, we used the equivalent of two and a half full-time employees to manually key in charges for the services provided by our clinical staff.
Problem
The sheer amount of data that passed through the hands of our billing staff on a daily basis was staggering, and as a result, we became concerned about staff members possibly sustaining repetitive-motion injuries. For that reason, we considered purchasing automated charge capture software.
We assumed our providers were probably undercoding some charges, and we knew this type of software could help eliminate missed charges, ensure coding accuracy and reduce our audit exposure. But this was not the primary motivation behind our decision to purchase the software. Our intent was much more basic. We simply wanted to eliminate the process of manually keying charges and help our staff avoid injuries.
Solution
Once we decided to purchase a charge capture and code-editing system, the search for the specific product was brief and easy. We did not evaluate a long list of vendors or schedule multiple demonstrations. We knew we wanted to purchase the CodeScan Scanning Edition through Columbia, S.C.-based Companion Technologies—a company with whom we were already familiar.
Companion Technologies has a reseller agreement with the product’s developer (White Plume Technologies of Birmingham, Ala.) to offer CodeScan as an integrated charge capture and coding module for its PM system. Our primary requirement was that it integrates seamlessly with our PM system and its accounts receivable module.
We knew Companion Technologies’ PM system implemented well with other software, having successfully integrated it with other systems in the past, including software that checked patients’ insurance eligibility. Further, a nearby community health center in our 13-clinic consortium, Golden Valley Health Centers, had integrated CodeScan with its Companion Technologies PM system, and highly recommended it.
Installation, Implementation and Training
Companion Technologies installed their CodeScan interface on our server, and the systems worked together flawlessly. With CodeScan, we replaced our traditional encounter forms with Scantron “scannable” encounter forms. The new forms were developed specifically for our practice and offer our providers more diagnosis codes, procedure codes and modifiers from which to choose. We also receive quarterly updates to the CodeScan product to ensure coding accuracy and compliance with the latest regulations.
We anticipated this would result in more accurate coding and a slight reduction in missed charges, but again, this was not our primary concern.
We were successful in accomplishing staff buy-in by keeping everyone informed throughout the process and inviting every staff member to provide input. Design of the Scantron encounter forms, for example, was a collaborative effort.
After we installed the CodeScan software on our billing office PCs and added the CodeScan interface to our PM system, a White Plume representative provided CodeScan training to all of our providers and billing staff during the installation process. I attended the training sessions, and we all participated in follow-up meetings to ensure that everyone knew exactly how to use the system before we went live.
Hardware and Components
Hardware requirements for implementing the CodeScan solution were limited to a Scantron scanner and a Kyocera FS-9520DN printer. The scanner was included in the quote from Companion Technologies, and we leased the printer.
The printer is fairly large, as it utilizes various trays required by the different types of encounter forms, as well as nine different output trays representing our various check-in windows. Prior to an encounter, a form is printed and handed over to the provider. Several fields are already populated at that point, including the patient’s name, encounter type, insurance information and other data. The provider completes the form by checking off boxes during, or immediately following, the encounter.
CodeScan also is available in a Tablet Edition, which allows providers to record charges electronically on a tablet or desktop PC, instead of paper forms. However, we chose the Scanning Edition.
Benefits and Results
We have used CodeScan as part of our PM system for nine months, and are definitely more at ease regarding the well being of our billing staff. Our providers simply record charge data for each patient encounter by checking boxes on the form with a pen or pencil. The forms are taken to our billing area, where they are scanned at a rate of 20 forms per minute, and checked by CodeScan for potential coding errors, including validation of CPT and ICD-9 codes and verification of the correct use of modifiers. Clean claims are then uploaded to our PM system on the front end of the claims process.
We fully expected to eliminate the process of manually keying in and editing charge data. We also anticipated that enhanced coding accuracy would result in a slight increase in the average charge per patient encounter. Charges did indeed rise, but the increase cannot be regarded as slight.
Our clinic has seen an average increase of charges per encounter of $4.21, all of which can be attributed to eliminating missed or undercoded charges. With an average of 3,469 encounters per month, this increase comes to more than $14,600 per month, or more than $175,000 per year. One provider, who handles mostly walk-ins and routine cases, saw an increase in average charges from $74.05 before CodeScan to $101.15. That is an increase of $27.10 per encounter.
After factoring in the cost of forms and maintenance contracts, our anticipated annual ROI is nearly $169,000. Not to mention the reduced risk of injury to our staff.
We anticipated the technology would add $1.50 to $2 to the average charge per encounter. We did not expect more than $4, and we did not expect the product would more than pay for itself within six months. We also have seen a substantial reduction in claim denials and lost charge slips, but I have yet to quantify those results.
While our billing staff spends roughly the same amount of time entering encounters as they did prior to implementing CodeScan, they are spending considerably less time correcting errors and finding lost charge slips. After the initial month, we were able to reallocate approximately 0.75 FTE of billing staff to collections and appointment confirmation.
One hundred percent of the increased charges were attributed to 75 percent of our providers. We plan to use an analysis of the coding to provide additional training, and we believe this will help us reduce missed charges from other providers in the coming months.
Overall, implementation and adoption of CodeScan into our PM system has been a greater success than we imagined. The new polices and procedures have become second nature to our staff. We have benefited financially, while increasing employee morale, billing accuracy and provider efficiency.
For more information on CodeScan from White Plume Technologies,
www.rsleads.com/612ht-207
For more information on practice management solutions from Companion Technologies,
www.rsleads.com/612ht-208
