Artistic Background

Cutting Edge Receivables Management Company Turbo-charges Collections with AutoMate

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Confidential Client, n/a

Background

A leading provider of account receivables management services for the healthcare industry uses its deep experience and a specialization in the Emergency Medicine market to provide unparalleled service to hospitals throughout the Southeastern United States. This Company delivers value to its customers by eliminating costs associated with medical coding and insurance reimbursement collection, and by accelerating the timeline of the payment collection cycle.

The Company's core business process starts by retrieving images of patient charts from its clients (i.e., hospitals) every day. These charts are created when patients check into the hospitals, typically the emergency rooms, and receive emergency services. The hospitals maintain chart information on their internal systems which vary widely depending on the software vendor of the health information system.
After the Company transfers chart images from the hospitals to its servers, personnel read the charts and enter appropriate medical cost codes (which are based on the procedures performed and doctors' notes) into an internal system. The Company also captures the insurance information for each patient chart it reviews so that it can submit a bill for the insurer to pay.

In this business process, time is of the essence and accuracy is paramount. The Company must send insurers complete and accurate medical coding information, and do so extremely quickly, so it can collect the full amount due in the shortest time possible. Any activity that contributes to a speedier and more accurate process has a major impact on the business process and the value the Company delivers for its clients.

The Challenge

The Senior IT Manager at the Company had the challenge of improving the speed and accuracy of the medical billing process. His goal of streamlining the process was complicated by the diverse nature of clients' systems that are the source for patient charts, not to mention the cumbersome manual process of accessing the systems, printing the charts, and collating the information.

Additionally, IT Manager was tasked to lay the groundwork for a "chart tracking" application that many of the Company's customers had requested. Chart tracking software helps hospitals know the precise status on all patient charts - whether they are pending reimbursement, complete, or incomplete. As such, chart tracking software improves process efficiency, as well as provides better customer service by increasing transparency.

The Solution

The IT Manager's first step in streamlining the Company's core business process was to capture electronic images of the patient charts automatically. To accomplish this, he created an automated process for each hospital that is triggered when the hospital securely transfers a file via FTP to the Company's server. The file contains patient account numbers of the individuals who received medical services the previous day. When the file appears on the server, an AutoMate task is set into motion. AutoMate securely logs into the hospital's information system, and by submitting the patient records read from the file, downloads a digital image of each patient record. AutoMate renames each file to correspond with a naming convention consisting of the patient number and the date of receipt, and also deposits the file in specific networked directories for easy access and retrieval by the Company's medical coding personnel.

According to the IT Manager, "This automated process has enabled our company to redeploy three employees from the drudgery of logging in to hospital systems, calling up charts one-by-one, and printing the charts. These employees can now focus on the real value-added part of our business, which is reviewing the charts and assigning accurate and complete cost codes to each one."

In addition to streamlining data access, the IT Manager's AutoMate solution laid the groundwork for the chart tracking service so many of the Company's customers were demanding. As the IT Manager notes, "Chart tracking software can only work if you actually have charts that you can track. In the past, all we had were heaps of hard copies piled up on a desk. Now, with the AutoMate solution, we have organized, easily accessible digital charts that chart tracking software can point to. This makes providing this important service to our customers a feasible option."

The Benefits

The Company has leveraged the AutoMate solution to save costs, provide superior customer service, and accelerate the cash collection cycle. The IT Manager says, "AutoMate has impacted three critical pillars of our business. We have streamlined our core business process which saves a lot of money, but we are also now able to speed up the collection cycle because our coders no longer have to wait for printouts of patient charts. And, if a question about the completeness or status of a specific chart arises, it is very easy for our people to look up the information and get answers fast. This means we continue to enhance our service levels to further separate the Company from the competition."
An added benefit of AutoMate for the IT Manager is that it makes him more efficient in his job. Instead of using one of his standard IDE Visual Studio programming languages, he often turns to AutoMate for one-off jobs. And AutoMate's error handling capabilities give him the control and power to ensure unforeseen issues are identified and rectified.

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