National Ambulatory Hernia Institute
Taking FileMaker Pro to the Next LevelFileMaker iPad-‐izaton Success Story
Situation / Challenges
The National Ambulatory Hernia Institute͛Ɛ (NAHI) Operations Manager, Vicky Vansurksum, was challenged with managing multiple office locations, physicians, patient flow of care and scheduling, complex billing for both workers comp and private patients, Insurance company and adjuster management, patient chart and media management (EMR), data auditing, mobilized accessibility and remote access, PC and Mac compatibility along with many other information related challenges.
Assessment
Desiring to improve medical outcomes and increase business efficiencies with these highly complex and sophisticated requirements NAHI contacted ACG Technologies to help coordinate and develop a solution that could meet all their needs. Vicky Vansurksum, Operations Manager at NAHI, worked closely with Chris Quinn, president of ACG Technologies, to review their current business processes and in-‐efficiencies and together as they collaborated was able to identify and solve all their challenges including a fully functional QuickBooks integration eliminating the need for any double entry.
Identifying Opportunities
Working together, Chris and Vicky set out to identify specific areeas of opportunity where both business efficiencies and patient healthcare could be significantly improved.
Key focus areas were patient billing and transaction management, scheduling and mobilizing patient information. Patient billing and payment transactions was a laborious effort that required one and a half full time administrators three weeks a month to invoice and track many difficult and different types of billing, payment and collection efforts.
Dz were a
laborious effort that required one and a half full
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Developing an Integrated and Multi-‐Faceted FileMaker Database Solution
dŚƌŽƵŐŚŚƌŝƐĂŶĚsŝĐŬLJ͛ƐĐĂƌĞĨƵůƉƌŽĐĞƐƐĂŶĂůLJƐŝƐĂŶĚƚĂƌŐĞƚĞĚŝŶƚĞŐƌĂƚŝŽŶŽĨƚŚĞ&ŝůĞDĂŬĞƌWƌŽĚĂƚĂďĂƐĞĂŶĚƐŽĨƚǁĂƌĞ development application the billing and payment process was reduced to less than four hours a month and now only
requires one administrator. This process was also enhanced by integrating FileMaker to QuickBooks that quickly and
effortlessly pushes all FileMaker transactions directly into QuickBooks.
Billing and Payment requirement challenges had to include: x Creating a Custom Procedures Library
with Unlimited Charges Capability x One Click Submission of a Procedure
with Multiple Charges to a Patient Record
x Detailed and Editable CPT Charges x HICFA Billing for Pre-‐Printed and Non-‐
Preprinted Forms
x Billing for Multiple Office Locations x Professional and Facility Payment
Tracking and Check Printing
x Contract integration for Professionals and Facilities
x Payment Selection from Multiple Bank Accounts
x Payments to Practice Partners and other Professionals
x Multiple Application of Different Adjustments and Discounts e.g. PPO͛Ɛ x ƉƉĞĂů͛ƐWƌŽĐĞƐƐĨŽƌInsurance Payment
Tracking
x Unlimited Payments Received on a Charge
x Unlimited Payments to Professionals and Facilities per Charge
x A/R Tracking and Collection Follow Up x Collection Effort Tracking Log
x Professional Payment and Ledger Transaction Tracking
x Data Auditing for Any and All Data Changes
Dz hundred twenty
hours per month to less than four hours a monthǤdz
Image: Payments Received and Processing Dashboard
Results and Benefits
Automating Payments Received and Payment Processing: To allow for many billing variables ACG Technologies experienced developers created a billing dashboard that conditionally filters by only Professionals and Facilities that are currently owed money, or only charges with remaining balances. As the administrator applies and pays the professionals/facilities the charge falls off the screen leaving only any remaining unpaid charges to process. This filtered process allows the administrator to quickly process their accounts receivables and payables and not
Automated payment distribution, discounts, simple write off and contract integration has sharply reduced the process for applying payments received and payments owed across many charges with a single click of the mouse. All accounting is managed within the FileMaker Pro database including the printing and synchronization of checks between FileMaker and QuickBooks. Once transactions have been processed FileMaker then pushes all newly processed transactions to QuickBooks via the custom data connector developed by ACG.
When an outstanding charge is paid by the insurance company and the paid amount is NOT correct or up for dispute͕ďLJƐŝŵƉůLJĐůŝĐŬŝŶŐƚŚĞ͞ƉƉĞĂůĞĚ͟ĐŚĞĐŬďŽdžthe item is calendared and sets the charge to the appealed status and put into the collection process. The appealed charge is now available in a collection queue for the collections department to begin the appeals process. Because all these charges are tightly integrated with different departments, errors and lost revenues have been significantly reduced.
There are many more integrated and automated procedures that have been implemented into the solution in order to reduce inefficiencies, human error, improve data entry to help ensure correct and accurate data impute. The administrator also has the ability to toggle between any charge in the receivables/payment dashboard and any patient information they might require during the Accounts Receivables and Accounts Payables process.
Patient Scheduling, Electronic Medical Records (EMR)/Document Management and Actionable Flow of Care: Managing and monitoring Patient Flow of Care was a big concern for Vicky. Her objective was not only to automate this process but also put all the patient information in one place and at the fingertips of her staff. From the patient record the administrator has instant access to:
x Patient Detail and Assigned Physician x Patient Referral
x Bill Type and Method x Office Location x Nurse Case Manger
x Patient Appointment History x Patient Individual Calendar x Patient Notes
x History of Injury
x Unlimited and Server Based EMR Records x Patient HCFA Records
x Exam Information
x Prescriptions Data and Electronic Prescription History
x Patient Family and Personal Insurance Information
x Patient Charges
x Web Integrated Map with the Patients Location and Directions to the assigned Clinic or Hospital Location that is Easily Emailed to the Patient
x Data Auditing that Tracks all Field Changes to a Patient Record
x Patient Ledger x And Much DŽƌĞ͙
Patient and professional ƚĂƐŬƐĂƌĞĐĂůĞŶĚĂƌĞĚĂŶĚǁŝƚŚŽƵƌĂůĞƌƚŝŶŐŵŽĚƵůĞŝŵƉŽƌƚĂŶƚƚĂƐŬƐĚŽŶ͛ƚŐĞƚŵŝƐƐĞĚ͘ The flexible calendar module is a unique calendar in that it allows you to filter by Professional at any location, Patient, and of course by day, week or month. Because of FileMaker Pros excellent plug-‐in architecture integrating our calendar to Outlook is easier than ever.
Our Monthly Calendar view summarizes the types of appointments by day, who type and by name.
Filter the calendar by:
x Office Location x Type: o Patient o Professional o Staff o Referrer
x Name (Conditional by Type)
Very granular giving the administrators great flexibility and many choices when scheduling or reviewing schedules
The Daily Schedule allows the administrators to, for example, filter by all professionals or one professional.
The Appointments Dialog is also easy to use and assisted with conditional menus for filtered lists making data entry a breeze.
EMR and Document Management Module
The full featured EMR ŽĐƵŵĞŶƚDĂŶĂŐĞŵĞŶƚDŽĚƵůĞǁĂƐĚĞƐŝŐŶĞĚƚŽĞĂƐŝůLJĂĚĚĂŶLJĚŝŐŝƚĂůŵĞĚŝĂĨƌŽŵW&͛Ɛ͕ Word Documents, Spreadsheets, and Video etc. to any patient specific record. Another advantage is that all digital media is located to a single server location in a patient directory for multiple reasons. The advantage of localizing the digital media in one location is as follows:
x Media Security ʹ All patient records are organized at the server in one location for easy security and backup management x All EMR and Attached Media is NOT
embedded in the database but rather organized and located in one directory location
x The administrator can open any digital media right from the FileMaker ͞ZĞĐŽƌĚƐ͟ portal in the application it was developed in x Organizing patient related digital content
right on the patient record makes chart and
other media easily available to the Administrator
x Completely Automated EMR and Document Management is Secure, Organized by Patient, Not Embedded into the record unburdening the database, Open media right from the patient record
Phase 2
iPad-‐ization
iPad-‐ization of the FileMaker Medical Database
Mobilizing the NAHI Medical Database ǁĂƐ Ă ďƌĞĞnjĞ ǁŝƚŚ &ŝůĞDĂŬĞƌ͛Ɛ 'Ž ĨŽƌ ƚŚĞ ŝWĂĚ and iPhone. The new FileMaker Go for the iPad application is simple to deploy, just go to the online Apple App Store, download the FileMaker Go app and open it on your iPad, connect to your local network and open the database right to your
iPad or iPhone. zĞƐ͕ŝƚ͛ƐƌĞĂůůLJƚŚĂƚĞĂƐLJ. In our initial testing FileMaker Go performed well beyond our expectations and gives our doctors the ability to carry critical patient information with them right into the exam room. Accessing any patient record is easy, quick and convenient. Having that information at their fingertips improves patient care. FileMaker iPad Go makes mobilizing patient data simple and without the high cost of developing a separate unique application.
ACG Technologies is an innovative software development services company, providing a comprehensive offering of custom application development consulting, IT Support, e-‐commerce, web design and e-‐marketing services. For more than a decade, companies have used ACG products and services to automate, streamline and promote their businesses.
