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

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...I also feel that the solution is competitive regarding affordability... The billing tool does cut down on time spent submitting claims. The auto posting is immediate and eliminates 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 four-county system in the foothills of North Carolina. Federal mandates and the Commission on Accreditation of Rehabilitation Facilities (CARF), a national accrediting body, are required 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 is practical, easy-to-use software with high-quality customer service.
  • For paperless records and transparent billing lifecycle.
  • Increased pressure by federal mandates and accreditation bodies has forced mental health agencies to be more flexible with costs and outcomes by increasing patient record accessibility.
  • Creating billing inefficiencies and increasing operational workflow.
  • To meet the 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 solutions of expEDIum Workshop & Patagonia Health based on colleagues' recommendations and evaluation of other 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 wears many hats," said Quality Management Training Director. "However, in reality, the process has gone very smoothly. We approached the implementation process purposefully and slowly–one service at a time. Overall, it has been a very easy learning curve for our staff."

Solution Implemented
  • Enhanced workflow and better efficiency due to the elimination of paper record handling.
  • Faster reimbursement: An easy-to-use billing system makes 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 needed to be made 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/rejection processing.
Return on Investment (ROI)
  • The biller received Electronic ERAs (auto posted) for about 96.74% of the claims sent from our system and the remaining 3.26% on paper EOBs (manually posted). The 96.74% auto posting saved 100s hours of data entry savings annually.
  • This clinic processes over 1500 HCFA claims a month with less than a 1.2% denial rate compared to the earlier 5% denial rate.

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