The
use of Electronic
Medical Records
has undergone a
significant transformation
in the past 20
years from various
individual corporate
developments using
the PC Operating
System in first
generation computers
to new interfaces,
faster communications
and advanced WEB-based
software. The
advent of the Internet
and advanced 3G
and 4G technology
makes older devices
such as the FAX
machine obsolete
in most cases as
digital signatures
graphics and imagery
methods have been
introduced and
computer memory
sizes and mass
storage devices
have expanded. These
developments offer
modern Physicians
invaluable benefits
to their practice
not only in the
introduction of
new devices significant
improvements to
the productivity
of their offices.
www.chdpgateway.com
: The “CHDP
Gateway” suite
is
a
fully
integrated
and
robust
solution
which
include
the
reporting,
insurance
billing,
payment
receipt
and
patient
reporting.
|
Starting
with the basic
Electronic Health
Record and advanced
input technology
an Electronic Health
Record becomes
developed at a
newborn's early
age and as a standardized
HL7 computer file,
will be able to
live with individuals
for their lifetime.
Medical
specialties are
progressing in
their development
and addition of
related imaging
techniques, drug
usage and prescription
records matching
the development
of new treatment
techniques. Yet,
despite the advancements
made, some elements
in the practice
have not improved,
namely billing,
since there has
been a wide disparity
in formats for
submission of claims
statements to insurance
companies, federal,
state and local
offices for efficient
compensation to
physician individual
and group practices. This
problem has also
been addressed
by 4eGuru Inc. with
the integration
of the claims billing
process with the
Electronic Health
record system with
a new software
module called "4eCHDP" enabling
direct statement
preparation and
electronic transmission
to government offices
immediately following
visits with unnecessary
clerical tasks
which now consume
the time and resources
of the physician,
nurse practitioner,
assistants, and
clerical staff,
improving the productivity
of all and allowing
more patients to
be treated while
providing much
more effective
reimbursement. The
financial benefits
far outweigh the
cost of installing
and utilizing "4eCHDP". Its
ease of use has
been proven through
many man-months
of use in targeted
physician installations.
Training and support
during the transition
from the manual
clerical methods
now in use is provided
by 4eGuru to ensure
complete operational
facility by physicians
and staff before
the system goes
fully operational.
Additional support
and troubleshooting
of is provided
by local staff,
not some remote
e-mail address.
4eGuru
Inc.'s "4eCHDP" online
submission flow
and module has
been approved
by California State
Department of Health
Care Services Medi-Cal. It supports
online batch claim
submission (CHDP-Green
form or PM160)
and prepares paper
print claim submission
forms if required,
without going through
any third party
or claim clearinghouse.
A cost-benefit
estimate
has been
prepared
below in
moving
to
4eGuru’s
Electronic Health Record and using the "4eCHDP" automatic
online claim submittal method.
CHDP
Paper Claim vs.
Online Web Submission
Claim Cost Comparison:
The
present CHDP paper
claim form completed
by manual entry
and mail submission
is not the optimum
method to submit
physician visit
payment claims
compared to electronic
paper-less technology. As
shown below, economic
benefits can be
quickly and easily
realized by converting
a paper-based medical
insurance payment
claim or billing
to a fully integrated,
paperless record
system as provided
by 4eGuru with
the "4eCHDP" claim
module, with a
breakeven period
of about 6 months.
Further as a result
of the ARRA
stimulus program which
provides a reimbursement
incentive for conversion
to electronic technology
the cost of conversion
results in an additional
financial payoff
for a four year
time period.
How
much is Physician
time worth?
What if you could save an hour or two per day? If you currently submit CHDP
paper forms manually, your office is wasting a valuable resource "Time", whose
use when optimized, can generate cost savings, enhanced revenues and
more efficient office operations.
For a typical Physician or Multi-physician Practice cases, billing paper
flows follow the procedure in the diagram above; not only does
the individual physician have to take the time to write the notes
for a biller or and/or their assistant, but the Practice has to
forward the visit data in paper summary form to the Billing Office
which generates a paper form, copies, packages and mails the billing
information to the state in the case of Medi-Cal or to an insurance
company. In these cases, labor time savings would occur if data
electronically entered an qualified by the Doctor directly could
bypass the unnecessary steps of manual entry by the Assistant and
then forwarding pre-claim paperwork to generate the claim forms
in proper format forwarding the data to the Billing Office and
onward. Manual handling of all the data induces errors, requires
filing copies, stuffing envelopes mailing and recording the transactions
for follow-up as required. The analysis below demonstrates
how an Electronic Health Record combined electronic forms handling
creates major financials reward and many intangible benefits to
the practice.
Time
and Money Saving
Steps - For CHDP
Claims:
A.
Physician and
Provider side:
Doctor and Assistants Activities
A
#1. Practice
Statistics –Biller/Assistant:
|
Paper
data
provided
to
office
biller |
Preparation
time
and
Activity |
Data
collection & preparation
period |
Document
Management
after
submittal |
|
Average
time
taken
by a
biller
to prepare
and fill
out paper
CHDP
form |
Collecting
patient
data |
10
minutes |
10
minutes |
|
Estimated
Average
time
saved
by electronic
preparation & submission
of CHDP
form |
Direct
computer
entry
and submittal
of Screening/Billing
data by
Physician/Assistant |
5
minutes |
5
minutes |
|
Average
Biller
entries
per day |
|
12 |
12 |
|
Total
minutes
saved
per day |
12
visits
x 5 minutes |
60
(1 hr) |
60
(1 hr) |
|
Total
hours
saved
over
12 months |
5
hours/wk
x 48
wks |
240
hour |
240
hour |
|
Total
weeks
of work
saved
per year |
(240
hrs /
40 hrs/wk) |
6
weeks |
6
weeks |
|
Total
Time
Savings |
480
hrs(12
weeks) |
|
|
A #2. Total Biller Cost Savings per year
|
Biller
/Assistant |
Hours
Saved |
Minimum
Cost
@ $15/hr |
|
Total
weeks of
worked
saved per
year |
480
hrs |
$7200.00 |
|
|
|
|
|
Total
Savings
per biller per
year |
|
$7,200.00 |
A #3. Practice Statistics - Doctor: needs
to complete required
diagnostic information data
for each visit for each CHDP claim
|
Average
time
taken
by a
doctor to
record visit
data
on paper
form |
|
5
minutes |
|
Average
estimated
time
saved
by using
4eGuru
medical
template |
|
2
minutes |
|
Average
Doctor
appointments
per day |
|
25 |
|
Total
Minutes
Saved
per Day |
(12
visits
x 2.5
minutes) |
30
min (say
1/2 hours) |
|
Total
estimated
time
worked
in 12
month
period |
(5
days/wk
x 48
wks) |
240
days |
|
Total
estimated
hours
saved
per
year |
(240
days
x 1/2
hour/day) |
120
hour |
A
#4. Savings from
reduced Doctor
Labor:
|
Doctor |
Rate |
@
$60/hr |
|
Total
labor
saved
per year |
120
hrs |
$7200.00 |
|
|
|
|
|
Total
Savings
per
Doctor
per
year |
|
$7,200.00 |
A #5. Additional Savings from reduced materials cost: (Paper, Cartridges,
Envelopes, Mail)
|
Total
forms
submittal |
Estimated
savings |
Annual
Savings |
|
Paper,
Cartridges,
Envelopes,
Mail |
($1.70
per form
x 3000
) |
$5,100.00 |
|
Total
Savings
per
Doctor
per
year |
|
$5,100.00 |
A #6a. Maintenance Savings from reduced filing, storing, retrieving,
accessing, paper forms for review, and follow-up etc.
|
Estimated
cost of
filing,
storing,
accessing,
retrieving
- maintenance
of paper
forms ~ 1/2 hour
per year
@ $15.00/hr |
~($8.00/form/year) |
$8.00
(est.) |
|
Estimated
maintenance
of an electronic
form |
~($1-2/form/year) |
$2
(est.) |
|
Annual
savings
per form |
($8
- $2) |
$6 |
|
Assumed
active
forms per
Doctor |
One
form per
visit or
12/day
x 240 day |
Estimated
3,000 visits
per year |
|
Estimated
Savings
per Doctor
per form
per year |
3,000
forms
x $6 |
$18,000.00 |
A #6b. Savings after Benefits paid in Explanation of Benefits (EOB) Posting
Phase from retrieving, accessing, paper forms for review, and follow-up
etc.
|
Estimated
cost of
filing,
storing,
accessing,
retrieving
- maintenance
of paper
forms 1/2 hour
per year
@ $15.00/hr |
~($8.00/form/year) |
$8.00
(est.) |
|
Estimated
maintenance
of an electronic
form -10
min |
~($1-2/form/year) |
$2
(est.) |
|
Annual
savings
per form |
($8
- $2) |
$6 |
|
Assumed
active
forms per
Doctor |
One
form per
visit or
12/day
x 240 da |
Estimated
3,000 visits
per year |
|
Estimated
Savings
per Doctor
per form
per year |
3,000
forms
x $6 |
$18,000.00 |
A
#7. Summary of
First Year Estimated
Savings by using
4eGuru Digital
EHR Records and
4eBill CHDP/CM1500
Forms Submittal
Methodology
|
From
Item #2 |
Annual
Savings
from Reduced
Biller/Assistants
Cost |
$7,200.00 |
|
From
Item #4 |
Savings
from Reduced
Doctor
labor Per
Year |
$7,200.00 |
|
From
Item #5 |
Savings
from reduced
Materials
costs |
$5,100.00 |
|
From
Item #6a |
Savings
from reduced
manual
forms maintenance |
$18,000.00 |
|
From
Item #6b |
Savings
from reduced
manual
forms maintenance
in Explanation
of Benefits Phase |
$18,000.00 |
|
First
Year
Summary |
Total
Savings
per Year |
$55,500.00 |
A #8. Cost of Implementation
|
First
Year
Investment
Costs |
Estimated
Expense |
|
First
Year
HW Costs,
two computers
and printers,
modems
interconnects
, etc |
-$5,000 |
|
One
time CHDP
billing
and
Pediatric
EMR
SW
Costs
with
HL7Capability |
-$12,000 |
|
Annual
Network,
HW and
Software
Maintenance |
-$6,000 |
|
Initial
Training
for New
Updates
and New
Staff |
-$1,500 |
|
Total
First
Year
Cost
Estimate |
$24,500 |
A #9. Individual Physician Savings over a Four year period:
|
Year |
Investment |
Annual
Savings |
Financial
return |
|
Year
1 : Hardware
Software &Training
Maintenance
Total |
$18,500.00
$24,500.00
|
FROM
ABOVE
$55,500.00 |
$31,000 |
|
Year
2: |
$6,000.00 |
$55,500.00 |
$49,500 |
|
*Years
3,4
Estimated
total
over
2-year
period |
$12,000.00 |
$100,000
Est |
$88,000 |
|
4
YEAR
CUMULATIVE
RETURN |
|
|
$168,500 |
A#10. Additional
financial benefits:
|
Annual & Accelerated
Hardware
Depreciation |
3-year
Depreciable
Investment
on hardware |
|
ARRA
Government
Credit |
Four
year program
provide
large incentive
for acquisition
of 4eGiuru
systems |
|
Reduced
payment
times due
to speed
of electronic
submit |
Estimate – one
day for
submittal |
|
Reduced
Errors
and re-submittals
due to
error checking
and integration
with Patient
Record
information |
Intangible |
A#11. Four Year Summary in a Group Practice of 10 Physicians not including
Cost Group Discounts
|
Year |
Investment |
Annual
Savings |
Financial
return |
|
Year
1:Hardware
Software & Training
Maintenance
Total |
$185,000.00
$245,000.00
|
See
#9 ABOVE
$555,000 |
$310,000 |
|
Year
2: |
$60,000.00 |
$555,000 |
$495,000 |
|
*Years
3,4
Est.
Total over 2-year
period |
$120,000.00 |
$800,000 |
$400,000 |
|
4
YEAR
CUMULATIVE
RETURN |
|
|
$1,205,000 |
Note:
In third and
fourth years
there may be
software and
hardware upgrades
so
operational
savings are conservatively
reduced.
The "EMR4Clinic" software
suite is a fully
integrated and
robust solution
tying together
the patient information
and clinical examination
and procedure room
to the practice
management aspects
of the medical
office which include
the reporting,
insurance billing,
payment receipt
and patient reporting.
The
software operates
as a Web-based
and Client-Server
application, which
runs on all computer
platforms including
Windows- XP, Vista
or Windows 7 servers,
Linux. Mac OS X,
and on all Internet
Web-browsers. These
include Internet
Explorer/Firefox,
Mozilla, Safari,
and on all devices
such as desktops,
laptops, tablet
computers, iPhones,
and other PDA devices. User can
maintain full administrative
management control
to maintain patient
data privacy over
all applications
by restricting
access only to
appropriate authorized
and authenticated
levels.
“EMR4Clinic” Medical
software product
improves office
work efficiency,
lowering office
costs, makes
patient record
storage and retrieval
flow more easily
and with less
error, enabling
the entire office
to become virtually
paperless. |
CHDP- Online submission USA
Practice Management System
Dr.
Keshav Naraian, MD, US