Cardiology Practice Overcomes Disheartening EDI Reports with CGM APRIMA EHR

Practice Administrator Sandy Van Wagner used to get very frustrated with plowing through giant EDI reports listing claims errors. Claims could sit for weeks until someone had time to go through the report and laboriously track, correct, and resend them, usually because of small errors like a missed digit.

CGM APRIMA’s integrated electronic health record (EHR) and practice management (PM) solution changed all that. No more giant reports. Now Van Wagner and her staff work from an integrated, searchable superbill list.

“I don’t even have to print anything. I can bring up rejected claims by category, by the claim status or carrier. With CGM APRIMA, I can fix errors on the fly, reset, and turn claims back over. If there’s a big error that affects multiple claims, I can regenerate all of them with one click. It’s just slick!”

Making Life Easier

When Heart Cardiology Consultants was choosing a new PM and EHR system in 2008, the managers looked at more than electronic claims, of course. Van Wagner and the physicians requested demonstrations of four systems. Two were eliminated immediately for being too difficult to learn and clumsy to use.
CGM APRIMA stood out for its intuitive, flexible design and integrated PM and EHR architecture. The physicians knew they could get up to speed on the system quickly and tailor it for each doctor’s individual needs.

“Each of my physicians uses the system differently,” says Van Wagner. “Some take their laptop into the exam room, others go back to their office. Many use the Dragon speech recognition.

It works for everyone, and everyone gets a good note out of it.” Cardiology, by its nature, involves many nighttime and weekend emergency calls. With 13
physicians, the doctor on call frequently needs to treat patients she or he has never seen personally. CGM APRIMA gives all the physicians access to any patient’s records at any time. They can connect securely over a virtual private network (VPN) from anywhere instead of having to drive to the office to pull a chart or make treatment decisions with incomplete information.

Back in the Office

In the back office, Van Wagner is most excited with CGM APRIMA’s billing and collections capabilities. In fact, when Heart Cardiology Consultants started negotiating a contract with Providence Hospital in 2010, CGM APRIMA was part of the negotiations: Van Wagner insisted that the hospital allow them to continue using their CGM APRIMA system.

Billers can see claim statuses immediately and follow up or make corrections simply by clicking on a claim in the superbill list. CGM APRIMA takes them directly to the claim itself, where they can quickly fix an error and resend a claim.

The tightly integrated nature of CGM APRIMA — where clinical data, superbills, claims statuses, and demographics are all connected — eliminates the work once needed to look up data or cross-reference all these disparate pieces. Auto-posting alone saves Van Wagner’s six-person billing staff countless hours of work.

“Our A/R has gone down tremendously,” Van Wagner says. “The number of claims older than 100 days is half what it used to be because CGM APRIMA gives us the ability to rework superbills, track claims, and address errors.

“Before CGM APRIMA, little things — like missing a digit in a Medicare number — would sit until you could print a big report and work it. Now we can spot those claims and fix the errors quickly instead of waiting for someone to work an A/R report.”

Building the Bottom Line

The dramatic reduction in A/R is just one way CGM APRIMA is improving Heart Cardiology Consultants’ finances. Although Van Wagner isn’t able to quantify the impact on total billings, she knows CGM APRIMA has made a difference.

She explains, “Before CGM APRIMA, the doctors tended to downcode themselves. The billers and the physicians both noticed that average visit levels have increased. The doctors can see that there’s solid documentation justifying those higher levels.”

CGM APRIMA’s biggest quantifiable financial impact has been reducing transcription costs. Heart Cardiology used to spent $3,000–4,000 every week on transcription. Those costs have dropped by 75% since the doctors started charting electronically. The transcription costs incurred now are for dictating letters, recommendations, and other correspondence. Annual savings: nearly $156,000 a year.

The back office is leaner now, too. Van Wagner estimates that she is saving at least one, perhaps two, full-time-equivalent staff who used to be needed for medical records, filing, and correspondence. Including benefits, that probably saves $80,000–90,000/year.

After more than two years, Van Wagner knows that her practice made the right decision by choosing CGM APRIMA’s solution. “It’s definitely been a positive experience. I would recommend CGM APRIMA to anyone who’s thinking about it.”

*Customer received compensation as a referral and was told in advance that they would be featured in an advertisement.