Cardiology Practice Pumps Up Cash Flow

Even smaller-sized practices can be consumed by administrative tasks and risk losing focus on the driving force of advancing the health

Problem

South County Cardiology is a full-service cardiology practice, serving patients at multiple locations in Rhode Island's fastest growing region. These include an office and a testing facility in Wakefield where the practice is based, a newly opened office in North Kingston and three hospitals in the surrounding area. Between these, our 28-person group has 2,200 to 2,400 patient encounters per month and what amounts to a seemingly unmanageable amount of administrative work for our five core office staff members.

Even though I have more than 25 years of experience in medical practice management, supervising a busy, multisite practice like South County Cardiology can be extremely challenging. When I joined the practice in 2002, I soon realized that our workflow and cash flow were being severely impeded by an outdated and cumbersome practice management system. I wanted to improve our revenue cycle by increasing operational efficiencies throughout the organization, and I knew that only a full-featured, Web-based practice management system would allow us to do that.

Solution

Because of my previous experience in driving system implementations, I was charged with managing South County Cardiology's effort to choose and implement a new practice management system, and set up some basic, yet key criteria for an ideal system.

First and foremost, the system would need to have the tools and flexibility to manage all billings and collections in-house. In addition, I required a system that supported real-time reporting capabilities-one that provided a complete picture of accounts receivable (A/R), including unpaid and inactive claims, payment verification, and pending and bad debt adjustments. The system also needed to be user-friendly, to simplify the front-office tasks of scheduling, check-in and eligibility verification. Most importantly, the system had to be affordable enough to make fiscal sense for a practice of our size.

After a seven-month research and evaluation process that included side-by-side comparisons of several practice management system vendors, we selected CareTracker from LighthouseMD. CareTracker met all of my core requirements and, unlike other solutions designed with strict system requirements, there wasn't a mold into which we had to fit. During the process, we included the observations and suggestions of the staff to ensure that the solution would meet their needs as well. I presented my findings and recommendations to our physician partners, and the CareTracker practice management system selection was cemented.

CareTracker automates clinical and business workflow-integrating everything from patient scheduling, eligibility verification and record keeping to billing, claims submission and reimbursement management. Workflow rules, user alerts, task flags and real-time reporting are built right into the system, and all of this functionality is available to the practice's authorized users from any location via a secure browser connection. By being so user-friendly, the CareTracker system provides our multisite practice a level of flexibility that we had not seen in other systems.

Implementation and Training

In June 2005, South County Cardiology made the switch from our old practice management system to CareTracker. LighthouseMD's implementation team worked with my staff to transfer all maintenance files and our old database, including patient demographics to the new system. LighthouseMD listened to our unique needs and was able to create a fully customized, flexible solution.

Two weeks prior to the practice management system going live, our entire staff went to LighthouseMD's facility, where they learned how to use all of CareTracker's functionality. This training process was much easier at this facility because it was held in a classroom setting without the need for everyone having to hover over someone's workstation at the practice. Since LighthouseMD divided the training for us into two shifts over different days, we were able to keep our practice up and running, and conduct the training around our physicians' schedules. In addition, our staff was given temporary user passwords so they could practice the system's scheduling, billing and reporting functions when their schedules would permit.

On the day the system was launched, LighthouseMD's implementation team worked with our practice for an entire day, providing hands-on training and ensuring that the conversion complemented existing workflow. The staff walked through most day-to-day functions that they would encounter including reconciling patient scheduling and co-payments. Implementation consultants were available the next day as well, to see if my staff had any questions from the day before. Within a couple of weeks, as we started to receive payments from the claims generated by CareTracker, our trainer from LighthouseMD returned a third time for follow up with our billing staff to make sure that they were up to speed with payment input procedures, reconciliation and reporting.

Through the combination of the implementation team's support and CareTracker's user-friendly interface, our staff was up and comfortable with the system in no time. It was the easiest implementation I have ever experienced because the group did not have to reconfigure existing hardware. We just used our computers and accessed the system through a Web browser.

Results

Since the initial implementation, our patient workflow is much more efficient. Not only can our front office staff manage the process of each patient's status-from scheduling, check-in, examination room, through check-out-we can easily track the process from the physician side. CareTracker creates custom time reports for us to track how efficiently physicians are using their time, such as "How long is the average patient visit for each physician?" or "Is one physician spending more time than another in between appointments?"

Our front-office collections have improved by 15 percent. Because the system has the ability to automatically verify eligibility with payers, it saves administrative time. We now track which employee handled a patient's check-in and whether or not required copays and self-pays were collected.

Our staff uses the system's realtime reporting capabilities and single-view dashboard feature to ensure that our A/R (accounts receivable) is more current than ever before. Specifically, A/R over 60 days has improved by 20 percent, and our staff can track all of our accounts and monitor operations by simply clicking a mouse-instead of taking hours to generate reports. All allowables and fee schedules are integrated into the system, so it identifies incorrect insurance payments as well as unpaid, pending and written-off claims.

CareTracker has not only improved our cash flow and collections, it has also saved our practice considerable labor costs by drastically changing the efficiency of our operations. Shortly after installing CareTracker, we opened our North Kingston office without the need for any additional administrative employees. While the new office increases its capacity, we were able to have one staff member transfer from the Wakefield office to manage all of the front-office activities, including scheduling, patient check-in and billing. Initially, we had anticipated needing to hire one or two additional staff members to handle the increased patient flow and administrative tasks. This could only be possible because of the inherent efficiency and flexibility of our practice management system, which allows it to manage growing, multisite practices.

The CareTracker system gives our physicians the ability to write prescriptions, track diagnostic history, capture and store clinical images, send and receive test results, capture each visit in an electronic patient record, enter clinical notes, and document and manage patient communications to help us deliver a higher level of service. With these capabilities, our staff are equipped to better respond to patient inquiries and concerns, and keep our focus where it needs to be-patient care.