The San Antonio Orthopaedic Group

A Decade of Partnership Strengthens Orthopaedic Practice

 

The San Antonio Orthopaedic Group has been in practice for more than 60 years. "Our previous systems were IDX, Medical Manager, paper, and before that, I think, stone," quips Chief Operating Officer Chris Kean. Over the years, the group has grown to seven offices, 23 physicians, and 280 employees. With more 100,000 patient visits annually, the group requires efficient systems for medical billing, clinical practice, and patient communications. athenahealth has been able to answer all of those needs.

Initial Benefits of Partnership

The practice did a pilot implementation of athenaCollector in 2001. "The rules engine was a huge seller," says Carrie Miller, Director of Professional Reimbursement. "Nobody offered that then, and I don't think even now anyone's rules engine is as sophisticated as athenahealth's." The rules engine promised to increase the practice's 10% resolution rate for claims. The group also recognized the convenience of web access from anywhere. Finally, they needed implementation in 90 days, and athenahealth promised to meet this goal.

In the event, the changeover timeline was met, and staff members began using athenaCollector effectively within one week, compared with many weeks to train staff on just the rudiments of the old system. "The percentage of claims we submitted that had errors dropped from 90% to the low single digits and we increased collections from $50,000 per to $90,000 per day in just three months, says Chief Executive Officer Usman B. Mirza." The group's DAR also went from 120 to 35 days.

Partner Goals Aligned with Practice Goals

San Antonio Orthopaedic has long been impressed by the way athenahealth stays involved. "So many companies say, 'We'll be here for two days; we'll train you as a group; and then we're out of here; you can call this 800 number,'" says Miller. "athenahealth assigns you an implementation team that sticks with you until you're out of the implementation phase." Kean continues, "Then, you get an account manager who manages your practice with you, troubleshoots for you. Unlike with other vendors we've used, we have a relationship with athenahealth."

Mirza believes that athenahealth's pricing model encourages a partnership relationship. "Other companies are only motivated to sell you the software," he says. "They don't care what your collections are, or if you run the system efficiently, or if you load in all the contracts. They just want to sell you the product, and they're out. With athenahealth's pricing model, our incentives are aligned. The more money we make as a practice, the more money athenahealth makes."

Kean adds, "There's an advantage to our fees being in relationship to our revenue. For example, if the government doesn't fix this Medicare situation, and we have a 21% reduction in our payments, athenahealth's going to get hit with that, too. If I was paying a fixed price, the cost for my medical billing would go up relative to my revenue going down."

Growing Needs, Growing Partnership

Over the years, San Antonio Orthopaedic has seen athenahealth make continuous improvements. "We like to slice and dice the data many different

ways in order to run our practice more effectively," says Miller. "athenahealth has made that possible." There was initial fear about downtime, but, in fact, the practice has had far less downtime with athenahealth than with its previous vendors. "Even our doctors aren't afraid of downtime any more—and that's saying something," says Kean.

When it came time to choose an electronic health record (EHR) solution, San Antonio Orthopaedic chose athenaClinicals. "We had some initial adjustments, because we were a pilot implementation again," says Kean, "but we believe that athenaClinicals will be the absolute best product for EHR going forward."

"The portability provided by athenaClinicals is a very powerful enticement," says Mirza. "For example, a doctor could be in another country, see what his clinic schedule looked like, and determine whether he could stay an extra day." Kean adds, "If doctors are on call and dealing with patients they don't know, they can see the patients' charts immediately. We forget that in some practices doctors still have to open up the office and pull charts to do this."

athenaCommunicator's on-demand, automated, and live patient communication services is San Antonio Orthopaedics' latest pilot implementation, and they're already excited about its possibilities. "One great aspect of athenaCommunicator is that it will enable us to track and bill e-visits, identify to payers how many we have, and prove to them that e-visits should be an insurance benefit," says Miller. The portal will enable patients to securely exchange messages with physicians via the Web and e-mail, request appointments, print forms, view account balances and pay account balances. This new technology can reduce no-shows, improve self-pay revenue, and reduce the expense of paper.**

A Partner Looking to the Practice's Future

San Antonio Orthopaedics feels it has a true partner in athenahealth, one that provides continuous, seamless, real-time introduction of upgrades and new features. "That kind of improvement and integration just keeps going and going," says Miller.

"I don't think athenahealth gets enough credit for that," says Mirza. "With all the capabilities that are integrated into athenahealth's products, we save money in many areas. We save on reminder calls, on hiring experts to deal with managed care contracts, on loading in data, on employee training, and because of clean claims we are able to collect our money faster. Instead of having multiple products that do these things—and maybe not do them as well athenahealth—we accomplish it all with one company."

*These results reflect the experience of this particular practice and are not necessarily what every athenahealth client should expect. athenahealth average client Days in Accounts Receivable (DAR) in Q3 2009 was 39.3 days. athenahealth average client First Pass Paid Rate in Q3 2009 was 92.5 days.
**athenaCommunicator data was gathered during our beta testing period, prior to full release to the general public.

At a Glance

Client

The San Antonio Orthopaedic Group, San Antonio, TX

Organization

  • 23 physicians
  • 280 employees
  • 7 offices
  • 100,000 patient visits annually

Issues

  • Long wait for payments
  • Huge error rate in claims submissions
  • Too much server downtime
  • Doctors and administrators tied to office
  • Difficult or impossible to get practice data

Solutions

Results

  • Average days in accounts receivable (DAR) reduced from 120 days to 35 days
  • Collections increased from $50,000 to $90,000 per day within three months (in 2001)
  • First-pass claims resolution rate increased from 10% to over 90%
  • Little system downtime; network redundancy enables work to continue
  • Doctors and administrators can work from anywhere
  • Practice data of all kinds accessible in real time