46 / CAP TODAY May 2009 Part 1 of 9 See accompanying article on page 42 Name of billing/accounts receivable system Cerner Corp. Jen Cisar jen.cisar@cerner.com 2800 Rockcreek Parkway Kansas City, MO 64117 816-201-1024 www.cerner.com Cerner Millennium ProFit First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 2000/March 2009 Last major release of this B/AR system February 2009 No. of contracts for sites operating B/AR system 35 Contracts signed since March 2008 4 Contracts gone live since March 2008 3 No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 55 No. of inpatient invoices handled by sites annually No. of outpatient requisitions handled by sites annually Largest No. of hospitals/pathologists serviced by one B/AR system Percentage of installations that are stand-alone B/AR systems 0 In entire company In B/AR systems division only 7,300+ total 36/35 for support/7 No. of user workstations in sites operating B/AR system Average No. of user workstations in sites operating B/AR system Server platform PC/workstation platform Innovative peripherals Operating system(s) Databases and tools used Information systems/software interfaces Compaq, IBM RS/6000 Intel Pentium image storage Open VMS, AIX, Unix Oracle MedAssets, Relay Health, Practice Insight, Emdeon, Oracle EBS, Lawson, others Experience the CAP difference Established fields of anatomic and clinical pathology New technologies Laboratory management To fill your Pathology, Laboratory Medicine or Laboratory Management positions, advertise in CAP TODAY classifieds for the best results. Call 1-800-983-7737 Patient demographics transferred via interface from LIS to B/AR system 1500 claim form generation (paper version) UB-92 claim form generation (paper version) Client invoices Patient invoices Reprints of above on demand Key indicator tracking (online view of site-assigned key indicators) available first quarter 2010 Test profile vs. component billing not available Medical-necessity screening for Medicare Professional component billing Auto delete of nonbillable procedures not available Technical component only Retain demographic data, repeating patients Accounts and patient payment posting Accounts receivable system Management or marketing reports Automatic balance billing to patients Capitation billing plus billable tests not available Utilization reports for managed care Global charges for lab tests Unlimited user-defined fee schedules Track financial classes Allow open-item accounting (each line item on bill can be handled separately) User report writer Collection agency system User-configurable dunning Client services or call tracking module not available Rules-based processing or claims scrubbing Multi-lab or multi-company processing Support all HIPAA transaction sets B/ AR system supports electronic data interchange with third-party payers and claims Functions offered Third-party payers and claims clearinghouses with which system is interfaced Type of claim data generation Third-party rules and coding updates supported by system claims, payments, eligibility, referral/authorization (will interface with any clearinghouse and payer) UB-92, 1500, UB-04 Medical Necessity, Info-X, CPT-4, ICD-9 Complete ASP solution for B/AR system? Method of charging for ASP service fixed fee Client software required requires that software be on a client PC ASP information conduit operates over the Internet Client contracts supported from data center not operated by client 130+ How data center is operated by vendor Indexed field in each test definition for LOINC code? Provide LOINC dictionary for each new installation? Journaling?/source code? /no Smallest stand-alone B/AR system Largest stand-alone B/AR system Smallest B/AR configuration for integrated lab system Largest B/AR configuration for integrated lab system no no improves cash flow and reduces claims denials simplifies billing statements and improves customer service streamlines business operations and reduces labor costs Survey editors: Raymond D. Aller, MD, and Hal Weiner
48 / CAP TODAY May 2009 Part 2 of 9 Computer Service & Support Cortex Medical Management Systems Jim O'Neill jimjr@csslis.com Stan Gordon sgordon@cortexmed.com 2106 New Rd., Building E6 2107 Elliott Ave., Suite 201 Linwood, NJ 08221 Seattle, WA 98121 800-336-4277 206-812-6981 See accompanying article on page 42 www.csslis.com www.cortexmed.com Name of billing/accounts receivable system AR-2000 Lab Billing System Cortex Medical Billing First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1980/January 2009 1987/January 2009 Last major release of this B/AR system December 2008 October 2008 No. of contracts for sites operating B/AR system 65 26 Contracts signed since March 2008 5 5 Contracts gone live since March 2008 3 5 No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 62 (0/61/0/0/0/1 in Canada) 26 (1/1/23/0/1 ER billing service/0) No. of inpatient invoices handled by sites annually 25,000 2,000,000 (avg., 750,000) 0 No. of outpatient requisitions handled by sites annually 25,000 2,000,000 (avg., 750,000) 2,000 100,000+ (avg., 67,500) Largest No. of hospitals/pathologists serviced by one B/AR system 4/15 Percentage of installations that are stand-alone B/AR systems 60% 15% In entire company 6/6/3 4/5/4 In B/AR systems division only 2/2/1 4/5/4 No. of user workstations in sites operating B/AR system 2 50 1 26 Average No. of user workstations in sites operating B/AR system 10 9 Server platform IBM RS/6000 Windows 2000, XP, 2003 PC/workstation platform Windows on PC Windows 2000, XP, 2003, Vista Innovative peripherals Operating system(s) AIX 6.0, Linux Windows XP, 2003, Vista Databases and tools used LabBase Microsoft SQL server, Dynamics SL Information systems/software interfaces Orchard, Allscripts, Aspyra, ClinLab, McKesson, GE, Emdeon, ADSC Cortex, Impac, SCC Soft Computer, Aspyra, Cerner Patient demographics transferred via interface from LIS to B/AR system 100% 98% 1500 claim form generation (paper version) 100% 100% UB-92 claim form generation (paper version) 0 Client invoices 100% 75% Key indicator tracking (online view of site-assigned key indicators) 100% 100% Test profile vs. component billing 100% 98% Medical-necessity screening for Medicare 100% 0 Professional component billing 20% 75% Auto delete of nonbillable procedures 100% 0 Technical component only 20% 75% Management or marketing reports 100% 100% Automatic balance billing to patients 100% 100% Capitation billing plus billable tests 25% Utilization reports for managed care 100% 100% Global charges for lab tests 100% 100% User report writer 75% 100% Collection agency system 65% 100% Client services or call tracking module available third quarter 2009 not available Multi-lab or multi-company processing 100% 100% Support all HIPAA transaction sets 100% B/ AR system supports electronic data interchange with third-party payers and claims Functions offered secure Web portal claims, statements, payments Third-party payers and claims clearinghouses with which system is interfaced Capario Zirmed, McKesson, Office Ally, direct to Medicare, Blue Cross Blue Shield Type of claim data generation 1500 1500 Third-party rules and coding updates supported by system Complete ASP solution for B/AR system? no Method of charging for ASP service fixed fee Client software required browser based, terminal services ASP information conduit operates over the Internet, requires use of a VPN or other dedicated connection Client contracts supported from data center not operated by client 4 How data center is operated by a third party (Adhost) Indexed field in each test definition for LOINC code? no Journaling?/source code? / /escrow Smallest stand-alone B/AR system $5k/$10k/$5k/$0.25k $ /0 (ASP)/$7k/$0.4k Largest stand-alone B/AR system $15k/$75k/$15k/$1.5k $ /$200k/$42k/$3.6k Smallest B/AR configuration for integrated lab system $5k/$10k/$5k/$0.25k $ /0/$7k/$0.4k Largest B/AR configuration for integrated lab system $15k/$75k/$5k/$1.5k $ /$200k/$42k/$3.6k electronic Medicare claims (ANSI v. 4010) and transmission to over 2,100 commercial insurance carriers and each state s Medicare plan; electronic Medicare, Medicaid, and commercial payment posting and reconciliation multiple fee schedules and flexible, automatic discounts by client optional nursing home and Medicare Part A module available; full financial reporting suite with commission reports; full suite of statistical reports one account per patient spanning multiple visits and multiple insurances all detailed data charges, payments, and adjustments kept online forever more than 130 Crystal Reports with source code
50 / CAP TODAY May 2009 Part 3 of 9 Healthvision Solutions (formerly MediSolution) Hex Laboratory Systems Jim Schroeder jschroeder@healthvision.com Susan Bollinger sbollinger@hexlab.com 5030 Riverside Drive, Suite 300 1042B El Camino Real, Suite 308 Irving, TX 75039 Encinitas, CA 92024 480-834-0936 800-729-2085 See accompanying article on page 42 www.healthvision.com www.hexlab.com Name of billing/accounts receivable system MediAR (formerly Revenue Cycle Management) Lab/Hex Billing & Cash Management First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1975/December 2008 1983/March 2009 Last major release of this B/AR system December 2008 January 2009 No. of contracts for sites operating B/AR system 50 37 Contracts signed since March 2008 3 2 Contracts gone live since March 2008 3 2 No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 102 (2/6/0/3/0/91 in Canada) 37 (0/33/1/0/3 veterinary, health department/0) No. of inpatient invoices handled by sites annually 1,500 145,000 (avg., 40,000) No. of outpatient requisitions handled by sites annually 1,500 5,200,000 (avg., 300,000) 10,000 1,300,000 (avg., 200,000) Largest No. of hospitals/pathologists serviced by one B/AR system 47/0 /20 Percentage of installations that are stand-alone B/AR systems 75% 2% In entire company 99/159/59 4/9/2 In B/AR systems division only No. of user workstations in sites operating B/AR system 2 200 3 64 Average No. of user workstations in sites operating B/AR system 25 16 Server platform any Windows or Unix-based servers Intel open platform PC/workstation platform Windows 2000, NT, XP, Vista Windows Innovative peripherals bar-code readers, image scanners document scanning Operating system(s) Unix, Linux, Windows Linux Databases and tools used Oracle, Oracle Tools Thoroughbred Basic, 4GL, SQL Information systems/software interfaces Cerner, Allscripts, Eclipsys, Clinibase, McKesson, Wyndgate Technologies, Orchard, Aspyra, Technidata, Meditech, Healthvision, proprietary Allscripts, Cerner, CPSI, Experior, McKesson, Hearts, Medinformatix, MediPro, Medic, Medical Manager, PMSI, Practice Partners, Siemens, Sunquest, 4Medica, Emdeon, GE Healthcare, others Patient demographics transferred via interface from LIS to B/AR system 100% 100% 1500 claim form generation (paper version) 100% 100% UB-92 claim form generation (paper version) 20% 100% Client invoices 100% 100% Key indicator tracking (online view of site-assigned key indicators) 5% 100% Test profile vs. component billing 80% 100% Medical-necessity screening for Medicare 40% 100% Professional component billing 100% 100% Auto delete of nonbillable procedures 100% 100% Technical component only 100% Management or marketing reports 100% Automatic balance billing to patients 100% 100% Capitation billing plus billable tests 60% 100% Utilization reports for managed care 100% Global charges for lab tests 100% 100% User report writer 100% 100% Collection agency system 100% 100% Client services or call tracking module 100% 100% Multi-lab or multi-company processing 100% 100% Support all HIPAA transaction sets 100% 100% B/ AR system supports electronic data interchange with third-party payers and claims Functions offered insurance inquiry/response (270/271), claims primary and all secondary (837 I/P), claims inquiry/response (276/277), remittances (835) claims, remittance, rebill, acknowledgement reports, medical necessity, eligibility, financial reports Third-party payers and claims clearinghouses with which system is interfaced Medicares, Medicaids, Highmark Blue Cross Blue Shield, Emdeon, Availity, Anthem, Capario, RealMed, THIN, Medicare, states Medicaid Capario, Availity, THIN, McKesson, Post-N-Track, others Type of claim data generation UB-92, 1500 UB-92, 1500, ANSI 4010 Third-party rules and coding updates supported by system 3M, CodeMap CodeMap, MCF compliance, Info-X, ADP, Ingenix, any tab-delimited file Complete ASP solution for B/AR system? no Method of charging for ASP service fixed fee or transaction based user s choice Client software required requires that software be on a client PC ASP information conduit requires use of a VPN or other dedicated connection Client contracts supported from data center not operated by client 0 How data center is operated by vendor Indexed field in each test definition for LOINC code? Journaling?/source code? /escrow /escrow Smallest stand-alone B/AR system $5k/$7.5k/$5k/$0.2k Largest stand-alone B/AR system $25k/$65k/$25k/$1.25k Smallest B/AR configuration for integrated lab system $1k/$7.5k/$2.5k/$0.1k Largest B/AR configuration for integrated lab system $10k/$35k/$5k/$0.5k user-configurable rules-based system design exception-based processing integrated with online workflow management automated denial management integrated with online workflow extensive flexibility with custom invoices and statements for clients and patients; alternate pricing schedules and other user-definable features medical necessity with ABN printing and other tools to track missing information to assure correct billing for fast payment features that reflect experience in all lab markets, such as nursing homes, independent labs, specialty labs, clinics, and hospitals
52 / CAP TODAY May 2009 Part 4 of 9 McKesson Medical Information Technology (Meditech) Joseph R. Stabile joseph.stabile@mckesson.com Paul Berthiaume pberthiaume@meditech.com 5995 Windward Parkway Meditech Circle Alpharetta, GA 30005 Westwood, MA 02090 404-338-6000 781-821-3000 See accompanying article on page 42 www.mckesson.com/laboratory www.meditech.com Name of billing/accounts receivable system Horizon Lab Financials (formerly Telcor Billing Information System) Meditech Revenue Cycle client/server First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 2006/March 2009 1977/March 2009 Last major release of this B/AR system May 2008 April 2008 No. of contracts for sites operating B/AR system 1 do not track Contracts signed since March 2008 2 do not track Contracts gone live since March 2008 1 do not track No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 2 (2/0/0/0/0/0) 391 No. of inpatient invoices handled by sites annually do not track No. of outpatient requisitions handled by sites annually do not track Largest No. of hospitals/pathologists serviced by one B/AR system 2/ do not track Percentage of installations that are stand-alone B/AR systems 0 do not track In entire company 32,000 total 642/1,597/507 In B/AR systems division only 23 total 48/103/8 No. of user workstations in sites operating B/AR system 4 50 do not track Average No. of user workstations in sites operating B/AR system 20 do not track Server platform Intel, Windows Hewlett-Packard, Dell, EMC, IBM PC/workstation platform any standard Windows any PC using Windows 2000 Professional or higher Innovative peripherals integrated fax, PDF, e-mail, Excel export speech recognition, PACS scanning, identity management, patient monitoring Operating system(s) Windows Windows 2000, XP Professional, Vista on PCs; Windows 2000, 2003 on server Databases and tools used SQL server, Crystal Developer Meditech database management system Information systems/software interfaces McKesson Lawson, Lynx Patient demographics transferred via interface from LIS to B/AR system 1500 claim form generation (paper version) UB-92 claim form generation (paper version) Client invoices Patient invoices Reprints of above on demand Key indicator tracking (online view of site-assigned key indicators) Test profile vs. component billing Medical-necessity screening for Medicare Professional component billing Auto delete of nonbillable procedures Technical component only Retain demographic data, repeating patients Accounts and patient payment posting Accounts receivable system 100% Management or marketing reports Automatic balance billing to patients Capitation billing plus billable tests Utilization reports for managed care Global charges for lab tests Unlimited user-defined fee schedules Track financial classes Allow open-item accounting (each line item on bill can be handled separately) User report writer Collection agency system User-configurable dunning Client services or call tracking module available in summer 2009 Rules-based processing or claims scrubbing Multi-lab or multi-company processing Support all HIPAA transaction sets B/ AR system supports electronic data interchange with third-party payers and claims Functions offered paper and electronic claims submission, payments, eligibility, automatic reprints and rebills, customizable invoice ANSI 278 for authorization requests, ANSI 837 for institutional claims, ANSI 837 for professional claims, ANSI 835 for electronic payment Third-party payers and claims clearinghouses with which system is interfaced (can interface with any clearinghouse) HDX, NEHEN, Veriquest, SSI, Emdeon, MedUnite, Quovadx, others Type of claim data generation UB-92, 1500 UB-92, 1500 Third-party rules and coding updates supported by system CCI LCD/NCDs, CPT, NPI, ICD-9 3M, HANYS, HSS, IRP, QuadraMed Complete ASP solution for B/AR system? no Method of charging for ASP service transaction based Client software required browser based ASP information conduit operates over the Internet Client contracts supported from data center not operated by client 0 How data center is operated by vendor Indexed field in each test definition for LOINC code? Provide LOINC dictionary for each new installation? no Journaling?/source code? /escrow / Smallest stand-alone B/AR system Largest stand-alone B/AR system Smallest B/AR configuration for integrated lab system Largest B/AR configuration for integrated lab system designed for the workflow and business of outreach and reference laboratories extensive decision support and business management tools, profitability analysis, utilization inquiry, revenue inquiry uses the latest technology with unparalleled data access 39 years of experience in developing and implementing health care software maximum revenue efficiency through an integrated revenue cycle and laboratory information system accurate, up-to-the-minute patient data and charge information
54 / CAP TODAY May 2009 Part 5 of 9 Medical Information Technology (Meditech) Medical Information Technology (Meditech) Paul Berthiaume pberthiaume@meditech.com Paul Berthiaume pberthiaume@meditech.com Meditech Circle Meditech Circle Westwood, MA 02090 Westwood, MA 02090 781-821-3000 781-821-3000 See accompanying article on page 42 www.meditech.com www.meditech.com Name of billing/accounts receivable system Meditech Revenue Cycle Magic Meditech Revenue Cycle 6.0 First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1977/March 2009 1977/ Last major release of this B/AR system March 2009 April 2008 No. of contracts for sites operating B/AR system do not track Contracts signed since March 2008 do not track do not track Contracts gone live since March 2008 do not track do not track No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 581 No. of inpatient invoices handled by sites annually do not track do not track No. of outpatient requisitions handled by sites annually do not track do not track Largest No. of hospitals/pathologists serviced by one B/AR system do not track do not track Percentage of installations that are stand-alone B/AR systems do not track do not track In entire company 642/1,597/507 642/1,597/507 In B/AR systems division only 48/103/8 48/103/8 No. of user workstations in sites operating B/AR system do not track do not track Average No. of user workstations in sites operating B/AR system do not track do not track Server platform Hewlett-Packard, Dell, EMC, IBM Hewlett-Packard, Dell, EMC, IBM PC/workstation platform any PC using Windows 2000 Professional or higher any PC using Windows 2000 Professional or higher Innovative peripherals speech recognition, PACS scanning, identity management, patient image scanners, EDI interfaces monitoring Operating system(s) Windows 2000, XP Professional, Vista on PCs; Windows 2000, 2003 on Windows server 2003 Enterprise x64 Edition or Datacenter 64 Edition server Databases and tools used Meditech database management system Meditech database management system Information systems/software interfaces Lawson, Lynx Lawson, Lynx Patient demographics transferred via interface from LIS to B/AR system available but not 1500 claim form generation (paper version) available but not UB-92 claim form generation (paper version) available but not Client invoices available but not Patient invoices available but not Reprints of above on demand available but not Key indicator tracking (online view of site-assigned key indicators) available but not Test profile vs. component billing available but not Medical-necessity screening for Medicare available but not Professional component billing available but not Auto delete of nonbillable procedures available but not Technical component only available but not Retain demographic data, repeating patients available but not Accounts and patient payment posting available but not Accounts receivable system 100% available but not Management or marketing reports available but not Automatic balance billing to patients available but not Capitation billing plus billable tests available but not Utilization reports for managed care available but not Global charges for lab tests available but not Unlimited user-defined fee schedules available but not Track financial classes available but not Allow open-item accounting (each line item on bill can be handled separately) available but not User report writer available but not Collection agency system available but not User-configurable dunning available but not Client services or call tracking module available but not Rules-based processing or claims scrubbing available but not Multi-lab or multi-company processing available but not Support all HIPAA transaction sets available but not B/ AR system supports electronic data interchange with third-party payers and claims Functions offered ANSI 278 for authorization requests, ANSI 837 for institutional claims, ANSI 837 for professional claims, ANSI 835 for electronic payment ANSI 278 for authorization requests, ANSI 837 for institutional claims, ANSI 837 for professional claims, ANSI 835 for electronic payment Third-party payers and claims clearinghouses with which system is interfaced HDX, NEHEN, Veriquest, SSI, Emdeon, MedUnite, Quovadx, others HDX, NEHEN, Veriquest, SSI, Emdeon, MedUnite, Quovadx, others Type of claim data generation UB-92, 1500 UB-92, 1500 Third-party rules and coding updates supported by system 3M, HANYS, HSS, IRP, QuadraMed 3M, HANYS, HSS, IRP, QuadraMed Complete ASP solution for B/AR system? no no Method of charging for ASP service Client software required ASP information conduit Client contracts supported from data center not operated by client How data center is operated Indexed field in each test definition for LOINC code? Provide LOINC dictionary for each new installation? Journaling?/source code? / / Smallest stand-alone B/AR system Largest stand-alone B/AR system Smallest B/AR configuration for integrated lab system Largest B/AR configuration for integrated lab system 39 years of experience in developing and implementing health care software maximum revenue efficiency through an integrated revenue cycle and laboratory information system accurate, up-to-the-minute patient data and charge information 39 years of experience in developing and implementing health care software maximum revenue efficiency through an integrated revenue cycle and laboratory information system accurate, up-to-the-minute patient data and charge information product is not yet but company has contracted for nine licenses representing 20 sites
May 2009 55 / CAP TODAY Part 6 of 9 Multidata Computer Systems Netlims NJ, LLC Michael Slater mrslater@mul.com Avi Allerhand avi@netlims.com 160 Broadway, Suite 1010 111 Town Square Place, Suite 700 New York, NY 10038 Jersey City, NJ 07310 212-967-6700 201-894-5300 See accompanying article on page 42 www.mul.com www.netlims.com Name of billing/accounts receivable system MultiTech A/R AutoBilling First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1984/2003 2003/February 2009 Last major release of this B/AR system September 2008 December 2008 No. of contracts for sites operating B/AR system 36 5 Contracts signed since March 2008 0 0 Contracts gone live since March 2008 0 1 No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 36 (2/34/0/0/0/0) 5 (0/4/0/0/0/1 in India) No. of inpatient invoices handled by sites annually 0 No. of outpatient requisitions handled by sites annually 15,000 5,000,000 (avg., 400,000) 120,000 1,200,000 (avg., 580,000) Largest No. of hospitals/pathologists serviced by one B/AR system 1/ Percentage of installations that are stand-alone B/AR systems 20% 0 In entire company 4/5/2 55/37/12 In B/AR systems division only 2/2.5/1 5/7/4 No. of user workstations in sites operating B/AR system 4 100+ 4 30 Average No. of user workstations in sites operating B/AR system 15 20 10 Server platform Intel x86 compatible, most Unix/Linux, HP Alpha open platform PC/workstation platform Intel x86 compatible Windows compatible Innovative peripherals optional image input/output management images attachment, management Operating system(s) Windows Vista, XP, 2003; Unix/Linux; HP VMS Windows, Unix Databases and tools used Caché, Kofax, VSI-Fax any RDBMS Information systems/software interfaces Siemens, Netsmart, GE Healthcare, Epic, Cerner, Psyche Systems, SCC Soft Computer, Aspyra Siemens, Cerner, GE Healthcare, Allscripts, SCC Soft Computer Patient demographics transferred via interface from LIS to B/AR system 75% 100% 1500 claim form generation (paper version) 100% 100% UB-92 claim form generation (paper version) 10% available but not Client invoices 100% 100% Key indicator tracking (online view of site-assigned key indicators) 100% 100% Test profile vs. component billing 100% 100% Medical-necessity screening for Medicare 100% 100% Professional component billing 40% 100% Auto delete of nonbillable procedures 100% 100% Technical component only 20% 100% Management or marketing reports 100% 100% Automatic balance billing to patients 100% 100% Capitation billing plus billable tests 100% 100% Utilization reports for managed care 100% 100% Global charges for lab tests 80% 100% User report writer 25% 100% Collection agency system 100% 100% Client services or call tracking module 100% 100% Multi-lab or multi-company processing 25% available but not Support all HIPAA transaction sets 100% 100% B/ AR system supports electronic data interchange with third-party payers and claims Functions offered claims, payments, eligibility, service authorization claims, payments, eligibility, rebill, authorization Third-party payers and claims clearinghouses with which system is interfaced Emdeon Emdeon, NEIC, Express Bill, Zirmed, ProxyMed, others Type of claim data generation UB-92, 1500 1500, client bill, ANSI 837 Third-party rules and coding updates supported by system 3M, CodeMap, AMA Complete ASP solution for B/AR system? no no Method of charging for ASP service Client software required ASP information conduit Client contracts supported from data center not operated by client How data center is operated Indexed field in each test definition for LOINC code? Provide LOINC dictionary for each new installation? no Journaling?/source code? optional/escrow /escrow Smallest stand-alone B/AR system $10k/$50k/included/$0.75k Largest stand-alone B/AR system $100k/$200k/included/$3k Smallest B/AR configuration for integrated lab system $5k/$25k/included/$0.5k $10k/$100k/$25k/$8k Largest B/AR configuration for integrated lab system $50k/$200k/included/$3k $15k/$200k+/$40k+/$16k+ designed for commercial labs, with tools to address payer determination and patient eligibility in an environment where most specimens originate in nonlab facilities optional integrated imaging/management module for requisitions and other related source documents system can be customized for special requirements exceptions and denials automatic tools allow easy tracing and handling automation travel algorithm, reinvoice, colliding panels advanced service to tests logic allows accurate billing
56 / CAP TODAY May 2009 Part 7 of 9 SCC Soft Computer Schuyler House Ellie Vahman ellie@softcomputer.com Janet Chennault jlc@schuylerhouse.com 5400 Tech Data Drive 26027 Huntington Lane, Unit F Clearwater, FL 33760 Valencia, CA 91355 727-789-0100 800-706-0266 See accompanying article on page 42 www.softcomputer.com www.schuylab.com Name of billing/accounts receivable system SoftA/R SchuyLab First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1993/2008 1994/March 2009 Last major release of this B/AR system 2008 March 2009 No. of contracts for sites operating B/AR system 73 184 Contracts signed since March 2008 5 5 Contracts gone live since March 2008 8 5 No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 167 (156/8/1/0/2 large clinic, tribal health/0) 189 (12/134/0/21/17 veterinary/5 in Guam) No. of inpatient invoices handled by sites annually 100 2,000+ No. of outpatient requisitions handled by sites annually 1,000,000 6,500,000 (avg., 4,300,000) 25,000 500,000+ Largest No. of hospitals/pathologists serviced by one B/AR system 3/7 Percentage of installations that are stand-alone B/AR systems 0 In entire company 770/415/257 2/3/1 In B/AR systems division only 35/15/6 1/2/0 No. of user workstations in sites operating B/AR system 3 50 1 60 Average No. of user workstations in sites operating B/AR system 10 6 Server platform IBM System p (AIX) PC PC/workstation platform Microsoft Windows workstations Dell recommended; can use any standard PC Innovative peripherals SoftMedia (integrated document management) voice input Operating system(s) server: IBM AIX (Unix); workstation: Microsoft Windows Windows XP, Vista Databases and tools used Oracle Pervasive, Btrieve Information systems/software interfaces SCC Soft Computer, Cerner, McKesson, Eclipsys, Epic, Siemens, GE Healthcare, IntraNexus, QuadraMed, Meditech, CPSI, others A4, Acer, Affinity, AMI, Allscripts, CA Linx, Cyber Ren, Healthland, Digital MD, GE Healthcare, McKesson, Siemens, others Patient demographics transferred via interface from LIS to B/AR system 100% 100% 1500 claim form generation (paper version) 50% 80% UB-92 claim form generation (paper version) 2% Client invoices 80% 100% Patient invoices 50% 100% Reprints of above on demand 50% 100% Key indicator tracking (online view of site-assigned key indicators) 100% Test profile vs. component billing 100% 100% Medical-necessity screening for Medicare 100% 20% Professional component billing 100% 100% Auto delete of nonbillable procedures 100% 100% Technical component only 30% 100% Retain demographic data, repeating patients 100% 100% Accounts and patient payment posting 80% 100% Accounts receivable system 50% 100% Management or marketing reports 100% 100% Automatic balance billing to patients 50% 100% Capitation billing plus billable tests not available Utilization reports for managed care not available Global charges for lab tests 100% not available Unlimited user-defined fee schedules 100% 100% Track financial classes 50% 100% Allow open-item accounting (each line item on bill can be handled separately) 100% not available User report writer 100% not available Collection agency system 50% not available User-configurable dunning 50% not available Client services or call tracking module available through vendor s general LIS or third party not available Rules-based processing or claims scrubbing 100% not available Multi-lab or multi-company processing 2% not available Support all HIPAA transaction sets 50% not available B/ AR system supports electronic data interchange with third-party payers and claims Functions offered claims, payments, secondary claims, acknowledgements claims, rebill, remittance Third-party payers and claims clearinghouses with which system is interfaced Medicare, Blue Cross Blue Shield, Quadax, ProxyMed, MVP, Emdeon, Office Ally, ProxyMed, Palmetto, Capario Zirmed, Gateway EDI, eprovider Solutions, others Type of claim data generation UB-92, 1500, 837 Professional and Institutional 1500 Third-party rules and coding updates supported by system Quadax, 3M (Info-X) CodeMap Complete ASP solution for B/AR system? no no Method of charging for ASP service Client software required ASP information conduit Client contracts supported from data center not operated by client How data center is operated Indexed field in each test definition for LOINC code? Journaling?/source code? /escrow no/escrow Smallest stand-alone B/AR system $30k/$30k/$40k/$2k Largest stand-alone B/AR system $200k/$500k/$100k/$10k Smallest B/AR configuration for integrated lab system 0/$30k/$40k/$2k $1k/$5k/$1.5k/1% of purchase price Largest B/AR configuration for integrated lab system 0/$500k/$100k/$10k $2k/$30k/$1.5k/1% of purchase price unlimited multi-tiered pricing, unlimited payer rules, carve-outs, billing edits, with full A/R functionality, centralized billing for multi-site, multicompany institutions modular product offering that can be tailored to accommodate many types of laboratory environments integrated with SCC SoftLab LIS and does not require additional servers; set-up/implementation hours required are greatly reduced; less FTE hours to build and maintain based on number of contracts, not sites direct Medicare and Medicaid billing in all regions of the United States reasonable prices with on-site training full integration with LIS
58 / CAP TODAY May 2009 Part 8 of 9 Seacoast Laboratory Data Systems Sunquest Information Systems Jim Whitehurst jim@sldsi.com Elinore Craig elinore.craig@sunquestinfo.com 195 New Hampshire Ave., Suite 140 250 S. Williams Blvd. Portsmouth, NH 03801 Tucson, AZ 85711 603-431-4114 877-239-6337 See accompanying article on page 42 www.sldsi.com www.sunquestinfo.com Name of billing/accounts receivable system SurroundLab AR Sunquest Clinical Financial (formerly Misys Clinical Financial) First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 2001/February 2009 1985/2008 Last major release of this B/AR system November 2008 2008 No. of contracts for sites operating B/AR system 60 81 Contracts signed since March 2008 7 0 Contracts gone live since March 2008 5 0 No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 67 (4/56/7/0/0/0) 225 (41/153/31/0/0/0) No. of inpatient invoices handled by sites annually 12,000 maximum (avg., 8,000) No. of outpatient requisitions handled by sites annually 1,200 3,000,000 (avg., 900,000) 5,000 4,000,000 (avg., 250,000) Largest No. of hospitals/pathologists serviced by one B/AR system /8 8/45 Percentage of installations that are stand-alone B/AR systems 40% In entire company 15/25/10 In B/AR systems division only 8/15/5 No. of user workstations in sites operating B/AR system 4 100+ 5 125 Average No. of user workstations in sites operating B/AR system 20 35 Server platform Intel x86 IBM, HP PC/workstation platform Dell, HP Innovative peripherals digital fax Operating system(s) Windows, Linux AIX, HP-UX Databases and tools used Caché, M-21 Caché Information systems/software interfaces Sunquest, Cerner, Siemens, McKesson, Epic, Eclipsys, SCC Soft Computer, GE Healthcare, LabCorp, Impac, Meditech, others Patient demographics transferred via interface from LIS to B/AR system 100% 100% 1500 claim form generation (paper version) 100% 95% UB-92 claim form generation (paper version) 30% 10% Client invoices 100% 100% Key indicator tracking (online view of site-assigned key indicators) 100% 100% Test profile vs. component billing 100% 100% Medical-necessity screening for Medicare 100% 95% Professional component billing 40% 95% Auto delete of nonbillable procedures 100% 100% Technical component only 40% 90% Management or marketing reports 100% 100% Automatic balance billing to patients 100% 90% Capitation billing plus billable tests 20% 20% Utilization reports for managed care 30% 100% Global charges for lab tests 100% 90% User report writer 100% Collection agency system 100% Client services or call tracking module 100% available through vendor s general LIS or via third party Multi-lab or multi-company processing 100% 100% Support all HIPAA transaction sets 100% 100% B/ AR system supports electronic data interchange with third-party payers and claims Functions offered claims, payments, eligibility submission, remittance Third-party payers and claims clearinghouses with which system is interfaced many Per-Sé, Emdeon, Cydata, NEIC, Quadex, Regence, Medical Manager of Ohio, others Type of claim data generation UB-92, 1500 UB-92, 1500, custom Third-party rules and coding updates supported by system CodeMap 3M Complete ASP solution for B/AR system? no no Method of charging for ASP service Client software required ASP information conduit Client contracts supported from data center not operated by client How data center is operated Indexed field in each test definition for LOINC code? no Journaling?/source code? /escrow /escrow Smallest stand-alone B/AR system $10k/$50k/$10k/$1k Largest stand-alone B/AR system $40k/$300k/$50k/ Smallest B/AR configuration for integrated lab system Largest B/AR configuration for integrated lab system designed exclusively for the commercial laboratory real-time billing and accounts receivable data complete access to data via ODBC connection modular implementation scales from start-up, client-only invoicing to full-scale insurance billing and accounts payable provides a seamless interface to leading LIS applications with extensive management-analysis capabilities extensive validation prior to claims submission reduces claim rejection rate
May 2009 59 / CAP TODAY Part 9 of 9 Telcor Xifin Mitch Fry Bill Taylor btaylor@xifin.com 7101 A St. 3394 Carmel Mountain Rd., Suite 200 Lincoln, NE 68506 San Diego, CA 92121 402-489-1207 858-436-2995 See accompanying article on page 42 www.telcor.com www.xifin.com Name of billing/accounts receivable system Billing Information System Xifin Revenue Cycle Management First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 2004/February 2009 2001/February 2009 Last major release of this B/AR system March 2009 February 2009 No. of contracts for sites operating B/AR system 24 21 Contracts signed since March 2008 14 7 Contracts gone live since March 2008 4 5 No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 24 21 (8/10/3/0/0/0) No. of inpatient invoices handled by sites annually No. of outpatient requisitions handled by sites annually 45,000 2,655,250 (avg., 535,000) 62,964 6,792,000 (avg., 1,000,000) Largest No. of hospitals/pathologists serviced by one B/AR system 4/26 Percentage of installations that are stand-alone B/AR systems 84% 100% In entire company 14/27/27 43/25/10 In B/AR systems division only 7/13/8 43/25/10 No. of user workstations in sites operating B/AR system 4 200 19 209 Average No. of user workstations in sites operating B/AR system 20 80 Server platform Intel-based Windows server SaaS (software as a service) Web browser based PC/workstation platform Windows XP PC Intel with Internet connection Innovative peripherals integrated fax, PDF, e-mail, Excel export bar-code printers, image management, OCR readers, fax, archived storage Operating system(s) Windows 2005, 2008 server Microsoft Windows 2000, XP, Vista with Internet Explorer 6, 7 Databases and tools used Microsoft SQL 2005,.Net 3.5 platform, Crystal Reports 2008, Excel, Adobe PDF reader Oracle 10g Enterprise Edition, Business Objects Enterprise XI Information systems/software interfaces Invision, McKesson, Cerner, Sunquest, Siemens, Orchard, others McKesson, Cerner Patient demographics transferred via interface from LIS to B/AR system 100% 100% 1500 claim form generation (paper version) 100% 100% UB-92 claim form generation (paper version) 20% 100% Client invoices 100% 100% Key indicator tracking (online view of site-assigned key indicators) 100% 100% Test profile vs. component billing 100% 100% Medical-necessity screening for Medicare 100% 100% Professional component billing 100% 100% Auto delete of nonbillable procedures 100% 100% Technical component only 100% 100% Management or marketing reports 100% 100% Automatic balance billing to patients 100% 100% Capitation billing plus billable tests 100% 100% Utilization reports for managed care 100% 100% Global charges for lab tests 100% 100% User report writer 100% 100% Collection agency system 100% 100% Client services or call tracking module available in December 2010 100% Multi-lab or multi-company processing 20% 100% Support all HIPAA transaction sets 100% 100% B/ AR system supports electronic data interchange with third-party payers and claims Functions offered claims, remittance, rebill, automatic status update systems integration; payer and clearinghouse management; electronic submissions, remittance, eligibility, acknowledgement, status check; payer edits; secondary claims generation; others Third-party payers and claims clearinghouses with which system is interfaced Express Bill, Claim.MD, THIN, Epremis, e-gate, GHN, McKesson, Medicare, Medicaid, Blue Cross Blue Shield, UHIN Medicare carriers and FIs, Medicaids, Blue Cross, UHC, Aetna, Cigna, Capario, Per-Sé, Softrix, McKesson, Matrix Type of claim data generation UB-92, 1500, UB-04, state specific UB-92, 1500, nonstandard Medicaids Third-party rules and coding updates supported by system allows import from CMS files CCI, NCD/LCD rules, CPT, diagnosis LCD/NCDs, CCI, OCE, ICD-9, procedure codes by payer and year, others Complete ASP solution for B/AR system? Method of charging for ASP service fixed fee fixed fee, transaction based Client software required requires that software be on a client PC browser based ASP information conduit requires use of a VPN or other dedicated connection operates over the Internet Client contracts supported from data center not operated by client 0 100% How data center is operated by vendor by a third party (Savvis) Indexed field in each test definition for LOINC code? Journaling?/source code? / /no Smallest stand-alone B/AR system $10k/$48k/$20k/$1k /$1.25 per accession/$145k per site/included Largest stand-alone B/AR system $50k/$348k/$149k/$6k /$0.89 per accession/$300k per site/included Smallest B/AR configuration for integrated lab system /$1.25 per accession/$145k per site/included Largest B/AR configuration for integrated lab system /$0.89 per accession/$300k per site/included specifically designed for the workflow and business of outreach and reference laboratories, including the ability to collect payments at time of service from patients at patient service centers extensive decision support and business management tools, profitability analysis, utilization inquiry, revenue inquiry ICD-10 compliant services include ongoing programming, integration, database maintenance user-configurable, rules-driven workflow automation facilitating incorporation of lab procedures and best practices comprehensive error/denial management resources and correspondence capabilities