Healthcare Informatics 100 Company Profiles

SSI: EDI advantages are its claim to fame

The SSI Group, Mobile, Ala., claims the #73 slot in this year's Healthcare Informatics 100 list. Founded in 1988, SSI specializes in revenue cycle management, EDI and claims management. As both an EDI company and one of the nation's EHNAC-certified clearinghouses, it processes more than $588 billion in transactions annually.

Most of SSI's clients are hospitals, but interest is growing quickly among surgery centers, long-term care facilities, nursing facilities and others.

“Once they get a taste of the benefits of EDI, it's easy for them to jump to the next level of revenue cycle benefits,” says Doug Bilbrey, executive vice president for sales and marketing at SSI. “Over time, most hospital providers have done the basic things pertaining to electronic claims. Now, they're looking for tools that can allow them to squeeze tighter margins out of that revenue cycle and enhance their workflow.”

The company's ClickON Claims Management suite provides all the features of advanced EDI claims systems. SSI's new ClickON ClearView 5010 application allows providers and payers to test their 5010 processes.

“We've now bundled our billing, claims status, payment posting and workflow reporting offered via Software as a Service (SaaS), with several pricing models based on volume,” Bilbrey says. “What's different about our tools is that they have editing, formatting and reporting capabilities, too.”

Recent interest also has been growing around the company's ClickON RADs (Recovery Audit Defense system) product, which can catch inaccurate billings that would otherwise be pushed into audits by Recovery Audit Contractors”, he says.

“Historically, claims scrubbers would tell you what's wrong with the claim. But now we also need to tell providers, ‘you could have done this,’ or, ‘make sure you include A and B before you send this claim out,’ or ‘this could become a potential issue down the road,’” he explains. “Now that the edits have become more analytical and productive, it'll make the providers much more efficient in catching errors before they go out.”

SSI processed 311 million transactions last year. The company has more than 2,400 clients nationwide, including 900 payers and 1,500+ health plans.

Webmedx: Transcribing Documentation for Quality Analytics

Atlanta-based Webmedx debuts this year on the Healthcare Informatics 100, ranking #71.

Founded in 1996, the Web-based documentation transcription company has enjoyed steady growth over the past four years; it is now the third-largest transcription company in the U.S. healthcare market.

Back in the late 1990s, the application service provider (ASP) model was a hot, new frontier in healthcare, but not necessarily for medical records. The company had to prove the reliability of the model for physician documentation, mainly by providing accurate reports, quick turnaround and top-notch customer service, recalls CEO Sean Carroll.

Today, the company is focused on the newest demands in the transcription market: front-end speech recognition, EHR-ready data, and quality analytics tools.

“On an increasing basis, what we produce for a customer needs to be ready for integrated use by an EHR, regardless of vendor. The stakes for accuracy, both for the information and the integration integrity, have ratcheted up very quickly as more EHRs are being implemented,” Carroll notes, adding that the company has invested heavily in speech technologies while also developing interfaces to all the major EHR vendors. “And, with today's emphasis on core measures, quality reporting, and the ‘meaningful use’ criteria, the time for quality analytics tools is now.”

Webmedx uses multiple technologies to capture and transcribe narrative physician documentation and extract meaningful data sets, Carroll explains. “We incorporate Natural Language Processing technologies with our query-based script intelligence to re-purpose usable information, whether reports are dictated or speech-generated.”

Remaining a top player amid the rapidly changing demands of healthcare documentation means being willing to make constant investments in the company's technology capabilities and its own employees, Carroll says.

“Our real fuel is our strong field of 1,000 employees, and keeping our employees long-term is a big part of our business strategy of quality and continuity.” One clue: Three of the last six presidents of the Association for Healthcare Documentation Integrity have worked for Webmedx.

The company processes about 6 million documents annually, while maintaining a client retention rate of 98%. In an ASP-based market where dissatisfied clients can go elsewhere easily, the retention is a clear indicator of the company's quality of service, Carroll notes. “Clients have to see that you're committed to getting it right.”

Vitalize: Expertise along healthcare's regulatory road

Over the past four years, Vitalize Consulting Solutions, Inc. (VCS), Reading, Mass., has climbed 20 spots on the Healthcare Informatics 100, ranking #66 this year.