Integrated PMS + EHR Solution reduced denials rate and saved 100s of manual data entry hours

The Health Director of a District Health Department continuously works to improve patient care within the public health system covering three counties in the north-western region of North Carolina. The District Health Department has approximately 45 users across all three counties including practice managers, nurses, providers and others.

They were frustrated with an antiquated system they were using and facing the following issues and had requirements:

• They were using earlier a legacy billing system and some claims were sent on paper, also had paper based medical records charting.
• A completely paper-based system requiring practice personnel to re-key patient data multiple times across multiple screens.
• Not having a robust integrated system and lacks many features.
• Manual processes and create operational inefficiencies.
• Not having a centralized and integrated electronic claims processing and submission solution.
• System was cumbersome and very slow and no integration of data and reports.
• Being able to support any number of users.

After consulting with the rural health center and a community care consulting physician who had evaluated a number of commercially available PMS+EHRs, the decision was made to implement iTech & Patagonia's integrated EHR, practice management and billing solution in August 2012 fiscal year. This integrated solution ranked very highly in terms of technology and support, and it was able to offer a competitive price point for the fully integrated solution.

The solution has built-in Public Health Specific features such as debt set off, bad debt write off, handful of custom reports, sliding fees schedule, Atypical IDs and other features, the need for being able to submit claims to insurance companies and gets paid and manage the practice effectively.

• Once the application was up and running, the department rolled out Practice Management to one county and then rolled-out to remaining counties in a few months.
• Completely transformed from a largely paper-based office to electronic office.
• Improve overall workflow and increases efficiency.
• Gain instant access to financial data within the system.
• Department personnel and providers no longer have to repeatedly re-key patient data across multiple screens, which make scheduling patients easier.
• A very easy to use billing system, making the process of billing to third party insurance companies faster and more efficient.
• Turnaround time to receive reimbursement/payment within a week, at the latest, if not sooner. In the past they were lucky to get payments back within three weeks to four weeks.
• Increases on cash flow/patient collection due to the comprehensiveness of the software.
• Ability to find any errors in the claims and corrections are made prior to submitting them to insurance companies or clearinghouse.
• Now they have reports that are needed such as aging, AR report, cost analysis and is user friendly.

• The biller processes over 1300 HCFA claims a month with less than 6% denial rate compared to the earlier 10% denial rate.
• The biller received Electronic ERAs (that are auto posted) for about 93% of the claims sent and the remaining 7% on paper EOBs (that are manually posted).The 93% auto posting saved 100s of hours of data entry savings every month.

The integrated EMR+PMS solution of iTech & Patagonia is the leading software vendor in the Public health clinic space in the state of North Carolina and are expanding our Public health clinic provider base in other states such as Ohio, Maryland, Kansas and Illinois. The integrated solution currently has 500 plus providers in 48 counties and processes over 600K claims across all Public Health Clinics combined.