For Doctors, negotiating the insurance bureaucracy is as difficult as battling a dread disease. It means hours spent filling out forms, haggling with payer representatives to iron out inconsistencies, and waiting weeks or even months to receive reimbursement. The process clogs productivity like plaque in an artery. But Dr. Mark Michaels, head of the Cincinnati, Ohio-based Allergy Asthma Center, found a cure. In 1992, he computerized his five-year old practice so he could spend more time with patients and spend less time on administration. Michaels' 10-employee staff manages all the casework in each of the Center's three offices using a software from NDC Health Information Systems. Now they can even submit all their claims electronically, and have practically eliminated paperwork altogether.
Why Did You Want This System?
"Most physicians, like myself, don't know much about computers. But I've never used external billing, because I believe in the philosophy that nobody cares about your money as much you do. A couple of years ago we started using the electronic submission process. It's much easier and more efficient. We bill from our office, and everything is done the same day. Because we are getting payments a lot sooner, it gives us better control over our billing."
How Does The Process Work?
"We use our system for billing, insurance, and posting payments. A check-in sheet includes patient and insurance information, then services and diagnoses are checked on the sheet. At the end of a visit, information from the patient file is keyed into the computer. We input the charges, diagnoses, and types of service, then submit it electronically at the end of the day. The claim is screened immediately."
How Has This Helped?
"We can identify problems immediately. If we write the patient's address with one digit wrong on the zip code, it tells us why. If we misplace a service or a diagnosis is not compatible, it will tell us immediately after the transmission. That's better than waiting four or six or eight weeks to hear from the insurance company. I also use it for notes. I record what every patient reacts to after we finish allergy testing, and back it up every day in case the record gets damaged."
What's The Biggest Payoff?
"Before we went from paper to computers, doing statistics and research on the practice was almost impossible, or at least very difficult. Now I can go back and see how I did in '98 or '99. I can specify certain procedures to see how we did, trace insurance companies to see how they paid us and how much. I have unlimited access to information that I never had before."