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In Search of Paperless Workflow

July 1, 2006
by Bonita Shelar
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MaternOhio partnered with KeyBank and Donnell Systems to develop a patient payment and medical records system.

HIPAA compliance requirements have complicated the already cumbersome hard-copy management of patient billing records and medical information.Bonita Shelar

Manually extracting data from complicated EOB forms and re-keying information into IT systems introduced clerical errors and used to take 60 to 90 minutes of work every day at MaternOhio, a Columbus-based professional services cooperative serving 200 physicians. This task now takes 15 minutes in a secure, digital environment.

We partnered with KeyBank (Cleveland) and Donnell Systems (South Bend, Ind.) to develop a cross-platform system integration that automates operations, coordinates patient information and provides transparent, practice-wide information accessibility. As secure as it is efficient, the system complies with HIPAA requirements.

Members look to MaternOhio for reduced costs through shared administrative support functions, business support services, such as contract negotiations with suppliers, and vendors and malpractice coverage. In addition, we provide shared IT infrastructure to reduce implementation and support costs.

The goals

We wanted a patient payment and medical records system based on shared digital document imaging so that different staff members could work with the imaged, linked documents at their individual workstations. We wanted to use optical character-reading capacity to end the paper chase, reduce check float, integrate cross-referencing of information and document research while controlling access for HIPAA compliance and improving disaster-recovery capabilities.

Working with KeyBank and Donnell Systems, we developed an integrated, image-based lockbox solution that automates payment posting, reconcilement and billing. It stores check and remittance images electronically, automatically updates our in-house patient accounting system, offers full data and document integration for maximum system-wide access and maintains confidentiality.

Quicker posting of payment information into our accounting systems converts receivables into cash more quickly and accurately than previous collection methods.

Defining opportunities and objectives together, we shared with KeyBank and Donnell the costs for a year of beta testing, cooperating to produce an integrated, practical solution.

As our financial services provider intimately familiar with our operations, KeyBank leveraged its knowledge and analysis of our financial data to determine the greatest value that our data could provide, collaborating with us to identify the most useful information and functions that planned system integration could provide.

Donnell Systems provided its Online Computer Image Exchange (OCIE) to the project and supplied system hardware while retaining ownership of the equipment and taking responsibility for its performance. KeyBank and Donnell installed a new server behind a firewall on our IT network, custom-configuring the server to query KeyBank's lockbox electronically every night, as well as our billing system, through secure connections. KeyBank and Donnell optimized image quality, ensured data integrity and maximized network reliability, security and user-friendliness, all without increasing our infrastructure costs.

The results

The system automatically integrates files from the KeyBank lockbox and our payment system, using Donnell's OCIE capability to collect data and document images from separate locations. OCIE also facilitates on-demand document printing, form-overlay viewing and printing, ad-hoc reporting, and data mining for real-time applications and databases.

When patients call with questions, our staff is able to access EOB and other data images online in real time…”

The system has improved the speed and accuracy of information management and processing for our members. As we receive payments, KeyBank captures digital images of checks, invoices, statements and EOB forms. Donnell's software finds specific data on the images, despite multiple, non-standardized formats, through OCR technology, and matches EOB information with information from our applications. The system expedites payments by receiving them electronically early in the morning. Check and remittance images are electronically "stapled," preventing loss.

Remittance document images are cross-referenced with our account database for automated population of patient information in OCIE.

Document images are immediately available for online viewing, e-mailing or printing. To expedite research, new payments are linked to the patient's electronic payment history. Quicker posting of payment information into our accounting systems converts receivables into cash more quickly and accurately than previous collection methods.

We have also improved customer service through faster document research and retrieval, cutting patient accounting research time in half. Information for insurance and patient payments comes through the lockbox. When patients call with questions, our staff is able to access EOB and other data images online in real time, rather than searching through paper files. Backup of the server ensures HIPAA-compliant document security and disaster recovery.

Authorized staff can securely access patient names and accounts without compromising confidentiality, alerting one another through our standard e-mail system to confidential information in OCIE mailboxes.

The lockbox server that KeyBank and Donnell supplied, and that Donnell now maintains at our facility, indexes, archives and secures documents, making them available for authorized users only. Secure linkages protect data in transit within our system, which archives transactions, automatically posting them to the general ledger and providing disaster recovery.

Our experience suggests that an image-based lockbox service can benefit any healthcare organization that receives payments from patients or insurance companies. Due to economies of scale, the ideal user is a mid- to large-sized physician's practice. However, the system would also be useful to hospitals, medical groups and management practices.

We have found that the benefits of this integration extend into every phase of our payment-related information management, without the need to invest in additional IT infrastructure, staff or training.

Author Information:

Bonita Shelar

Bonita Shelar CCS-P is payment services manager, MaternOhio Management Services.

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