Methodology

Our goal is to provide users with a brief and simple illustration of a few of the ways that Greenway Health can help to improve a medical practice’s bottom line.

Scope

The data used in this calculator are based on actual physician activity captured by Greenway Health in the course of providing our solutions, surveys we’ve taken of vendors, and third-party research.

Assumptions

In developing this calculator, we relied on our experience with our clients in assuming that a practice will generally be replacing their current EHR vendor. We have also assumed that a practice’s providers are all eligible ambulatory health care providers and therefore qualify for HITECH Act incentives. In the TCO, we quantify miscommunication between clients of other ambulatory vendors and their customer service reps, support tickets closed without being fixed, or take weeks or months to solve, causes frustration and lost productivity for all staff involved. Other vendors will charge extra for continuous training and new employee training. Software upgrades often cost extra and often result in obsolete clinical templates, reports and interfaces – that require more fees to fix.

Calculations

The assumptions provided above are used to calculate the results in each of the following categories:

  • Increase charge per visit: 6% is offered as the default for the percentage increase charge per visit because that is the average increase for our clients, based on Hobson research participation. Prime Suite suggests a higher code if clinically supported. Customizable clinical templates allow for easy data capture that clearly supports all submitted charges for maximum reimbursement. Clinical decision support tools identify and recommend reimbursable, clinically appropriate procedures and tests as alternatives to non-reimbursable choices. Greenway Revenue Services teams ensure that payer fee schedules are up to date to maximize revenue capture.
  • Increase in net collections: 6% is offered as the default for the percentage increased net collections because that is the average increase for our clients, based on Hobson research participation. User interface allows for batch eligibility checks prior to patient visit, increasing upfront collections and decreasing losses from incorrect insurance data. Optional scheduling lock prevents patients with a pending collection status from being seen by a physician, limiting growth of the practice’s bad debt balances. Advanced clearinghouse integration improves visibility into the denial process and allows for easy access to claim status and work queue, giving practices the ability to rework claims in a timely fashion. Standardized reports offer insights into performance by payer and other variables, which allows practices to spot and fix denial trends. Greenway Revenue Services team submits, tracks and updates all claims and files secondary claims to maximize collections. Advanced denial management dashboards give practices a better understanding of A/R, so root causes of denials can be identified and corrected.
  • Average reduced days in A/R: 6% is offered as the default for the percentage increase charge per visit because that is the average increase for our clients, based on Hobson research participation. Greenway Revenue Services teams ensure timely submission of charges, which results in faster cycling time to secondary payers and faster time to get patients a statement on what they owe. This minimizes accounts receivable over 90 days, which will eventually be written off. Greenway Revenue Services teams proactively reach out to payers to check on claims, which helps ensure the claims do not reach their timely filing limit.
  • Improved office efficiency: 15% is offered as the default for improved front office efficiency, and 50% for back office due to automated patient processing, scheduling and review functionality decreases demands on staff time so they can manage additional responsibilities. Electronic workflows eliminate time and resource costs associated with scanning forms and manually managing the registration queue. Online patient registration, along with batch and real-time eligibility checking gives practices the ability to re-allocate clinical billing office staff who would otherwise manually perform these tasks. Easy-to-use, efficient system functionality eliminates the need for multiple resources to work commercial, Medicare and workers’ compensation claims. Electronic posting capabilities reduce payment posting needs. Trained revenue cycle management professionals have knowledge of all billing aspects and ICD-10; expertise that is transferred to the practice through best practices training. Consultative phone calls help staff learn best practices for billing and collections to increase revenue.
  • Improve clinical unit efficiency: 3% is offered as the default for the Specialty-specific templates are customizable and sharable so providers can easily find or design a template that matches their preferred workflow. New templates can easily be added during examination. Clinical vocabulary maps directly to CPT and ICD-10 codes. Enhanced ICD-10 search capabilities make finding the right codes quick and easy. Fast access to patient data and medical history. Single, integrated interface provides better usability for e-Prescribing and encounter notes. Updated orders tracking module allows for efficient management of all inbound and outbound lab orders and results.