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Brookline Village Dermatology improves productivity, increases revenue,
 cuts collection time, and reduces errors with Ingenix CareTracker

Challenges

Brookline Village Dermatology, based in Brookline, Massachusetts, is comprised of one part-time and two full-time physicians, and averages 40 to 90 patient visits per day. For years, the business was managed using sub-par, outside billing services. It was not unusual for the practice to regularly have thousands of dollars in accounts receivable for six months or more, because their existing billing service provided no easy way to gain a simple financial snapshot of the business.

Brookline Village Dermatology needed to streamline its billing process, yet had no easy way of knowing how much was sitting in accounts receivable and what was still waiting to be collected. When Brookline left its first billing service in 1996, it discovered that it had more than $80,000 sitting in accounts receivable for more than 180 days.

Brookline Village Dermatology had similar problems with its second billing service. Because of those problems, Brookline had more than $24,000 in refunds owed to patients, with some refunds going back more than five years. Their billing service did not routinely show when a patient had overpaid for treatment. This was the same issue that Brookline had with its prior billing service, when they owed $20,000 in patient refunds. This situation forced Brookline into the tedious and painstaking process of repaying hundreds of patients and explaining the accounting errors.
 

Highlights

• With Ingenix CareTracker, Brookline Village Dermatology collects 73 percent of everything it bills, compared to 62 percent with the previous vendor
• In the first ten months of using Ingenix CareTracker, Brookline Village Dermatology collected more in revenue than in any other entire year of its existence
• Ingenix CareTracker has saved Brookline Village Dermatology thousands of dollars because it provides cleaner claims and an increased cash flow compared to the previous vendor
• Before the use of Ingenix CareTracker, a claim rejection would not be found until the patient’s insurance company adjudicated the claim. Now CareTracker automatically reviews each claim prior to submission with the powerful Claims Manager rules engine, eliminating denials, reducing A/R, and increasing cash flow
• Under the previous billing vendor, it would take three to four weeks before bills were distributed, and then another week or two for the vendor to post the payments. With Ingenix CareTracker, Brookline Village Dermatology can bill patients at the end of their visits

Solutions

When the practice reached a critical patient volume, Brookline Village Dermatology realized that it was time to improve its clinical documentation. It began investigating EMR technology providers, not realizing there was also a better solution on the billing side as well.

Brookline Village Dermatology chose Ingenix CareTracker EMR, which it recognized would closely meet its needs in better managing clinical workflow. The EMR system could be easily scaled to the size of the small practice, while still providing the ability to speed clinical tasks, write prescriptions, track diagnostic history, enter structured text, and customize clinical notes.

During the demonstration of the Ingenix EMR capabilities, Brookline Village Dermatology decided to investigate the Ingenix full-service, revenue cycle management and practice management system as well. One of the main reasons the practice decided to seriously investigate switching billing services was that every month, its current service would delay the entering of charges for one and a half to two weeks. There were also major depositing issues affecting the practice’s cash flow.

During implementation of Ingenix CareTracker, the Ingenix team walked Brookline Village Dermatology’s front office and administration staffs through the new system, carefully explaining how it works. The Ingenix database conversion team worked directly with the old billing vendor to transfer all of the pertinent patient data to facilitate a smooth transition. The final stage of the transition to the Ingenix system, in March 2006, was conducted on a day that the physicians were out of the office, so there was no effect on the physicians’ schedules or patient appointments.

Now, before patients come in for visits, Brookline Village Dermatology runs patient eligibility reports to check that all of the information is still accurate, speeding the claims process and significantly decreasing the chance that the visit will be rejected by an insurance carrier. The system is intuitive, and alerts the front office staff when there is any missing or inaccurate information. For example, if someone mistakenly enters a diagnosis that is typical for an elderly person but the patient is a child, the system will alert staff to the error. With the old system, those types of errors would not be found until the patient’s insurance company rejected the claim five or six weeks later.

With nearly half of the practices’ patients insured by HMOs, the old billing service constantly bogged office staff down by requesting referral and waiver information. Now, the flow of patients is much more manageable because staff members no longer waste valuable time evaluating plan eligibility while the patient is checking in; information is already stored in the system. In addition, a pop-up window appears during appointments to let the front desk know whether the patient is owed a refund or is behind on payments. The old system and other vendor services that the practice investigated did not offer those features.

The practice has also benefited from its relationship with its Ingenix account manager. Leah Arteaga, Office Manager for Brookline Village Dermatology says that “our account manager decreases our workload significantly. Anytime there are missing patient demographics or a billing code error, she finds it and immediately contacts us to solve the issue. In addition, our account manager contacts us each week with a list of patients that have not been charged but should have been, or anyone in need of a reimbursement. Because she is so proactive, the lists do not get the chance to grow to an unmanageable size. She has the same goal as we do—to make sure that the collections are clean.”

Under the previous billing vendor, it would take three to four weeks before bills were distributed, and then another week or two after that for the vendor to post the payments. With Ingenix CareTracker, the payments are sent directly to the vendor, and any billing changes are input into the system on the same day. The  practice can now bill patients at the end of their visits.

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“The CareTracker Services model has saved us thousands of dollars compared to our old billing service provider because it provides us cleaner claims and a quicker turnaround of receipts. In the past ten months of working with Ingenix, we have already collected the highest number of annual billings ever, because we are working more efficiently and not chasing down claims that should have been paid six months ago.”
- Leah Arteaga, Office Manager, Brookline
Village Dermatology
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Results

Ingenix CareTracker has given Brookline Village Dermatology bottom-line results. In the first ten months of using Ingenix CareTracker, the practice collected more in revenue than in any other entire year of its existence. These results were not due to staff members and physicians working longer hours or charging more money from patients, but because of a cleaner, more efficient claims process. Now, there is no need to track down bills from six months previous, and data entry or billing errors have been eliminated.

Not including contractual adjustments, Brookline Village Dermatology now collects 73 percent of everything it bills. In the nine years using the old billing service, it collected 62 percent. In addition, because the billing timeline has been shortened, the practice’s money in hand has increased exponentially.

 Ingenix CareTracker also makes it easy for Brookline Village Dermatology to easily manipulate financial, workflow, and clinical reports. And, because the system is secured through a password-protected log-in for each user, it adds an additional layer of staff accountability on each task performed.

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“Ingenix CareTracker has reinvented the way in which we manage our practice. Every day, the system provides us with clean claims, clean billing, and a quick turnaround of receipts—saving us thousands of dollars, in addition to cutting down on the time it takes to complete the billing process.”
- Leah Arteaga, Office Manager, Brookline
Village Dermatology
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About Brookline Village Dermatology

Brookline Village Dermatology, based in Brookline, Massachusetts, is comprised of one part-time and two full-time physicians, and averages 40 to 90 patient visits per day.

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100-2345 04/09 Original © 2009 Ingenix. All Rights Reserved