Alabama clinic taps Encoda to aid revenue cycle operations

Alabama Orthopedic Clinic, a 21-physician practice in Mobile, has gone live with revenue cycle management software and analytics from Encoda.

The practice is seeking to improve its revenue cycle operations by increasing the efficiency and effectiveness of its claims management and payment posting processes.

The clinic will bridge workflow gaps between their practice management system, clearinghouse and insurers using a library of payer and specialty-specific claim scrubbing edits supported with advanced remittance posting rules.

Encoda’s platform will enable Alabama Orthopedic to develop claims processing and posting strategies based on customized business logic specific to providers, procedure codes, payers and ANSI remark and reason codes.

The clinic previously struggled to identify lost claims, reallocate misapplied patient payments, reconcile payer recoupments and track staff productivity, according to Katherine McMichael, business manager at Alabama Orthopedic. If a billing associate accidently closed a session while working a claim in the practice management system, the claim would disappear until it was picked up on a subsequent aging report.

“Our staff now are presented only with those claims that require our attention, while all other claims are scrubbed, sent to the payers for adjudication, paid and posted without use touching the claim or remittance,” McMichael adds. “Encoda’s business logic enables significantly faster payment posting, rather than hand-keying the remittances that were tripping up our billing software’s electronic poster.”

Other health IT contracts and go-lives reported during the past week include:

• Oklahoma Spine Hospital in Oklahoma City will replace its existing electronic health record system with the Thrive EHR from CPSI. The hospital will use the software-as-a-service payment model and expects to be live by the fourth quarter of 2019. The organization started looking for a new EHR after learning that the current vendor’s system was not certified to meet requirements of the Promoting Interoperability Program. CPSI’s track record with Oklahoma Spine’s sister facility, Black Hills Surgical Hospital, gave creditability to making the move to the Thrive EHR, which will help the hospital meet reporting requirements and increase physician and patient satisfaction.

• Humber River Hospital, a 656-bed acute care and teaching facility in Toronto, has gone live with an upgrade to the next-generation Expanse electronic health record of Meditech. Humber River, one of many Meditech clients that have upgraded, serves more than 850,000 people. The hospital also went live with the vendor’s emergency department and physician documentation software.

• Hendrick Health System, based in Abilene, Texas, with a 500-bed hospital and serving a 24-county region, has expanded an existing relationship with Allscripts with a large suite of software to create a single integrated clinical and financial patient record. The software includes ambulatory care, financial management, health information management, abstracting, knowledge-based charting, consumer and patient engagement platform, identity management and patient flow applications. Brad Holland, CEO at Hendrick Health System, says the tight integration will lead to improved outcomes for patients and the organization.

• Humboldt General Hospital, a critical access facility serving north-central Nevada, has selected the Cerner electronic health record to improve the patient experience and outcomes, as Cerner continues to aggressively target small hospitals with ways to make a top-line EHR affordable. The contract includes a new online patient portal to enable patients to securely message providers, schedule appointments, view and settle bills, and access health history. The hospital serves the community of Winnemucca with more than 20,000 residents and offers skilled nursing, residential care and memory care communities. The EHR will be installed this year.