Critical Access Hospital Has Stronger Cash Flow, Better Productivity with Cloud Based Billing and EHR Solution
Lost Rivers Medical Center in Arco, Idaho is a 14-bed Critical Access Hospital. Before implementing athenaOne for Hospitals & Health Systems, it took tremendous time and effort to maintain patient records and get claims out the door. With athenahealth’s cloud-based practice management and EHR solution, they enjoy a streamlined billing process, faster payments and much more efficient use of staff time.
‘Tedious’ Processes Gets Streamlined
Before going live with athenaOne for Hospitals & Health Systems, the billing staff at Lost Rivers Medical Center (LRMC) spent a great deal of time submitting and tracking claims across multiple vendors. “It was tedious,” recalls LeeAnn Betzer, CFO of LRMC. “We would generate a bill, then it would go to a clearinghouse, then another clearinghouse,” said Betzer. “It took one person to work all those areas on a daily basis because that claim would be stopped at each scrubber.”
“We came from a really dark place,” said Brad Huerta, CEO of LRMC. “We were using [software] that seemed like it was built in 1993.” Betzer agreed. “We were at the point of drowning,” explained Betzer. “Our AR was extremely high at 108 days. Out here in these small rural communities, you don’t hire people with a billing background. You find people and you train them which takes time and resources we didn’t have because we were so far behind. We were at the point of either work harder or get smarter and improve processes.”
athenaOne for Hospitals & Health Systems immediately streamlined clinical and billing processes. That’s because athenahealth offers a complete revenue cycle solution that handles everything from claims submission and tracking to patient statements—as well as a fullyintegrated EHR.
“There was a lot of satisfaction quickly with athenahealth,” said Huerta. “It’s fast. My chief of staff loves it. Providers like the level of support and flexibility of the system.”
“Once we started working with athenahealth, I held off on hiring the two people I was considering. I felt the way athena buckets tasks, the staff that I had would be sufficient once we got through the trial and error of implementation,” said Betzer. With a streamlined workflow and all the work that athenahealth handles on the hospital’s behalf, Betzer said, “we are more project focused, organized, and understand who’s responsible for what.”
The Rules Engine Eliminates Work
With athenaOne for Hospitals & Health Systems, LRMC is part of a continually updated network, ensuring that all payer and industry changes are automatically part of the revenue workflow. What’s more, the Billing Rules Engine—a continually evolving database—saves billing staff time by automatically flagging any claim issues so they can be addressed before claims go out. “athenahealth minimizes the time we need to spend editing claims,” Betzer said. “When we identify an issue and bring it to the attention of athenahealth, they update the Rules Engine, so everyone on the network benefits from the update and we don’t have to address it again.”
A Smooth Implementation
“Any implementation is hard,” said Betzer. But with only a “few hiccups here and there, going live with athenaCollector went fairly smoothly. And the support was great.”
For example, Betzer noted, there were initially some billing issues that needed to get resolved. “We worked together with athenahealth to fix issues based on our provider type. We are not a regular clinic or hospital. We have different billing rules.” She was grateful that athenahealth worked with her to quickly resolve the issues.
“Our account manager assists us with any cases we have open,” said Betzer. “If we express urgency to her, she helps push them to a higher priority. The call center team is very knowledgeable and takes time to understand what we are requesting.”
Better Use of Provider and Staff Time
The EHR workflow is designed to keep providers focused on patient care while meeting quality measures as easily as possible. “I like the system,” said Dr. Orie Browne, Chief of Staff. “I’m able to get through my work. [The EHR] doesn’t get in the way. That’s the way it should be.” In particular, Dr. Browne points out that EHR features such as “the ordering process, dictation and text macros have definitely made me more efficient.”
According to Director of Clinical Services Kevin Nelson, having multiple settings linked electronically improves care coordination and productivity. “The fact that the providers can swap seamlessly between the clinic and the hospital makes life so much easier,” Nelson said.
On the financial side, the billing staff can use their time more efficiently. “From the front-end processes, the admissions process, the coding process, to the entry of charges—it’s all more user-friendly than the products we’ve had in the past,” said Betzer. “The tasks all flow together. There’s no ‘try to find this and then come back in.’”
“Of course we’re a little overwhelmed because we’re still learning,” Betzer points out. “But each week we get more familiar with athenaCollector. And we get support when we need it.” Betzer is especially relieved that she doesn’t have to field problems anymore from her billing staff. “In the past, everybody came to me with problems,” she said. “I’d have to collect and submit the problems to a contact.” Now, she said, “I refer my staff to athenahealth directly for any questions they have.” As an added bonus, with such strong support and a clear workflow, Betzer points out it is much easier to assign responsibilities to staff.
Renewed Focus on Patients
LRMC staff have been very happy with how intuitive athenahealth’s EHR is, giving providers more time to care for patients. “Last weekend, a provider came in to work the ER with no training on our EHR,” said Nelson. “He immediately started navigating the EHR himself and only needed to ask the nurse an occasional question.”
Dr. Browne is enthusiastic about the features of athenaClinicals that engage and empower patients. “I’m excited to have lab results pushing through to the portal,” said Dr. Browne. “We really think that’s going to help our patients.”
Claims Don’t Disappear
Part of what makes Betzer and her staff happy—and productive—is the intuitive way the workflow is structured in athenaCollector. “Before, everybody was following up claims in folders,” said Betzer. “I looked at this, now I have to come back and check it.” But athenaCollector uses ‘hold buckets’ to show what claims that need attention. “No one wants to see anything in their hold buckets,” said Betzer. “But it’s a good way to make sure nothing gets left out.”
Now, Betzer explains, “Claims don’t disappear. You don’t have to wait 45 or 60 days to get a response, when it comes back from the clearinghouse with denial information. It’s immediately placed in a bucket that’s assigned to somebody and it’s there until it gets resolved.”
Practicing Business Better
CEO Brad Huerta now appreciates “the things that aren’t being said—‘EHR this, EHR that’—it doesn’t come up. It almost isn’t a concern anymore. Now we are able to think about things like ‘How do we hire more NPs?’ and ‘What new machines are we going to invest in?’”
Soon after implementing athenaOne for Hospitals & Health Systems, Betzer noticed that cash flow increased. “We have up weeks and down weeks for cash flow, but in general it’s faster. We’re not waiting for that money like we used to.”
Besides faster, more consistent cash flow, Betzer is excited about being up to date with technology. “We serve an older community, and everyone hates change. But the technology we use now is frosting on the cake,” said Betzer. “athenaCollector’s technology, the workflow, and the work athenahealth does on our behalf makes us productive and able to practice business better.”
And she sees athenaOne for Hospitals & Health Systems as a key factor in stabilizing and standardizing her staff’s work. “In six months, I see myself being able to go on vacation—and not having to fret about things getting done,” said Betzer. “Within the next few months, the workflows are going to be simple. We’re going to have the right people assigned to tasks. It’s going to be organized and managed.”
“There is real excitement in the community about our new system,” said Huerta. “They know that our little hospital is doing some really innovative things.”