St. Louis Surgical Consultants Achieves Internal Revenue Cycle Management and Future Stimulus Goals

While much of the Meaningful Use discussion has focused on Stage One clinical reporting functions, billing functions are also addressed. The federal Department of Health and Human Services (HHS) made clear in rulings released July 13, 2010, that Stage Two requirements will mandate practices to electronically determine patient eligibility and file claims for the majority of patients served.

Since 2008, St. Louis Surgical Consultants, a five-provider general and vascular surgery practice, has combined the functionality of Greenway Medical Technologies’ PrimeSuite® practice management, electronic health record (EHR) and interoperability solutions, with Gateway EDI’s clearinghouse and revenue cycle management (RCM) capabilities.

With this integration, St. Louis Surgical successfully submits between 1,200 and 2,000 claims per month to a variety of payers with an initial acceptance rate of more than 98 percent. In addition, the practice has already established the functionality necessary to achieve the future claims requirement of Meaningful Use.

PROBLEM – INEFFICIENT BILLING PROCESSES

Prior to combining the solutions, St. Louis Surgical utilized a six-step dial-up system to upload individual reports. The process was cumbersome, time-consuming and used outdated “send and receive” protocols, according to billing manager Mary Keune. “Now our system requires a lot less work and information is retrieved automatically. Gateway EDI and Greenway Medical Technologies started communicating immediately and set up all of the integration,” says Keune. “It was a no-stress process that has increased our efficiency and allows our claims to be accepted for payment within 24 hours.”

SOLUTION – INTEGRATING SYSTEMS

Through integration, Greenway Medical Technologies’ PrimeSuite® software is able to communicate seamlessly with Gateway EDI to perform billing transactions.

St. Louis Surgical utilizes Greenway Medical Technologies’ PrimeSuite® software to enter and store patients’ clinical and financial data. The data is then compiled and formatted to create the various transactions, including patient eligibility and health care insurance claims.

The information is transmitted to Gateway EDI’s database for review, editing, and then communicated in a HIPAA-compliant format to payers. Response data is then formatted and available for the provider. These transactions include eligibility, payment (electronic remittance advice), and claim status information which is automatically integrated back into the Greenway Medical Technologies’ PrimeSuite® software. By combining the two solutions, St. Louis Surgical Consultants realized efficiency throughout the billing process. “The eligibility automation allows us to tell patients up front if they have active coverage or not,” says Keune. They are also able to conduct real-time eligibility for new patients or for patients who change insurance. “If a new patient shows a card, we can check immediately for eligibility,” says Keune. “On the back end, one of my favorite features is the proof of filing that our payers like to know. We can compile custom acceptance reports to find internal trends on adjudication. At the end of each day, we submit claims and prepare the eligibility inquiries for the next day’s schedule so when we come in the next morning, everything is ready for us.”

RESULTS

With the integration of practice management solutions from Greenway Medical Technologies and Gateway EDI’s processing solutions, St. Louis Surgical Consultants streamlined patient scheduling and office workflows, gained efficiencies through stabilized RCM, reduced claim rejection and increased patient collections. In addition, they consistently exceed the automated patient eligibility and claims processing objectives planned for future Meaningful Use requirements.

St. Louis Surgical benefits from the strong relationship of Greenway Medical Technologies and Gateway EDI. According to Mary Keune, “After the patient’s visit, it’s really just a matter of two keystrokes with our practice management system, and then claims are sent to Gateway EDI. We know there’s another layer of editing before being sent to payers. Our errors have dramatically reduced. All I really have to do is press send and the Greenway and Gateway EDI systems do the rest of the work.”

ABOUT GREENWAY MEDICAL TECHNOLOGIES

Greenway Medical Technologies provides single-database and integrated clinical, financial and administrative physician practice solutions to more than 23,000 provider customers managing 20 million digital patient records through its electronic health record, practice management and interoperability solution, PrimeSuite®. Greenway’s PrimeSuite® 2011 is a pre-market Certification Commission for Health Information Technology (CCHIT) Certified® 2011 Ambulatory EHR, additionally certified for Child Health and Cardiovascular Medicine, with optional Advanced Reporting. An industry leader in customer service awards, Greenway’s EHR and practice management solutions have been named Best in KLAS in three categories in 2008 and 2009 based on customer surveys: PrimeSuite® Chart, Best in KLAS in Ambulatory EHR 6-25 physicians and 2 to 5 physicians, and PrimeSuite® Practice, Best in KLAS in Practice Management 6 to 25 physicians. Top 20 Best in KLAS Awards: Software & Professional Services report – www.klasresearch.com.

For more information about Greenway Medical Technologies, go to www.greenwaymedical.com.

ABOUT GATEWAY EDI

As one of the nation’s largest health care electronic data interchange (EDI) providers, Gateway EDI conducts over 20 million transactions monthly for 65,000 providers, managing nationwide insurance connections with 3,000 public and private payers. Gateway EDI’s solutions focus on four specific areas of functionality, each with tailored automation:

Claims Reporting

• Safety Net Reports

• Adjudication Analysis

• Transaction Summary

• Report Customization

Claims Management

• Primary and Secondary Processing and Reimbursement

• CCI Suspensions

• Viewable Claim File Reconciliation

Payment Management

• Electronic Remittance Advice

• Insurance Remittance View

• Patient Credit Card and ACH Payment Acceptance

• Reimbursement Analysis and Management

Patient Management

• Batch and Individual Eligibility

• Direct Patient Statements

• Patient Letters

Gateway EDI’s processes are accredited by the Electronic Healthcare Network Accreditation Commission (EHNAC), and its real-time eligibility (RTE) individual and integrated transaction solution received the Council for Affordable Quality Healthcare® (CAQH) Committee on Operating Rules for Information Exchange® (CORE) Phase 1 Clearinghouse Certification.

For more information about Gateway EDI, contact Nick Challen at 800.969.3666 x1489 or nchallen@gatewayedi.com.

The rules respectively define the functionality certified EHRs must provide and the incentive capture reporting objectives for eligible professionals and hospitals. Greenway’s analysis of the EHR functionality required by the final rules shows that eligible current and future customers of the company’s integrated electronic health record (EHR), practice management and interoperability solution PrimeSuite® can achieve Medicare or Medicaid pathway stimulus funds for EHR deployment and quality reporting.

“The final rule re-establishes the standards-driven components of data capture, exchange and interoperability that certified EHRs such as PrimeSuite are capable of,” said Justin Barnes, Greenway vice president of marketing, corporate development and government affairs and chairman emeritus of the Electronic Health Record Association. “The specific addition of the Health Information Technology Standards Panel (HITSP) C32 implementation specification is important because it speaks directly to nationwide interoperability.”

“Meaningful use is very important to us,” said Dr. George Morgan of Midwest Digestive Disease Specialists in Elmhurst, IL. “One of the things that we are really pleased with is that Greenway already is meeting the meaningful use requirements as we know them. And I feel very confident that all of the meaningful use requirements will be met and that the stimulus money that the government will put out there for us will be able to be captured.”

“Greenway’s selection by the majority of Regional Extension Centers that have publicly announced preferred EHR providers for the achievement of meaningful use by physician practices, including New York City and the states of New York and Iowa as well as statewide EHR initiatives such as the Alaska EHR Alliance, for example, along with providing our current and future customers a meaningful use guarantee based on our certification level and functionality, is a testament to PrimeSuite’s recognized ability to meet meaningful use requirements,” added Barnes.”

Focusing on flexibility through 15 Stage One meaningful use criteria and a subset of criteria eligible professionals can choose to add through 2012, the final rule also allows eligible professionals seeking EHR adoption incentive funds in the Medicare or Medicaid pathways an allowable reporting period of just 90 days within their first stimulus calendar year in which to capture maximum funds.

Since the beginning of 2010, HHS has also overseen the establishment of EHR certification programs now underway as of July 1, to further meaningful use standardization toward incentive capture (up to $44,000 per provider in the Medicare pathway and $63,750 under Medicaid) and strengthened provisions for the privacy and security of digital patient records.

“Electronic health records are the foundation of a high-performing healthcare system,” HHS Secretary Kathleen Sebelius noted during the release of the rulings. “If you want to improve the quality of care, you need to be able to accurately measure it. If you want to promote better coordination between doctors, you need to be able to quickly move health information wherever it’s needed. If you want to empower consumers to charge of their healthcare, they need to be able to access their health information without calling up five different doctor’s office … Our goal has never been technology for the sake of technology.”

Through a series of informational webinars begun in early 2010 and next scheduled July 22 and August 11, and through testimony to federal EHR Meaningful Use panels during the formation of the requirements, Greenway’s proven leadership in ensuring customer success has been realized with the release of the final Meaningful Use rules.

About Greenway Medical Technologies, Inc.

Greenway Medical Technologies provides innovative EHR, ambulatory healthcare and clinical research business solutions and services to more than 23,000 healthcare providers nationwide, in 30 specialties and subspecialties, by enhancing the delivery of patient care through advanced HIT software and on-demand services that allow physician practices to function at their highest level of efficiency. Greenway’s PrimeSuite is a comprehensive, interoperability component of the integrated physician’s infrastructure solution, which serves as the starting point of a long-term business plan for physician practices. PrimeSuite 2011 is a pre-market CCHIT Certified^® 2011 Ambulatory EHR, additionally certified for Child Health and Cardiovascular Medicine, with optional Advanced Reporting. PrimeSuite integrates a practice’s clinical, financial and administrative processes, and allows practices to increase profitability, enhance patient satisfaction and facilitate adherence to compliance guidelines. Established in 1998, Carrollton, Ga.-based Greenway Medical Technologies is a privately held company with more than 300 employees. For more information about Greenway, visit http://www.greenwaymedical.com/.

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Customized Clinical Templates Advance Primary Care and Specialty Practices

June 30, 2010, Carrollton, Ga. – Greenway Medical Technologies, Inc., provider of the integrated, single-database electronic health record (EHR), practice management and interoperability solution PrimeSuite®, has been awarded a patent for its innovative template builder module used to create custom clinical templates that can be integrated with financial and administrative workflows.

The United States Patent and Trademark Office recognized the unique template creation features that primary care and specialty practices can build upon and streamline to meet specific provider and practice needs.

“The template branching patent reveals an innovative process of using web browser, HTML and XML functionality to allow clinicians to develop clinical templates in a quick, logical format to fit their clinical environment,” said Greenway Chief Medical Officer Dr. Jim Ingram. “The ease of modification, as well as to build from scratch, can be done by the clinician, eliminating the dependence or cost of relying on third-party developers.”

The functionality utilizes existing patient history and demographics data to merge with diagnosis and examination checklist templates to standardize point-of-care patient encounters and coordinate care plans as well as preventive medicine, all of which is retained in the patient’s electronic chart and can be accessed for quality reporting analysis. Complaint and diagnosis data is merged with E&M, ICD and CPT codes to streamline billing functions.

Greenway’s PrimeSuite EHR is embedded with thousands of available templates, including those for referrals, orders tracking, consultations and correspondence aligned with primary care or specialty clinical templates, enhanced by the ability for practices to expand and tailor their capabilities as well as workflow.

Pediatric Associates, a seven-location, 80-provider practice based in Bellevue, WA, for example, created 20 physical examination templates to match patient age and demographic ranges.

“We recognized the need for digital templates stored in a central location,” said Dr. Steve Schiebel, medical director of Pediatric Associates’ Totem Lake practice, “so we took the available content library templates and analyzed our patient encounters to create a series of custom templates. We found this was the best way to match our workflows and offered an ease of use. That this templating was available was an attractive element of Greenway’s solutions.”

As chief template architect for Pediatric Associates, Schiebel also directed the branching of sick visit, well visit and patient history templates, for example, as well as such specifics as separate upper respiratory and lower respiratory templates.

“Greenway is gratified that the processes and dedication we devoted to improved practice workflows has been patented,” said Greenway President and CEO Tee Green. “As much we are very pleased that our custom templating ability is providing the means for improved healthcare outcomes through enhanced diagnosis and care plan development, which in turn leads to enhanced quality reporting that is increasingly needed for emerging reimbursement models.”

About Greenway Medical Technologies, Inc.

Greenway Medical Technologies provides innovative EHR, ambulatory healthcare and clinical research business solutions and services to more than 23,000 healthcare providers nationwide, in 30 specialties and subspecialties, by enhancing the delivery of patient care through advanced HIT software and on-demand services that allow physician practices to function at their highest level of efficiency. Greenway’s PrimeSuite is a comprehensive, interoperability component of the integrated physician’s infrastructure solution, which serves as the starting point of a long-term business plan for physician practices. PrimeSuite 2011 is a pre-market CCHIT Certified^® 2011 Ambulatory EHR, additionally certified for Child Health and Cardiovascular Medicine, with optional Advanced Reporting. PrimeSuite integrates a practice’s clinical, financial and administrative processes, and allows practices to increase profitability, enhance patient satisfaction and facilitate adherence to compliance guidelines. Established in 1998, Carrollton, Ga.-based Greenway Medical Technologies is a privately held company with more than 300 employees. For more information about Greenway, visit http://www.greenwaymedical.com/.

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May 17, 2010, Carrollton, Ga. – Greenway Medical Technologies, Inc., provider of the integrated, single-database electronic health record (EHR), practice management and interoperability solution PrimeSuite®, is announcing the availability of its remote clinical and financial solution PrimeMobile® onto Apple’s iPhone®, iPad™ and iPod touch®.

Providers utilizing the latest version of Greenway’s PrimeSuite EHR for clinical and administrative patient data can now access the information from any remote location by downloading PrimeMobile from Apple’s App Store as a desktop icon onto their iPhone, iPad or iPod touch. Greenway is also developing PrimeMobile for use on Blackberry and Droid mobile phones.

Greenway’s PrimeMobile provides secure login and password protected remote access of ambulatory and hospital-based patient data integrated within PrimeSuite to view schedules, clinical documents and lab results through patient search and filter functions that also tailor patient data to hospital rounds.

Clinically, PrimeMobile also provides patient summary and the addition of patient notes to further eliminate paper-based processes, as well as the ability to instantly assess patient or staff questions, accessed through Summary, Documents and Charges prompts.

PrimeMobile’s administrative and financial capabilities integrate charge capture and confirmation through the access of CPT and ICD codes to instantly route charges and notes to PrimeSuite for automated review and posting to accelerate billing cycles and reduce lost charges.

“In today’s healthcare environment there are constantly new frontiers and we developed PrimeMobile in anticipation of its ability to advance entire practice efficiencies,” said Greenway President and CEO Tee Green. “Providers need a secure, instantly accessible and full-spectrum remote capability adaptable to their devices. This is another example of Greenway collaborating with customers to drive innovations that ultimately ensure their success.”

About Greenway Medical Technologies, Inc.

Greenway Medical Technologies provides the latest in EHR, ambulatory healthcare and clinical research business solutions and services to more than 23,000 healthcare providers nationwide, in 30 specialties and subspecialties, by enhancing the delivery of patient care through innovative HIT software and on-demand services that allow physician practices to function at their highest level of efficiency. Greenway’s PrimeSuite is a comprehensive, interoperability component of the integrated physician’s infrastructure solution, which serves as the starting point of a long-term business plan for physician practices. PrimeSuite 2011 is a pre-market CCHIT Certified® 2011 Ambulatory EHR, additionally certified for Child Health and Cardiovascular Medicine, with optional Advanced Reporting. PrimeSuite integrates a practice’s clinical, financial and administrative processes, and allows practices to increase profitability, enhance patient satisfaction and facilitate adherence to compliance guidelines. Established in 1998, Carrollton, Ga.-based Greenway Medical Technologies is a privately held company with more than 300 employees. For more information about Greenway, visit http://www.greenwaymedical.com/.

The CORE Seal was awarded after Gateway EDI successfully completed certification testing for its clearinghouse product – a process ensuring that health care organizations can electronically exchange or access patient insurance information according to the CORE Phase I rules.

CORE-certification ensures that Gateway EDI customers can securely process electronic queries within 20 seconds and that providers will receive consistent patient administrative information.

“We are proud to have achieved the CORE Phase I Seal because of the significant benefits it offers our customers,” said Charlotte A. Martin, Gateway EDI’s president and chief operating officer. “This certification ensures that processes are in place to help our health care providers achieve dramatic cost savings, fewer claim denials and improved functions. We are pleased to be affiliated with CAQH because they work to simplify processes and reduce administrative burden.”

Martin continued, “Gateway EDI offers real-time and batch solutions for patient eligibility. The CORE certification will also ensure that we are processing these transactions as efficiently as we can. We are looking forward to more and more payers adopting the same rules to enhance and streamline the information we can route to the provider. This greatly enhances the value of these transactions.”

The CORE rules, which build upon national standards, including HIPAA’s eligibility (X12 270/271) transaction, make electronic administrative data communications seamless, streamlined and predictable, regardless of the technology. In many cases, the CORE rules eliminate the need for time-consuming phone calls and paperwork.

A recent study found that when trading partners exchange administrative data according to the CORE rules, the organizations reduce costs and streamline administrative processes. The CAQH study conducted by IBM Global Business Services shows that the CORE rules are accelerating adoption of HIT technology and helping to provide better access to patient coverage information. An industry-wide adoption of the CORE Phase I rules alone could save the industry an estimated $3 billion in three years.

“The CORE rules represent a cutting-edge approach to streamlining electronic administrative data exchange,” said Robin J. Thomashauer, CAQH executive director. “By adopting the rules and completing CORE-certification, Gateway EDI is reducing unnecessary health care administrative burden, and helping U.S. health care become more efficient and responsive to patient concerns.”

CARROLLTON, Ga., April 14 — /PRNewswire/ — Greenway Medical Technologies, Inc., provider of the single-database electronic health record (EHR), practice management and interoperability solution PrimeSuite®, is offering customers a financial guarantee that PrimeSuite meets the reporting functionality and requirements necessary for eligible providers to achieve meaningful use and qualify for stimulus funds.

Based on current and anticipated criteria prescribed by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), eligible professionals who utilize PrimeSuite technology to achieve meaningful use criteria and qualify for stimulus funds, but do not meet compliance based on PrimeSuite’s certification or reporting standards capability, will be compensated equal to the amount of lost stimulus funds during the time period necessary to meet the incentive criteria.

The guarantee, detailed at www.GreenwayMedical.com, also guarantees that Greenway will continue to pursue the highest level of ONC meaningful use temporary and permanent certification initially detailed in ONC’s Notice of Proposed Rulemaking published March 2.

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Advocate Physician Partners, a collaboration of more than 3,400 physicians and Oak Brook, Ill.-based Advocate Health Care, will recommend to its independent physicians the adoption of practice management and electronic health records software from eClinicalWorks Inc., Westborough, Mass.

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Girish Kumar Navani didn’t exactly plan on starting an electronic medical records company.

Now, Navani’s company, eClinicalWorks in Westborough, serves more than 30,000 physician practices all over the country with more than 100,000 users in all 50 states. 2008 revenues topped $85 million, up from $4 million in 2004.

Krames has partnered with eClinicalWorks to provide consumer-friendly patient education to physicians using the electronic medical records system, eClinicalWorks 8.0. The Krames solution allows eClinicalWorks physician users to seamlessly dispense targeted information to a patient based on a specific patient’s record.