Synopsis - Integrated solution for Revenue Cycle Management and Medical RecordsOverviewPhysician practices are being called on to do more than ever before. Today's physicians must treat more patients, document interactions more meticulously, wrangle with more complex managed care rules, keep track of an ever-expanding array of drugs, submit and track claims and pay rising malpractice insurance bills. In many cases, physicians must treat 20 percent more patients than they did five years ago to generate the same revenue. In the face of these burdens, some practices are struggling to remain financially viable.
For many practices, the biggest impediment to meeting these challenges is continual administrative burden, a lack of automated clinical documentation, and inefficient practice workflow systems. Despite the dramatic advances in many areas of healthcare technology over the past several years, most physician practices-especially small and midsize ones-are still using the same manual and paper-based office management systems they " ve used for decades. With mounting pressure from insurers, government agencies, and patients, physician practices need to reexamine the ways they work and interact. As physicians see more patients and insurers demand reformed documentation for rapid processing of claims, the manual healthcare systems that were adequate in the past will become less and less able to meet new demands.
The problem The paperwork burden among solo / small group physicians' is immense, adversely impacting the quality of patient care. In addition a common glitch in all the revenue cycle stages are inefficiencies, resulting in delays and loss of recoverable revenue. The consequences Revenue Cycle Management Medical record so Disproportionate amount of working capital tied up in receivable so The highest cost of collection in comparison to other industrie so The average M. D. physician has more than $150, 000 in outstanding accounts receivables at any given point in time Spend $7-$12 in direct expenses to file each paper claim Accounts receivable cycle is in excess of 45 days o Physicians do not have the relevant information to select the optimal treatments for their patient so Medical orders and prescriptions are handwritten and often misunderstood o The above leads to occurrence of preventable medical errors and reduces the quality of patient care Inefficient paper-based routines (e. g.
filing prescriptions, searching for patient histories, coding etc) have burdened physician's schedules and bred inaccuracies Business Opportunity (USA) o Significant majority of physicians are in solo / small group practice (63. 3% of total physicians in non-federal practice are either solo or in groups of up to 3) o Physician's ICT spending will grow from 6. 44 billion USD in 2004 to 8. 5 billion USD by 2008 at a CAGR of 7. 2%o EMR investment by small group physicians' practices will grow from 366 million USD in 2003 to 829 million USD in 2008 o Currently only 25% of the 1. 8 billion claims submitted by physicians are in the form of scanned documents or in electronic for mo Only 5% of physicians in solo or small group practices of three or lesser in size currently use some form of electronic medical records Definition of the service Integrating the revenue cycle management solution to medical records thus enabling real-time access to digitized clinical patient information from everywhere, simplifying clinical decisions, saving time, improving standards of coordinated care and opportunities for reimbursement for the solo / small group physician.
DTL Solution The integrated solution for revenue cycle and medical records management enhances both the clinical and financial aspects of the solo / small group physician's practice. Document management applications deployed to enhance collection, storage, retrieval, searching, sharing, sorting and purging of medical records assume form of a Digital Medical Record. This integrated with coding, capture, billing and AR & denial management decrease claim denials, accounts receivable and medical errors; enhance patient care; improve physician productivity, patient and employee satisfaction and cut the medical records coding backlog. Value Proposition Significant decrease in DAR (days in accounts receivable) o Increase in cash flow and ability to track outstanding claim so Higher reimbursement rates o Improved patient care through greater access to information Increased flexibility as to where and how clinicians work Reduced errors by eliminating paper-based system so Better efficiency through streamlining manual processes o Ability to see more patients with the same support staff Ability to locate information and answer questions more quickly Reduced patient wait time so Compliance with regulationsStrategyChoice of Alternatives Access to the customer Direct or channel partner Market coverage Full or selective Medical specialties All or selective Solution Model Stand-alone, data center or ASP.