"...I also feel that the solution is competitive in regards to affordability... The billing tool does cut down on time spent submitting claims. The auto posting is immediate and eliminates much time spent manually, posting claims."

EMR/PMS Project Manager of a Critical Access Behavioural Health Agency, North Carolina

A North Carolina based Behavioural Health Service Agency/CABHA manages 90 clinicians, healthcare providers and other support personnel across a fourcounty system in the foothills of North Carolina. Federal mandates and the Commission on Accreditation of Rehabilitation Facilities (CARF), a national accrediting body, requires to implement an EHR + PMS system.

The Program Director and her leadership team had to find an integrated EHR + PMS solution to meet the following requirements:
  • A Cost effective, easy to use software with high quality of customer service.
  • For paperless records and transparent billing lifecycle.
  • Increase in pressure by federal mandates and accreditation bodies have forced mental health gencies to be more flexible with costs and outcomes by increasing patient record accessibility.
  • Creating billing inefficiencies, and increasing operational workflow.
  • To meet requirements of federal funding and receive full CARF accreditation.
  • An EHR + PMS solution that would improve billing processes and internal workflow efficiencies.

The team selected integrated EHR, practice management and billing solution of iTech Workshop & Patagonia Health, based on colleagues' recommendations and evaluating other various solutions.They slowly began to implement the integrated solution in September 2012.

“We were initially afraid of the prospect of rolling out a new system across all of our facilities since we are a small agency and each of us wears many hats,” said Quality Management Training Director. “However, in reality, the process has actually gone very smooth. We approached the implementation process very purposefully and slowly–one service at a time. Overall, it has been a very easy learning curve for our staff.”

Solution Implemented
  • Enhanced workflow, better efficiency due to elimination of paper record handling.
  • Faster reimbursement: An easy-to-use billing system makes the process of billing to Medicaid and other 3rd party insurance companies more efficient, allowing PRACTICE to get reimbursed more quickly. In addition, the improved billing processes revealed payment gaps that PRACTICE was not even aware of, which further increased consistent money flow into the agency.
  • Limited IT maintenance: The solution requires very little support and maintenance, has little IT requirements, and does not require a secure server on site as all data is stored securely in the cloud. According to the IT Director, “the accessibility of data and limited IT requirements has been very convenient and one of the biggest IT-related advantages of the system.”
  • The overall productivity improved resulting in better claim visibility, automation and denial/rejections processing.
Return on Investment (ROI)
  • The biller received Electronic ERAs (that are auto posted) for about 96.74% of the claims sent from our system and the remaining 3.26% on paper EOBs (that are manually posted).The 96.74% auto posting saved 100s of hours of data entry savings every year.
  • This clinic processes over 1500 HCFA claims a month with less than 1.2% denial rate compared to the earlier 5% denial rate.

The integrated solution currently has 300 plus CABHA providers in 16 clinics which processes over 230K claims across all Mental Health/CABHA clinics combined.