Improved Cash Flow

Better Management of Payment Information

Thanks to DocuWare, each of St. John’s Clinic’s 180 offices now have access to HIPAA forms and accounts receivable information over the Web. Productivity has soared as document retrieval time was reduced from weeks to minutes, and faster processing of insurance documents has increased cash flow.

St. John’s Clinic, a division of the St. John’s Health System in St. Louis, is a physician-led organization comprised of 440 physicians, 90 mid-level providers and 1,800 co-workers. The Clinic averages 1.4 million patient visits per year between their 67 locations throughout southwest Missouri and northwest Arkansas. St. John’s Clinic is committed to providing clinical excellence, compassionate health care and outstanding patient service.

St. John’s Clinic Business Office (CBO) processes all the billing transactions and provides front and back-end support for all 180 offices. After struggling for two years with an inadequate document management system, the Clinic evaluated their needs and elected to install DocuWare.

Documents

The CBO needed to manage many different types of documents including; HIPAA forms, patient payments and correspondence, Explanation of Benefits forms or EOBs, as well as charity applications and accompanying financial documentation.

Work Processes

Before implementing DocuWare, St. John’s CBO was using a five station optical imaging system and storing the images in a jukebox that held 80 volumes. Unfortunately, scanning and retrieval could not be done simultaneously and only one person could access a volume at a time. To access information from a volume not in the jukebox, the system would have to be shut down and reloaded, a process that took up to eight hours.

Occasionally, the CBO would have to try and recreate a volume of information as a result of it becoming corrupted or getting erased. With only two retrieval stations to serve the information access needs of 145 CBO co-workers, productivity was severely bottlenecked. Once a co-worker was able to access a station, limitations in the imaging software resulted in a retrieval time of 5-20 minutes per document.

“We couldn’t even answer some patient questions and claim follow-up issues for weeks because the wait to have a piece of information accessed and printed from our old system was so backed up,” said Karen Norris, Clinic Business Office Manager of Cash Accounting for St. John’s Clinic.

IT Situation

The Clinic’s IT needs are managed by the St. John’s Health System IS Department. The CBO has 150 workstations.

Solution Requirements

Even with the frustrations of their current system, St. John’s saw the potential benefits of document imaging. They wanted to implement a new system that would give every user in the CBO, and each remote physician office, simultaneous access to information. They also wanted a system that would have minimal downtime and have the flexibility to expand with the Clinic’s changing needs. The new system needed to be able to import the documents from their existing optical disk system and allow them to meet the requirements of the Health Insurance Portability and Accountability Act or HIPAA law. Corporate Business Systems, an Authorized DocuWare Partner, recommended and implemented DocuWare.

Solution

St. John’s Clinic purchased a DocuWare Systems License, five FULL FUNCTION licenses and the DocuWare INTERNET-SERVER module. The Clinic also invested in four high-end scanners. Today, every remote office and everyone in the CBO has access to information over the Web.

Within a few weeks Corporate Business Systems converted the images stored in the optical system to DocuWare TIFF images. It was not necessary to change the CBO’s processes, so the transition was easy. The department still receives the mail, deposits the checks and batches EOB forms and statement heads. Then the reps work from the paper documents to post payments to the proper accounts. After posting, the documents are scanned and manually indexed by batch number and posting/deposit date, in order to mirror the way information was stored in the optical system.

Confidential information such as patient correspondence, applications for charity and accompanying financial documentation are scanned as received and stored in a separate cabinet that only certain people can access.

The CBO now scans on average 150,000 pages a month. During the initial HIPAA implementation in April of 2003 when every patient in the practice signed a Private Health Information or PHI form, the CBO was scanning 275,000 sheets a month. Now, privacy forms are scanned as they are received.

“I don’t know how we would have managed the PHI forms on the old system. We would have had to pull the form and fax it each time a remote clinic made a request. Our optical system did not have the capability to provide each office with self-serve access to information,” said Karen.

User Benefits

Clinic co-workers are now empowered with the ability to immediately access the information they need to do their jobs, resulting in lower frustration levels and more job satisfaction. Job performance has also increased, due to quick access to information, good audit trails and simple review and verification options.

“Posting payments from EOB forms involves a great deal of interpretation. Since implementing DocuWare, any Clinic co-worker can effortlessly pull an EOB form and see if the payment has been paid and posted correctly,” said Karen.

Department Benefits

With instant desktop access to patient statement heads and EOB forms, Clinic co-workers are able to answer patient questions while the patient is on the phone, instead of being forced to call the patient back in a few weeks after requested information was retrieved and printed from the old system. Productivity has increased and more patient information requests can be addressed by the same number of personnel. Additionally, DocuWare’s security features have helped meet HIPAA’s demanding requirements for improved control of confidential patient documentation.

The CBO was also able to improve their claim follow-up rate and reduce the Clinic’s over-90-days account receivables to below management’s benchmark. DocuWare makes it incredibly easy for each co-worker to access EOB forms while they are on the phone with an insurance company allowing issues to be resolved faster. Additionally, DocuWare’s ease of use has allowed the CBO to realize a time savings of at least eight hours a week because they are no longer loading and reloading the old imaging system.

For the remote medical offices, having access to the information stored in DocuWare enables them to answer patient questions without making a phone call to the CBO. Access to EOB forms and current payment information is immediate and secure, allowing each remote office to better manage their own accounts receivables.

Corporate Benefits

From a corporate compliance perspective, DocuWare enabled St. John’s Clinic to meet HIPAA privacy requirements. The Clinic’s privacy forms are centrally stored and can be accessed independently by all remote offices allowing the Clinic to store a single privacy form for each patient. This benefit results in accurate and up to date information without duplication or onsite storage at multiple locations. It also eliminated the need for the Clinic Business Office to manually fax privacy forms. By not printing and distributing copies of private information every time it needs to be verified, tighter document privacy control is maintained. DocuWare’s security features allows the Clinic to increase their patient’s privacy while significantly reducing regulatory risks.

DocuWare has simplified business processes and increased productivity. At a moments notice, any co-worker can access information directly from their desktop, relieving the retrieval bottleneck. An increase in productivity was not the only benefit the Clinic realized; they saw a reduction in labor and overhead costs. St. John’s Clinic saw an increase in cash flow due to faster processing of the EOBs. Additionally, once document storage was reduced from 6 months to 90 days, the Clinic gained more office space.

“Giving everyone in the Clinic simultaneous access to information was one of the major benefits of our DocuWare system. Our response rate has gone from weeks to minutes, improving our patient satisfaction, as well as productivity and cash flow. I cannot state enough how important each area of improvement is. DocuWare has made a huge difference for St. John’s Clinic,” said Karen.

Best of all, DocuWare helps St. John’s Clinic achieve their mission of providing clinical excellence, compassionate health care and outstanding patient service.