4eGuru released online EDI claim clearinghouse portal software, flow, claim forms' format & protocol are compliant with State of California Medi-cal (CMS1500)/PCHDP(PM160) form
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The
use of Electronic Medical Records has undergone a significant transformation
in the past 20 years from
various individual corporate developments using the PC Operating System in
first generation computers to new interfaces, faster communications and
advanced WEB-based software. The advent of the Internet and advanced 3G
and 4G technology makes older devices such as the FAX machine obsolete in most
cases as digital signatures graphics and imagery methods have been introduced
and computer memory sizes and mass storage devices have expanded. These
developments offer modern Physicians invaluable benefits to their practice
not only in the introduction of new
devices significant improvements to the productivity of their offices.
Starting
with the basic Electronic Health Record and advanced input technology an
Electronic Health Record becomes
developed at a newborn’s early age and as a standardized HL7 computer file,
will be able to live with individuals for their lifetime.
Medical
specialties are progressing in their development and addition of related
imaging techniques, drug usage and
prescription records matching the development of new treatment techniques. Yet,
despite the advancements made, some elements in the practice have not improved,
namely billing, since there has been a wide disparity in formats for submission
of claims statements to insurance companies, federal, state and local offices
for efficient compensation to physician individual and group practices.
This problem has also been
addressed by 4eGuru Inc. with the integration of the claims billing
process with the Electronic Health record system with a new software module
called “4eCHDP” enabling
direct statement preparation and electronic transmission to government offices
immediately following visits with unnecessary clerical tasks which now
consume the time and resources of the physician, nurse practitioner, assistants,
and clerical staff, improving the productivity of all and allowing more
patients to be treated while providing much more effective reimbursement.
The financial benefits far
outweigh the cost of installing and utilizing “4eCHDP”. Its
ease of use has been proven through many man-months of use in targeted
physician installations. Training and support during the transition from the
manual clerical methods now in use is provided by 4eGuru to ensure complete
operational facility by physicians and staff before the system goes fully
operational. Additional support and troubleshooting of is provided by local
staff, not some remote e-mail address.
4eGuru Inc.’s “4eCHDP” online
submission flow and module are compliant with California State Department
of Health Care Services Medi-Cal standard. It supports online batch claim submission
(CHDP-Green form or PM160) and prepares paper print claim submission forms if
required, without going through any third party or claim clearinghouse.
A cost-benefit estimate has
been prepared below in moving to 4eGuru’s Electronic Health Record and using the
“4eCHDP”
automatic online claim submittal method.
CHDP Paper Claim vs. Online Web Submission Claim Cost Comparison:
The present CHDP
paper claim form completed by manual entry and mail submission is not the optimum
method to submit physician visit payment claims
compared to electronic paper-less technology. As shown below, economic benefits can be
quickly and easily realized by converting a paper-based medical insurance
payment claim or billing to a fully integrated, paperless record system as provided
by 4eGuru with the “4eCHDP” claim module, with a breakeven period of about 6 months. Further
as a result of the ARRA stimulus program which provides a reimbursement incentive for conversion
to electronic technology the cost of conversion results in an additional
financial payoff for a four year time period.
How
much is Physician time worth?
What if you could save an hour or two per day? If you currently submit CHDP
paper forms manually, your office is wasting a valuable resource “Time”, whose
use when optimized, can generate cost savings, enhanced revenues and more efficient
office operations.
For
a typical Physician or Multi-physician Practice cases, billing paper flows
follow
the procedure in the diagram above; not only does the individual physician have
to take the time to write the notes for a biller or and/or their assistant, but
the Practice has to forward the visit data in paper summary form to the Billing
Office which generates a paper form, copies, packages and mails the billing
information to the state in the case of Medi-Cal or to an insurance company.
In these cases, labor time savings would occur if data electronically entered
an
qualified by the Doctor directly could bypass the unnecessary steps of manual
entry by the Assistant and then forwarding pre-claim paperwork to generate the
claim forms in proper format forwarding the data to the Billing Office and
onward. Manual handling of all the data
induces errors, requires filing copies, stuffing envelopes mailing and
recording the transactions for follow-up as required. The analysis below
demonstrates how an Electronic Health Record combined electronic forms handling
creates major
financials reward and many intangible benefits to the practice.
Time
and Money Saving Steps - For CHDP Claims:
A.
Physician and Provider side:
Doctor
and
Assistants Activities
A #1. Practice Statistics –Biller/Assistant:
Paper
data provided to office biller |
Preparation
time and Activity |
Data collection &
preparation period |
Document Management after submittal |
Average time taken by a biller to prepare and fill out paper
CHDP form |
Collecting patient data |
10 minutes |
10 minutes |
Estimated Average time saved by electronic preparation &
submission of CHDP form |
Direct computer entry and submittal of Screening/Billing data by Physician/Assistant |
5 minutes |
5 minutes |
Average Biller entries per day |
|
12 |
12 |
Total minutes saved per day |
12 visits x 5 minutes |
60 (1 hr) |
60 (1 hr) |
Total hours saved over 12 months |
5 hours/wk x 48 wks |
240 hour |
240 hour |
Total weeks of work saved per year |
(240 hrs / 40 hrs/wk) |
6 weeks |
6 weeks |
Total
Time Savings |
480 hrs(12 weeks) |
|
|
A #2. Total Biller Cost Savings per year
Biller /Assistant |
Hours
Saved |
Minimum
Cost @ $15/hr |
Total weeks of worked saved per year |
480 hrs |
$7200.00 |
|
|
|
Total Savings per biller
per year |
|
$7,200.00 |
A #3. Practice Statistics – Doctor: needs to complete
required
diagnostic information data for each visit for each CHDP claim
Average
time taken by a doctor to record visit data on paper form |
|
5 minutes |
Average
estimated time saved by using 4eGuru medical template |
|
2 minutes |
Average
Doctor appointments per day |
|
25 |
Total
Minutes Saved per Day |
(12 visits x 2.5 minutes) |
30 min
(say 1/2 hours) |
Total estimated
time worked in 12 month period |
(5 days/wk x 48 wks) |
240 days |
Total
estimated hours saved per year |
(240 days x 1/2 hour/day) |
120 hour |
A #4. Savings from reduced Doctor Labor:
Doctor |
Rate |
@
$60/hr |
Total labor saved per year |
120 hrs |
$7200.00 |
|
|
|
Total Savings per Doctor per year |
|
$7,200.00 |
A #5. Additional Savings from reduced materials cost: (Paper,
Cartridges, Envelopes, Mail)
Total forms
submittal |
Estimated savings |
Annual
Savings |
Paper, Cartridges, Envelopes, Mail |
($1.70 per form x 3000 ) |
$5,100.00 |
Total Savings per Doctor per year |
|
$5,100.00 |
A #6a. Maintenance Savings from reduced filing, storing,
retrieving, accessing, paper forms for review, and follow-up etc.
Estimated cost of filing, storing, accessing, retrieving -
maintenance of paper forms ~ ½
hour per year @ $15.00/hr |
~($8.00/form/year) |
$8.00 (est.) |
Estimated maintenance of an electronic form |
~($1-2/form/year) |
$2 (est.) |
Annual savings per form |
($8 - $2) |
$6 |
Assumed active forms per Doctor |
One form per visit or 12/day x 240 day |
Estimated 3,000 visits
per year |
Estimated Savings per Doctor per form per year |
3,000 forms x $6 |
$18,000.00 |
A #6b. Savings after Benefits paid in Explanation of Benefits (EOB)
Posting Phase from retrieving, accessing, paper forms for review, and follow-up
etc.
Estimated cost of filing, storing, accessing, retrieving -
maintenance of paper forms ~ ½
hour per year @ $15.00/hr |
~($8.00/form/year) |
$8.00 (est.) |
Estimated maintenance of an electronic form -10 min |
~($1-2/form/year) |
$2 (est.) |
Annual savings per form |
($8 - $2) |
$6 |
Assumed active forms per Doctor |
One form per visit or 12/day x 240 da |
Estimated 3,000 visits
per year |
Estimated Savings per Doctor per form per year |
3,000 forms x $6 |
$18,000.00 |
A #7. Summary of First Year Estimated Savings by using 4eGuru Digital
EHR Records and 4eBill CHDP/CM1500 Forms Submittal Methodology
From Item #2 |
Annual Savings from Reduced Biller/Assistants Cost |
$7,200.00 |
From Item #4 |
Savings from Reduced Doctor labor Per Year |
$7,200.00 |
From
Item #5 |
Savings
from reduced Materials costs |
$5,100.00 |
From Item #6a |
Savings from reduced manual forms maintenance |
$18,000.00 |
From Item #6b |
Savings from reduced manual forms maintenance in Explanation of
Benefits Phase |
$18,000.00 |
First
Year Summary |
Total Savings per Year |
$55,500.00 |
A #8. Cost of Implementation
First
Year Investment Costs |
Estimated Expense |
First Year HW Costs, two computers and printers, modems
interconnects , etc |
-$5,000 |
One
time CHDP billing and Pediatric EMR SW Costs with HL7Capability |
-$12,000 |
Annual Network, HW and Software Maintenance |
-$6,000 |
Initial Training for New Updates and New Staff |
-$1,500 |
Total
First Year Cost Estimate |
$24,500 |
A #9. Individual Physician Savings
over a Four year period:
Year |
Investment |
Annual
Savings |
Financial return |
Year 1 : Hardware Software &Training
Maintenance
Total |
$18,500.00
$24,500.00
|
FROM
ABOVE
$55,500.00 |
$31,000 |
Year 2: |
$6,000.00 |
$55,500.00 |
$49,500 |
*Years
3,4 Estimated total over 2-year period |
$12,000.00 |
$100,000 Est |
$88,000 |
4
YEAR CUMULATIVE RETURN |
|
|
$168,500 |
A#10. Additional financial benefits:
Annual & Accelerated Hardware Depreciation |
3-year Depreciable
Investment on hardware |
ARRA Government Credit |
Four year program provide large incentive for acquisition of
4eGiuru systems |
Reduced payment times due to speed of electronic submit |
Estimate – one day for submittal |
Reduced Errors and re-submittals due to error checking and
integration with Patient Record information |
Intangible |
A#11. Four
Year Summary in a Group Practice of 10 Physicians not including Cost Group
Discounts
Year |
Investment |
Annual
Savings |
Financial return |
Year 1:Hardware Software &
Training
Maintenance
Total |
$185,000.00
$245,000.00
|
See #9
ABOVE
$555,000 |
$310,000 |
Year 2: |
$60,000.00 |
$555,000 |
$495,000 |
*Years
3,4 Est. Total over 2-year period |
$120,000.00 |
$800,000 |
$400,000 |
4 YEAR CUMULATIVE RETURN |
|
|
$1,205,000 |
Note: In
third and fourth years there may be software and hardware upgrades so
operational
savings are
conservatively reduced.
The “EMR4Clinic” software suite is a fully integrated and robust
solution tying together the patient information and clinical examination and
procedure room to the practice management aspects of the medical office which
include the reporting, insurance billing, payment receipt and patient
reporting.
The software operates as a Web-based and Client-Server application, which
runs on all computer platforms including Windows- XP, Vista or Windows
7 servers, Linux. Mac OS X, and on all Internet
Web-browsers. These include Internet
Explorer/Firefox, Mozilla, Safari, and on all devices such as desktops,
laptops, tablet computers, iPhones, and other PDA devices. User
can maintain full administrative management control to maintain patient data
privacy over all applications by restricting access only to appropriate
authorized and authenticated
levels.
“EMR4Clinic” Medical
software product improves office work efficiency, lowering office costs, makes
patient record storage and retrieval flow more easily and with less error,
enabling the entire office to become virtually paperless. |