Better workflows, better work

Case Study | Southern Illinois Associates, LLC
  • Workflows

    5-provider practice offering psychiatric and psychological services

  • Glob and purple location pin

    Based in suburban St. Louis, Missouri


  • Cumbersome workflows detracted from patient experience
  • Lack of transparency and delays with third-party billing vendor
  • Lack of transparency into scheduling gaps
  • Unrealized point-of-service collections
  • Prior authorization lag
  • Lack of connectivity between providers and staff


  • athenaOne®
  • Marketplace partner CallMyDoc, third-party voice transcription app


  • Better communication internally and externally
  • More efficient workflows
  • Enhanced collection percentages and collection timeframe
  • Fewer scheduling gaps contribute to profitability
  • Prior authorizations reduced to an hour or less, versus 24 hours

Southern Illinois Associates, LLC, has seen increased patient volume due in part to accepting a larger variety of insurance plans than other local psychiatric and psychological service providers. But COVID-19 has also enhanced demand with what owner Dr. Sanjay Nigam describes as a slow burn. “Initially, my patients who have severe anxiety disorders, they were really happy — they said, ‘Hey, we don’t have to go out,’” Nigam said of the onset of the pandemic. “Now, many months into it, our anxiety patients are getting worse. We are seeing more anxiety outbreaks and depression exacerbation.”

Enhanced clinical and collection capabilities yield greater satisfaction

Dr. Nigam is happy to have tools like athenaCommunicator to interact with at-risk patients and to perform outreach campaigns via the portal. During the pandemic, he has been able to transition many of his patients scheduled for in-person visits to telehealth with campaign messaging.

Transitioning to athenahealth two years ago has afforded Nigam greater fiscal and clinical transparency that has helped him adapt as COVID-19 evolves. Southern Illinois Associates previously used another solution for clinical records keeping, and outsourced billing to a third party. He can now focus more on patient care thanks to streamlining and efficiencies across the organization, which include fewer back and forth emails with the biller. “I had to wait for an answer,” he said. “And sometimes, the answer was ‘That report is too hard to run, we have to charge you extra.’ That’s not the case with athena.”

Point of service collections have also improved since transitioning, as Nigam can easily monitor what’s been collected and when. “In the last two years I haven’t missed a single penny,” he said. Because they are able to better monitor outstanding balances, Southern Illinois Associates has maintained fiscal stability despite increasing the threshold for patient bills sent to collection agencies during the pandemic. “With everything surrounding COVID, we don’t want to be insensitive to our patients’ needs,” Nigam said.

Sensitivity extends to enhanced eye contact with patients thanks to using athenaClinicals during patient encounters. Connection in psychiatry is especially important, Nigam said. “People sometimes don’t understand it’s not just about doing the notes — how effectively you’re communicating with a patient is important,” he said. “If I’m just typing, the patients are then going to say, ‘Hey, look, they were not listening.’ To have that eye contact is very important. That’s what value I look into, and my EHR helps in that. Less typing means better eye contact, and better alliances.”

He and other clinicians are able to spend less time charting at the point of care thanks to text macros, enhanced workflows, encounter plans with many fields pre-populated for behavioral health needs, and templated submissions for common lab and medication order sets. Authorizations for medications are also easier now thanks to athenahealth’s prior authorization capabilities.

Over the past two years, Southern Illinois Associates has reported improved communication internally and externally. Thanks to athenahealth Marketplace third-party solution CallMyDoc, voicemails are transcribed and integrated directly into the EHR. Other enhancements that contribute to employee satisfaction include the visibility that the front desk now has when it comes to doctors’ notes. Requests for follow-up visits, are automatically flagged and staff don’t have to manually open fields during the patient exit process, for instance. “Overall, the workflow is, from intake to finish, much better,” said Dr. Nigam.

Sanjay K. Nigam, MD, psychiatrist and owner, Southern Illinois Associates, LLC