The process of admitting, discharging, transferring and registering has largely remained the same for several years. Although vendor development is focused on managing regulatory issues, “there are not a lot of new enhancements to the systems,” said Paul Pitcher, director of financial systems for KLAS Enterprises. Although it’s been largely a replacement market, some hospitals are switching systems for strategic reasons – based on what they are doing clinically. As a result, “the buying trend is less influenced by what they’re doing in patient accounting,” Pitcher said. Still, some companies, notably Epic, and third-party vendors are adding new capabilities in the area of revenue cycle management. The ranked list is from KLAS’ Top 20 2006 Year End Final Report on acute care registration, scheduling and patient accounting. The first seven products are ranked. The last three are notable products.
QuadraMed Patient Registration
KLAS Rank No. 1
Features: Streamline the entire patient intake process with QuadraMed Patient Registration. From pre-registration to admission, inpatient and outpatient, QuadraMed Patient Registration provides multiple registration flows tailored for various scenarios. It also provides customizable data collection requirements, comprehensive data capture, and integrated electronic document management, EDI and HIPAA support. This flexible solution delivers real value to your organization by enabling you to collect patient information required for admission, care and billing, while also managing beds and census reporting. QuadraMed Patient Registration is a core, foundational component of the Care-Based Revenue Cycle designed to get the patient to their place of care quickly.
With most billing processes standard, what distinguishes your product from others in this market? QuadraMed Patient Registration improves patient safety by integrating with QuadraMed Precise ID for exact person identification; “seeds” registration with information from previous visits to expedite the intake process and improve patient satisfaction; includes embedded, automated eligibility and benefit checking using the HIPAA EDI 270/271 transactions; integrates with QuadraMed Electronic Document Imaging for collection and viewing of pertinent documents; supports database extenders, custom questions, as defined by authorized users; provides HIPAA defined privacy capabilities including Notice of Privacy Practices tracking; and supports use of the QuadraMed Medi Kiosk Powered by Galvanon to expedite the check-in process.
What capabilities does your system have to filter out errors in the front end of admittance? Registration offers solutions such as a “Required Fields Explorer,” an intuitive Medicare Secondary Payer questionnaire, payer and service flows to assist with accurate and complete data collection. The Account Workflow Patient Service Representative Worklist provides an intuitive and exception-based means to filter and follow-up on collection of missing data.
Health Information Management
KLAS Rank No. 2
Features: Our Health Information Management product ensures quick registration of patients, positive patient identification throughout healthcare organizations and easy ongoing maintenance of accurate medical records. Information is easily retrieved from centralized storage, so patients are spared answering the same questions repeatedly, and staff members have a firm foundation from which to initiate the best possible care.
With most billing processes standard, what distinguishes your product from others in this market? The Registration functionality in Meditech’s Health Information Management product collects admission/registration patient data, including ED, surgical day, observation, recurring, referred and home health. The functionality ensures information is formatted, makes pre-certification/verification checks easier, communicates accurate data throughout the organization, eliminates duplication efforts among departments and home care admissions and provides an audit trail for managers to maintain quality assurance. Meditech’s bed board feature allows managers to view beds/occupancy levels and perform bed management functions, from a single access point.
What capabilities does your system have to filter out errors in the front end of admittance? Meditech’s Registration functionality correctly identifies the patient, by utilizing many different search methods, including name, alias and health care number. It automatically formats information, such as telephone and health insurance numbers, warning if the number is not in correct format. A user is flagged if a social security number is a duplicate. Also during the admissions process, the system will give prompts to update similar information such as patient, subscriber, and next of kin.
Centricity Business Access Management Suite (Registration and ADT)
KLAS Rank No. 3
Features: The GE Centricity Business Access Management Suite allows hospitals and integrated delivery networks (IDNs) to drive operational improvements from the front desk to the back office. Automated, rules-based logical tools make it easy to accommodate patients’ and providers’ preferences. An online interactive bed board, bed management functions, combined with proactive, rules-based online worklists guide staff through pre-admission tasks, increasing productivity and speeding the arrival and check-in process – all designed to enhance your bottom line.
With most billing processes standard, what distinguishes your product from others in this market? While traditional billing processes are standard, workflow processes are not. Centricity Business Access Management reflects industry best practice workflow processes. Configurable to your site-specific needs, the software is designed to increase patient and user satisfaction by proactively managing all patient information. Real-time, rules-based logic informs users when critical data is missing, based on the patient’s visit needs at every point in time. The information is pushed to users and, once corrected, automatically updated.
What capabilities does your system have to filter out errors in the front end of admittance? Centricity Business Access Management is an intuitive, single point of enterprise wide access designed to proactively enhance your revenue cycle. Intelligent rules-based, real-time system alerts and reminders proactively notify staff of outstanding tasks or missing information prior to the visit, helping to assure complete claims and increasing collections. Automated tools, such as address and area code correctors, help ensure that bills are clean and quickly processed, and patient communications are complete and timely.
Eclipsys Sunrise Access Management, Sunrise Patient Financials
KLAS Rank No. 4
Features: Sunrise Access Management supports and optimizes the administrative processes of patient care with comprehensive patient identification and registration/ADT (admit, discharge, transfer). Critical patient information is captured and validated as early as possible in the patient care cycle, allowing informed decision-making at the front end, so patients receive seamless care across multiple locations without administrative disruptions. Sunrise Patient Financials is a comprehensive patient-billing and receivables management solution that enables healthcare organizations to streamline billing processes and maximize reimbursements. When integrated with Sunrise Access Management, it provides a seamless revenue-cycle workflow between administrative and financial processes across single or multiple entities.
With most billing processes standard, what distinguishes your product from others in this market? Eclipsys solutions uniquely enable the integration of the “front end” (registration) with the “back end” (billing office). Eclipsys solutions help improve cash flow by moving key processes to the front end of the care process and gathering important data before the patient leaves the facility. Additionally, Eclipsys financial solutions enable complete and prompt reimbursement by automatically generating billing codes and calculations of expected reimbursement on the back end. Sunrise Patient Financials has a proven record of success. The solution provides: Dynamic work queue supports early intervention on all revenue cycle issues and increases employee productivity and efficiency; integrated contract management and compliance checking; fully integrated, multiple-entity system including MPI, combined business office and a single entry point for corporate and hospital-level information; and extensive claims editing capabilities so claims process cleanly without manual intervention.
What capabilities does your system have to filter out errors in the front end of admittance? Sunrise Access Management provides an integrated patient identification (MPI), registration (admit, discharge, transfer) and location management solution so healthcare enterprises can capture and validate patient information on the front end before the onset of patient care. Billing edits residing in the billing engine can be accessed at time of registration. By pushing edits to the front-end, staff will know whether all managed-care requirements have been met and essential billing information has been captured for reimbursement. If errors/omissions still exist, designated staff can be alerted to correct problems and eliminate subsequent billing problems.
McKesson STAR 2000
KLAS Rank No. 5
Features: Operating in an open-systems environment on a variety of hardware platforms, the STAR 2000 family of solutions includes STAR Patient Care, STAR Financials and STAR Clinicals (STAR Radiology, STAR Pharmacy and STAR Laboratory). Each solution is UNIX-based and follows industry standards such as HL7 to improve communication with third-party products, thereby protecting an organization’s IT investment. STAR products share a single logical database that populates reports and transactions throughout the system.
With most billing processes standard, what distinguishes your product from others in this market? The STAR solution allows for proven success in any size facility from small hospitals to large care delivery organizations and offers graphical user interfaces (GUI) for select applications, enhancing the product look-and-feel and making the products more user-friendly. In addition, STAR integrates with multiple McKesson products, providing the opportunity for additional or advanced functionality.
What capabilities does your system have to filter out errors in the front end of admittance? With STAR Pre-Bill Edit, claims can be evaluated against advanced edits any time prior to final billing, allowing claims to drop clean in less time. With STAR Pre-Bill Edit, you users can: manage claim edits at any time before an account is final billed; route specific edits back to any user/department for correction via a work list; create reports of all edits executed by the system; and more.
KLAS Rank No. 6
Features: Allegra, one of the most powerful and flexible patient accounting systems available today, easily administers multi-entity and multi-time zone processing, patient access/ADT, charge capture and patient account management. Allegra has a single, comprehensive database that enables tight integration of registration, eligibility, order processing, documentation and accounts receivable data. It can support a central business office or multiple business offices, as necessary.
With most billing processes standard, what distinguishes your product from others in this market? Our clients use Allegra to reduce revenue cycles by effectively integrating clinical data and financial information to provide flexible patient accounting solutions. Many of our Allegra clients have improved on the Healthcare Financial Management Association’s (HFMA) benchmark of 55 days for acute-care facilities. In fact, through the use of Allegra, many of our clients have AR days 25 percent less than the industry average.
What capabilities does your system have to filter out errors in the front end of admittance? Flexible rules provide the ability to filter errors to the field level. Client definable rules determine if users should receive warning messages and be allowed to proceed without correction, or if the data must meet specific format requirements to move forward. Insurance-based edits provide alerts for users to collect explicit information. Errors can be directed to user task lists. On-demand reporting provides statistics by admission type and/or user.
Siemens Medical Solutions
Siemens Envision RCO and ICO
KLAS Rank No. 7
Siemens has chosen not to participate in this story.
The following products’ preliminary scores did not meet KLAS’ minimum confidence level, but are noted below:
Millennium ProFit & Access Management
Epic Systems Corp.
Resolute Hospital Billing (with ADT/Prelude Enterprise Registration)
offers two products:
CareSuite OR Manager