Adapted from a Digitech implementation study – full PDF available for view or download here.
Rapid expansion means increased call for services
Gwinnett County, a suburban community of the Metro Atlanta area, has seen rapid population expansion accompanied by increased demand for services. The Gwinnett County Department of Fire and Emergency Services, formed in 1997, has since expanded as well. Maintaining a dependable revenue source to meet the Department’s rising operating costs became imperative.
Gwinnett issues call for proposals
By 2011, Gwinnett County had identified medical transport billing as a revenue source that might benefit from improved efficiencies. The Department was already using ESO Solutions ePCR software on Panasonic Toughbooks to generate electronic patient care reports from the field, which had brought improvements to the accuracy and completeness of their field data collection. Gwinnett was also using a bank lockbox for direct deposit of remittances to streamline the posting of receipts. Now the need was to speed up submissions – to be able to pull the data from the field reports, review claims and add information if necessary, submit claims to third party providers and receive remittances, all within a shorter time cycle. After extensive research into best practices and in-service solutions deployed at similar departments around the region and nationally, Gwinnett County assembled and issued an RFP for emergency medical billing services. The opportunity was right in the sweet spot for Digitech, who excels in creating process efficiencies for medical transport billing. Digitech knew they would submit a proposal.
Digitech sees opportunity
“The contract was something we really wanted to pursue as the County is considered a trend setter in the region,” reported Marty McNellis, Director of Business Development for Digitech. “We felt our robust reporting capability would be well received by the Gwinnett Fire Rescue, who were hungry for data and able to make good use of it.”
Digitech’s Ambulance Commander, the proprietary software platform which McNellis describes as “the heart and soul of Digitech’s ability to file claims” has been 25 years in development. “It’s already been integrated with all of the major ePCR applications,” said McNellis, “and has numerous customizable features that enable the Digitech development team to adapt it easily to the particular requirements of any implementation project.” Most importantly, Ambulance Commander’s track record is very solid, and has proven to increase collections with a high degree of success.
The contract was signed in late November and systems integration began immediately. “This was a fairly smooth transition,” commented Walt Pickett, Digitech’s Senior VP Development and support. “We had a great team to work with on their side – very well organized.” However, Digitech’s implementation was required to meet the benchmarks of the contract, one of which was a January 1 start date. Fortunately, because Digitech had already implemented an interface between the ESO Solutions ePCR software and Ambulance Commander, the deployment team was able to shortcut that piece of integration. The Gwinnett implementation of Ambulance Commander was made operational within four weeks, ready for the “go live” date planned for end of December. At the same time, Digitech account managers were preparing enrollments with third party insurance carriers such as Medicare and Medicaid at the same time they were gathering authorizations for the electronic transfer of remittances. “The credentialing process requires several steps,” reported Mary DelFranco, Digitech’s Senior Account Manager. “By posting payment in this way, it becomes much more efficient compared to keying data in manually.”
Also within this four week period, Joyce Kerulo, Digitech’s Senior VP for Billing Services, and her staff were getting prepared by setting up an organizational structure to handle the account. “One of our strengths is that we are able to process quickly,” she said, “usually within one business day of receiving claims.” Donna Buhler, CPA and Business Manager for the Gwinnett County Fire and Emergency Services Department, agrees. “Joyce always responded immediately to any of our change orders,” she stated. “She and the Digitech Billing team were always very thorough in everything they did.” As the first ESO ePCR reports were being received from Gwinnett County during the last week in December, Digitech staff began verifying third party insurance information using Digitech’s proprietary search process, Sleuth. Trained coders looked for the compliance issues to ensure third party insurers were being billed for the correct level of service. The first submissions were made to Medicare and Medicaid on January 6th, 2012. Within a window of some 14 days, Gwinnett County began to see remittances deposited into their lockbox account. Digitech’s Director of Finance reported that average monthly receipts between March and August 2012 totaled $1.3 million. 17% of that total was achieved during the first month of operation – January, 2012, and 77% during the second month. By the third month – March, 2012, Gwinnett County was receiving 100% of the $1.3 million average total and has maintained that amount in monthly remittances ever since.
Digitech follows through
“They exceeded our expectations in the way they were able to implement,” said Department Chief Mitch Holder, Battalion Chief, Business Services. “Any time we addressed an issue they were very proactive in delivering solutions, usually within 24 to 48 hours.” Once Digitech had demonstrated it could continue to deliver services as specified in the contract over a significant stretch of time, it was a good moment to cement the relationship with a face-to-face meeting that could help the County to take their reporting, their processes, and their planning to new levels.
“The transparency of Ambulance Commander’s reporting systems allows us to troubleshoot on any issue and about anything,” Chief Holder now says, commenting on the software. “The dashboard is a useful tool. We use it to create financial reports, or to research the age demographics of our patients, or to identify insurance carriers. We’ve seen a change both in the type of patient we transport and an increase in the number of transports. The software enables us to project future needs and build that into our budget process.” Donna Buhler agrees. “The reporting capabilities are extensive and accessible,” she says. “I can pull up any information that I need or drill down to any detail of any individual transport. My monthly reconciliation process is much less of a challenge and goes more smoothly.”
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