Getting paid on time and creating space for patient care

Bill Hambsh is the CEO and practice administrator of North Florida Women’s Care, a women’s health organization in Florida. We talked to him about how athenaOne® helped his organization reduce administrative burden, improve financial and operational performance, and support AI-driven efficiency and patient engagement.

Q: What makes North Florida Women’s Care unique, and what were you looking for in a technology partner?

A: We focus on being a center of excellence. All of our physicians, our mid-levels, and our staff are properly trained, good-quality employees. We have excellent technology. We embrace technology to identify ways to reduce costs, to improve patient outcomes and efficiency.

We have been around for close to 40 years. We are still an independent practice, which is a minority now, and we do try to make good decisions so we can remain independent.

Technology is a driving force in ways to improve automation and efficiency. The system we were on [before athenaOne] was a good system, but a bit dated. We were on it for 18 years, and it lacked a lot of interoperability with different systems and the forward-moving ability to enhance applications to take advantage of current technologies, whether it’s through AI or online portals.

It was really just finding ways to improve patients’ experience, our providers’ experience, while reducing costs and improving efficiency in our practice.

Q: How has athenaOne helped reduce administrative burden and modernize the patient experience?

A: Before athenahealth, administrative burden was a ton of paper. Paper, paper everywhere. It was paper all over the office. Reams of paper. We utilized even more paper than when we were on paper charts.

When we implemented Enhanced Self Check-In, it was life-changing in terms of reducing the amount of time patients had taken at check-in to complete a bunch of paperwork. They do it from their iPhones or computers, so their experience when they get to the office is fairly fast-tracked.

All of their histories, all of their medications, everything is reviewed in advance. So, when they get back to the nurse to work them up, that process is a lot more efficient, a lot more accurate, and complete in the data.

We have, during the encounters, a lot of consents that we’re pushing right to their phone for them to review and sign, and we countersign and put those right in the chart without having any paper introduced, no staff intervention required, to fast-track and improve the experience.

It was a tremendous lift and improvement to our office.

Q: What results have you seen from athenaOne on financial performance and operational efficiency?

A: We continue to improve with new technology. Claims creation and Enhanced Self Check-In are amazing technologies that were fairly easy to implement and manage, and we’ve seen immediate benefit from putting those in place.

Utilizing a lot of athenaOne’s tools to build rules and to monitor claims edits before the claims go out the door reduced our number of denials and additional information that is required in order to get the claims paid.

I’m proud to say it’s amazing that we are actually getting paid seven to ten days out from when the claim goes out the door. It’s quick. So, for cash flow purposes, it’s quite impressive to see the improvement.

Practice insights let us see how our performance is, if there are any anomalies or some areas where we do have challenges, and we can actually work to resolve those fairly quickly with the data.

We are also able to do a better job of monitoring accountability and reporting and monitoring our performance, both financially and through quality care, reducing our care gaps with patients.

Q: How has Automatic Claim Creation changed your workflows?

A: Automatic Claim Creation allows our office to remove some of the manual processes for getting the claims out the door. As soon as certain metrics are hit, with closing the encounter and signing off on the billing tab and certain other criteria, the claim actually just goes out without any human intervention.

What that allowed us to do was reduce our resources internally, which obviously reduced our costs. It was a little challenging for us to trust the system to allow that to happen without the billing staff reviewing the claims.

But we educated our providers that they are the coders and that it is their task to make sure that their coding levels are correct and get the claim out the door. It was fairly amazing how easy and successful it was.

We started with just a couple of the providers initially and a couple of the appointment types that were low-hanging fruit and easy to monitor. As we felt comfortable, we expanded more appointment types and more providers, and now, pretty much across the board, all of our claims are under Automatic Claim Creation.

It makes our staff, who used to focus on those claims, redirect their energies and their efforts into focusing on other areas to help the bottom line.

Q: How has athenaOne supported your growth and ability to serve new communities?

A: Being around for 40 years, we’ve seen a lot of change over that time. We were primarily in one building at the hospital on one floor. Now we’re on five floors in that building.

We also expanded to a building across the street because we had run out of space, and we had added some satellites in different areas outside of our county.

We added one of those about two months after going live on athenaOne. All we needed was a place to see patients, exam rooms, and internet, and we could pretty much see patients anywhere.

The community there has been so responsive and appreciative because they did not have these GYN (gynecological) services available to them. It’s just nice to be able to have a quick, easy way to add services in an area without large capital investment in technology.

Q: How are data and reporting helping you improve quality and prepare for value-based care?

A: Any successful business relies on data — good data — to track performance and the areas that we feel need some attention.

Having that data definitely helps improve areas that we want to focus on, whether it’s quality metrics, care gaps, financial performance, or engagement from the patients.

I had a meeting with [an insurance] carrier to talk about the performance with their patient members that were needing a mammogram, and I showed them with the data that was available through the quality metrics, that there was a significant number of their members who were not compliant with having a screening mammogram, which could translate to women walking around with breast cancer.

We couldn’t do that before having this data to sit down with them and identify that there was a significant problem.

Having access to quality metrics allows us to measure our performance at an enterprise level, but also down to the individual provider level, and to identify what metrics need more attention.

We strive to be a center of excellence. Part of that is reducing care gaps and monitoring performance in different areas of quality care.

We have a lot of ambition to be a market leader, to be the benchmark against that other women’s health practices are modeled. We need the data and performance with the systems available through value-based care in order to make sure we’re on the right path with that.

Q: Why does athenahealth feel like the right long-term partner for your organization?

A: It’s a partnership, and having our CSM (customer success manager) is basically a strategic partnership that keeps us focused on what our goals are, where our care gaps are, and to identify new solutions that are available within the application.

athenaOne being a cloud-based solution has allowed me the flexibility to be nimble and to make changes pretty quickly, without requiring a lot of resources to make adjustments in the system.

One of the things I love and why I chose to go with athenaOne in the beginning was the attention to improving the system. No system is perfect, but focusing on what’s important to the customers, to the practices, and making improvements and enhancements throughout the year is definitely a partnership that I value.

Technology continues to change, and having a digital partner that is on the journey with me to improve our outcomes, utilizing best practices and technology, is exciting.

You have to make the leap into new technology, better technology, and know that athenahealth is a partner with you, and is making enhancements along the way.

I love how athenahealth listens, and they make changes based on the feedback that the customer base is [providing]. I could not imagine life without athenaOne in our practice.

Q: How are you using AI today, and what excites you most about where it’s going?

A: AI is so exciting. The possibilities that we are currently utilizing and exploring are just wonderful to think about — what changes we can make down the road.

Currently, several of our providers are using Ambient Notes to improve their documentation while also giving all the attention to the patient in the exam room. The feedback is that they all love it and can’t believe that it took this long for us to actually adopt ambient technology.

In women’s health, there is a lot of documentation that’s required in the encounter, and if you don’t document it, you can’t bill for it.

Having the ability to document all of this through utilizing Ambient Notes has helped reduce the amount of time that the provider has after the encounter is over.

We’re a very busy practice, and there’s not a whole lot of time in between patients to complete notes. So, Ambient Notes does make that process more efficient.

[Our physicians] are actually getting home, they’re spending time with their families earlier in the evening, not spending so much time on the weekends doing all their documentation, and their documentation is more thorough and accurate.

By putting the phone down on the counter and allowing that physician to spend time interacting with the patient, listening to them, having a conversation with them, and not turning away and doing documentation on the computer or the laptop, it has allowed them to have a better relationship and a better experience.

I think the feedback is that patients feel that the provider is listening and more engaged in the encounter with them.

I hope that AI will evolve to help providers with clinical decision-making, to identify ways to improve patient treatment protocols, and for education and make their lives so much easier while giving the best care possible to patients.