Claimocity Case Study
Analyzing Charge Capture Values
Standalone charge capture software saturates the market, offering specialized efficiency but lacking comprehensive revenue cycle intelligence, potentially leading to revenue loss and overlooked billing complexities.
Summary of Findings
Standalone charge capture software options such as pMD, MDCoder, Ingenious Med, PatientKeeper, SwiftPay MD, NueMD, Medaptus, DrRounds, and others saturate the mobile medical app market. Often referred to as one dimensional or flat software options because of their singular and specialized focus on the charge capture segment of the RCM process, these software options perform very specific services efficiently (measured by time efficiency) but the associated cost comes in the form of lower revenue efficiency. As a stand-alone service they are missing the end to end revenue cycle intelligence necessary to drive higher efficiency models and larger bottom line revenue totals. The piecemeal approach to billing generates gray area sticky points and A/R bottlenecks that slip under the radar for busy doctors and practices who do not even realize there is an issue. Stand-alone charge capture software users lose an average of 10-16% of revenue to expired claims that needed a higher level of end to end billing expertise to finesse or push these charges through to the payout.
Participant Details
Top 3 Software Options Compared: IngeniousMed, pMD, MDCoder
Specialty: Hospitalist Group
Practice Name: Withheld Pending Publication Approval
Practice Location: Nevada
Practice Size: 11 Physicians
Primary Case Study Category: Revenue Efficiency
Secondary Case Study Category: Specialty – Hospitalist
Study Summary
A significant portion of the medical software market are stand alone charge capture software options, primarily mobile, that are often bundled with one or two other features such as advanced analytics or HIPAA compliant secure messaging, but how effective are these options compared to the native functionalities of charge capture built into an end-to-end billing process.
Evaluative Situation
Many providers and practices use separate software options, services, and companies for different aspects of their billing, practice management, charge capture, EHR, compensation management, accounting, and other workflow and productivity needs. The evaluative situation here is an exploratory look at whether multiple specialized and segmented options can perform better than a single end-to-end solution. This is a broad subject with a huge array of variables so for this study, we are less inclined to draw sweeping conclusions regardless of the data, but more get a general feel for what the top rated options on the market are capable of and how the pros and cons compare to Claimocity.
Expectations
The expectations follow the thought process of too many cooks in the kitchen, as our data has found in the past that with each integration, software, service, company a practice or provider uses, there is a correlated efficiency loss, which is one of the premises for developing the Claimocity all-in-one software solution in the first place. An intelligent end-to-end process is expected to perform better than several stand alone products and processes pieced together into a single billing and practice management chain.
Process
To begin, we created a comprehensive list of all the practice management, mobile billing, charge capture, and relevant software options in the market and then narrowed them down to only the ones applicable to doctors on the go. We then analyzed the various reviews and rating engines and aggregated the scores to give each product an average score across all sources. Since we did not have the bandwidth to evaluate more than four options (including Claimocity), we selected the top three options by rating on the assumption that evaluating the best on the market would provide the most insightful results. All three options ended up being stand alone mobile charge capture software options, validating our assumption that these represent the current state of the market. This particular cost-benefit analysis utilizes an 11 physician hospitalist group that has more than 1 year of familiarity with each of the software options tested in this case study. We asked them to allow our team to use each of the four software options for 60 days while our quality control, billing, and operations teams closely monitored their A/R process, billing, and daily workflow levels. In each case, we disregarded the first 30 days to reduce any implementation or adjustment issues and just compared the final 30 days for each option.
RESULTS
- The top three stand alone charge capture services maintain high levels of workflow efficiency, showing little to no drop off in time efficiency or number of average encounters.
- In all three competitor cases, revenue efficiency showed a significant drop off of between 10-16% due to bottlenecks and sticky points in the gray areas between the responsibilities of the capture process and the A/R process that the stand alone options lacked the audit capabilities or billing intelligence to catch or make the practice aware of. As these claims were outside of the normal workflow of the billing side, they ended up getting lost in gaps in the piecemeal process.
- Additionally, the stand alone software options resulted in coding efficiency decreases between 8-13% with no means of correction possible due to the separation of coding/charge capture from the claims processing and A/R side of the billing.