How modern technology helped a multi-location orthopedic group boost financial results and reporting

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1 CASE STUDY How modern technology helped a multi-location orthopedic group boost financial results and reporting CORE Orthopaedic Medical Center (CORE) has delivered outstanding orthopedic care to patients in the San Diego, California area for almost 30 years. With three locations, 15 providers including five board-certified, sub-specialty trained surgeons and state-of-the art technology, CORE has been successful in attracting patients and providing excellent care. However, in 2013, working with a local billing service and outdated software had the CORE team frustrated with inefficient workflows, weak reporting, and suboptimal financial results. Unsurprisingly, when CORE brought Leona Mathews, MBA, on as Administrator that October, finding a better revenue cycle solution was one of her first priorities. FAST FACTS: CORE Orthopaedic Medical Center Encinitas, CA 3 Locations (Main Clinic & 2 Physical Therapy Clinics) 15 Providers 50 Staff Members Solution: CareCloud Concierge Below, learn how Leona drew on her more than 20 years of experience as a Practice Administrator in Neurology, Dermatology, OB/GYN, and Orthopedic Surgery to find a modern revenue cycle management, practice management (PM), and Electronic Health Records (EHR) solution. Plus, read about CareCloud s impact on CORE s financial results. LEONA MATHEWS, MBA SAYING GOODBYE TO OUTDATED SYSTEMS A combination of cumbersome software and lackluster results drove CORE s urgency to move away from their billing service and the outdated PM-EHR solution the service required. Most "If you re going to run a practice, you have to be able to access data to reach best practice performance.

2 fundamentally, CORE did not trust that the billing service was managing its revenue cycle effectively and became convinced they were leaving revenue on the table as a result. The billing service offered little in the way of reporting and this lack of transparency only compounded CORE s concerns. Plus, the metrics they did report were not competitive with industry benchmarks. If you re going to run a practice, you have to be able to access data to reach best practice performance, Leona emphasizes. Making matters worse, the billing process required manual steps that stifled practice workflow. Most notably, the PM system was not set up for provider-based charge entry, so doctors had to physically write charge tickets that staff would then scan over to the billing service. Not only was this inefficient, but batches also routinely got lost during the exchange. We lost days as a result of this process, Leona notes. Billing errors were also a common issue that, coupled with poor denial follow-up, dragged CORE s collections down. Another significant drain on practice productivity was the lack of integration between the PM and EHR systems, despite being from the same vendor. CORE s clinicians and staff had to log in to the PM and EHR systems separately and the systems did not always talk to each other, so users lost valuable time to excessive mouse clicks and manual data entry. SEARCHING FOR A STREAMLINED SOLUTION Fed up with sacrificing productivity and profitability, the CORE team scoped out their dream solution and entrusted Leona with leading the search for it. In her words, CORE wanted to step up to the next generation of technology and tap into the benefits of a cloud-based platform. The team wanted to gain anytime, anywhere access to their schedules, notes, and reports, while avoiding the cost and hassle of maintaining servers. A 20-year member of the Medical Group Management Association (MGMA), Leona researched options and evaluated countless vendors at the group s meetings and conferences. After performing exhaustive additional research and seeking direct peer recommendations, she narrowed the field down to a select group of solutions. PARTNERING WITH CARECLOUD CORE ultimately chose CareCloud due to the combination of its modern technology platform and the dedicated people behind it. CareCloud offered a state-of-the-art solution with software written in the 2000s, Leona says. The fact that CareCloud offered a holistic solution, CareCloud Concierge, comprised of both integrated PM- EHR software and back-office revenue cycle services, was a big draw. "With CareCloud, all of the parts work together in a seamless manner." With CareCloud, all of the parts work together in a seamless manner, she emphasizes. Plus, since CareCloud is completely cloud-based, the CORE team gained the anywhere, anytime access they sought to the system.

3 "CareCloud has the most robust reporting package I ve found." CareCloud also stood out to Leona because it offered the powerful analytics she was looking for to help her manage and improve practice performance. CareCloud has the most robust reporting package I ve found, she says. During the search, CORE s leaders also looked for a spirit of partnership with the companies they evaluated. With CareCloud, that sense started with the Sales Director and extended through later interactions with the company s senior leadership. Leona explains, We wanted to form a relationship where we could provide feedback to make the product stronger. That ultimately makes the product more successful for our group, for the company, and for the broader marketplace. CareCloud was a great fit. SEEING CARECLOUD S IMPACT CareCloud offered a state-ofthe-art solution with software written in the 2000s. "INCREDIBLE" FINANCIAL RESULTS By moving to CareCloud, CORE has not only seen major improvements in key revenue cycle metrics, but the practice s results are also now competitive with industry benchmarks. The financial impact from switching to CareCloud has been incredible Leona says. Our revenue cycle is faster and we ve boosted cash flow significantly. In addition, CORE now has insight into key revenue cycle metrics that the billing service did not provide, such as first-pass resolution rate and net collection rate. The team is thrilled to see these metrics at 91% and 95% respectively with CareCloud levels competitive with industry and specialty benchmarks. "Our revenue cycle is faster and we ve boosted cash flow significantly." Highlights of CareCloud's Impact: 28% 40% 16 DAYS 11% CASH FLOW: UP 28% PER MONTH TOTAL A/R: DOWN 40% DAYS IN A/R: DOWN 16 DAYS % A/R >120: DOWN 11 PERCENT- AGE POINTS TO 24% "The financial impact from switching to CareCloud has been incredible." PROACTIVE DENIAL PREVENTION CORE s results reflect optimization across the entire revenue cycle, starting with key front-end processes like automatic patient insurance eligibility checking. We re now consistently and effectively checking eligibility for all patients and that s affected our collections. We re able to catch things at the front end now, Leona says. CollectiveIQ CareCloud s automated billing rules solution is also playing a powerful role in preventing billing errors proactively. CollectiveIQ is very robust. It automatically catches errors up front, so we can fix them before claim submission, resulting in cleaner claims and faster payment, CORE s revenue cycle manager reports.

4 GREATER TRANSPARENCY CORE feels more in control of their revenue cycle now, due in large part to their ability to take advantage of Electronic Funds Transfers (EFT) and Electronic Remittance Advice (ERA). We have most payers connected electronically, which streamlines cash flow and saves on labor costs, Leona states. Before, CORE lacked critical visibility, as remittances went straight to the billing service and CORE had only limited EFT capabilities. Now, the ability to see all the EFT payments in the remittance warehouse assures me that we re getting paid timely and accurately, CORE s revenue cycle manager says. Having these capabilities saves time and energy in the billing department, and deposits to the bank are accurate and prompt, Leona affirms. LOWER COSTS Since switching to CareCloud, CORE has not only seen a sizable boost to its top line, but also substantial improvement to its bottom line. The cost of the prior service and its associated software was astronomical, Leona notes. Why so high? On top of billing service charges, the need to pay maintenance fees on servers was another major contributor and a key driver behind CORE s move to the cloud. With CareCloud, our costs are about one third of what they were before and our results are remarkably better, Leona reports. "With CareCloud, our costs are about one third of what they were before and our results are remarkably better." "Having a seamless flow from the appointment, to the chart, to billing saves a lot of time." SMOOTHER WORKFLOW The results CORE has achieved with CareCloud extend far beyond the financial. CareCloud s intuitive and integrated design has saved time for its providers and staff alike by removing unnecessary steps between clinical and billing applications. Having a seamless flow from the appointment, to the chart, to billing saves a lot of time, Leona emphasizes.

5 Plus, CORE s providers now have access to the system whether they re in the office, at home, or on the go. Our providers love being able to access the system from anywhere and also use the iphone app CareCloud Companion to review their schedules and charts, Leona says. One of CORE s providers "Our providers love being able to access the system from anywhere and also use the iphone app CareCloud Companion to review their schedules and charts." echoes her enthusiasm saying, Having off-site access is a winner. Charting at home at any hour gives me flexibility, which is especially helpful as a parent of young children. DEEPER INSIGHTS For practice administrators like Leona, access to meaningful data is critical for effective practice management. CareCloud s powerful analytics solutions have given Leona the insight she needs to continuously improve CORE s processes and results. Command Center, CareCloud s practice scorecard, and Advanced Analytics, CareCloud s suite of tools for deep analysis, have been particularly impactful. Command Center and Advanced Analytics are fantastic tools that give you instant data, Leona says. "Command Center gives me a detailed snapshot of numerous KPIs instantly." Command Center helps Leona keep a constant pulse on CORE s key performance indicators (KPIs). Command Center gives me a detailed snapshot of numerous KPIs instantly, she states. And, since it not only provides point-in-time data, but also plots historical results on graphs in seconds, she can quickly assess trends. The visual display makes it easy for me

6 to see the improvements in financials, she notes, and I no longer have to go into Excel to build graphs myself. Plus, she can resolve questions rapidly. I can go in and get the answers I need immediately. It s just so easy, she says. I can go in and get the answers I need immediately. It s just so easy. "Advanced Analytics lets me drill down to almost any set of parameters I want." For deeper, more complex analyses, Leona turns to Advanced Analytics. Advanced Analytics lets me drill down to almost any set of parameters I want, she states. For example, I can run a report on CPT codes by provider, over any time period, with both encounters and units. The user-friendly solution has also drastically improved the month-end reporting process. Prior to CareCloud, I spent two days at month end extracting data from our old system, then had to clean up the charts in excel. And, I didn t get half the information as I get from CareCloud. This process takes about half a day with pre-populated charts for simple presentation at board meetings, she says. AN ENDURING PARTNERSHIP The relationship between CORE and CareCloud doesn t end there. As a CareCloud Concierge client, CORE has a designated client manager working closely with the team to help them strengthen financial results and get the most out of the CareCloud solution. Our client manager is extremely responsive and part of our regular team meetings. This in itself is an incredible benefit to the practice, Leona notes. Plus, Leona regularly engages with other members of the "CareCloud is dedicated to physician practices. Working with a vendor focused on improving physician practice management is an advantage." CareCloud team to help shape products in development. She emphasizes, CareCloud is dedicated to physician practices. Working with a vendor focused on improving physician practice management is an advantage. We get attention and we see our feedback make a difference. Want to learn more about the modern, integrated solution that has helped CORE boost financial results and streamline workflow? Visit CareCloud.com/Concierge or call us at to schedule a demo of our cloud-based software. CareCloud.com Miami, FL hello@carecloud.com