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National Ambulatory Hernia Institute
FileMaker Pro Taken to New Levels
Case Studies

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FileMaker Integration at a High Level!
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Patient Billing and Transaction Automation
Patient Scheduling and Calendaring in FileMaker Pro
Document and Electronic Media Management (EMR)
iPad-ization Mobilizing Patient Information

Key Automation and Efficiency Objectives
The National Ambulatory Hernia Institute's (NAHI) Operations Manager, Vicky Vansurksum, was challenged with managing multiple offices, physicians, patient flow of care, scheduling, complex billing for both workers comp and private patients, Insurance company and adjuster management, patient chart and electronic media management (EMR), data auditing, mobilized accessibility and remote access, PC and Mac compatibility along with many other informational related challenges.
Assessment
Desiring to improve medical outcomes and increase business efficiencies with highly complex and sophisticated requirements NAHI contacted ACG Technologies to help coordinate and develop a solution that could meet all their needs. Vicky Vansurksum, Operations Manager at NAHI, worked closely with Chris Quinn, president of ACG Technologies, to review their current business processes and in-efficiencies. Collaborating together, they were able to identify and solve all their challenges including a fully functional QuickBooks integration eliminating the need for any double entry.
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Patient Detail View
Working together, Chris and Vicky set out to identify specific areas of opportunity where both business efficiencies and patient healthcare could be significantly improved.
Key focus areas were patient billing and transaction management, scheduling and mobilizing patient information. Patient billing and payment transactions was a laborious effort that required one and a half full time administrators three weeks per month to invoice and track many difficult and different types of billing, payment and collection efforts.
"Patient billing and payment transactions were a laborious effort that required one and a half full time administrators three weeks a month. ACG Technologies automated our
process down to four hours."
Vicky VanSurksum

Developing an Integrated and Multi-Faceted FileMaker Pro Database Solution
1. Patient Billing and Transaction Automation
Through Chris and Vicky's careful process analysis and targeted integration of FileMaker Pro software development, the billing and payment process was significantly reduced to less than four hours a month and now only requires one administrator. ACG Technologies also integrated FileMaker Pro to QuickBooks to effortlessly push all FileMaker Pro transactions directly into QuickBooks.
Billing and Payment requirement challenges had to include:
  • Creating a Custom Procedures library with unlimited configurable charges capability
  • One click submission of a procedure with multiple charges to a patient record
  • Detailed and editable CPT charges
  • HICFA billing for pre-printed and non-preprinted Forms
  • Billing for multiple office locations
  • Professional and facility payment tracking and check printing
  • Contract integration for professionals and facilities
  • Payment selection from multiple bank accounts
  • Payments to practice partners and other professionals
  • Multiple application of different adjustments and discounts e.g. PPO's
  • Appeal's Process for insurance payment tracking
  • Unlimited payments received on a charge
  • Unlimited payments to professionals and facilities per charge
  • A/R tracking and collection follow up
  • Collection effort tracking log
  • Professional payment and ledger transaction

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Automating Payments Received and Payment Processing: To allow for many billing variables ACG Technologies ' experienced developers created a billing dashboard that conditionally filters by only Professionals and Facilities that are currently owed money, and only charges with remaining balances. As the administrator applies and pays the professionals/facilities the charges falls off the screen leaving only remaining unpaid charges to process. This filtered process allows the administrator to quickly process their accounts receivables and payables and not have to continually search for outstanding charges.
Automated payment distribution, discounts, simple write off and contract integration has sharply reduced the process for applying payments received and owed across many charges with a single click of the mouse. All accounting is managed within the FileMaker Pro database including the printing and synchronization of checks between FileMaker Pro and QuickBooks. Once transactions have been processed FileMaker Pro then pushes all newly processed transactions to QuickBooks via the custom data connector developed by ACG.
As outstanding charges are paid by the insurance company and if the paid amount is incorrect or up for dispute, by simply clicking the "Appealed" check box the item is calendared and sets the charge to the appealed status and put into the collection process. The appealed charge is now available in a collection queue for the collections department to begin the appeals process. Because all these charges are tightly integrated with different departments, errors and lost revenues have been significantly reduced.
Many more integrated and automated procedures have been implemented into the solution in order to reduce inefficiencies, human error, and improve data entry to help ensure correct and accurate data impute and accounting. The administrator also has the ability to toggle between any charge in the receivables/payment dashboard and any patient information they might require during the Accounts Receivables and Accounts Payables process.
2. Scheduling, Medical Records (EMR)/Document Management in FileMaker
Patient Scheduling, Electronic Medical Records (EMR)/Document Management and Actionable Flow of Care
Managing and monitoring Patient Flow of Care was a big concern for Vicky. Her objective was to not only automate this process but also put all the patient information in one place and at the fingertips of her staff. From the patient record, the administrator has instant access to:
  • Patient Detail and Assigned Physician
  • Patient Referral
  • Bill Type and Method
  • Office Location
  • Nurse Case Manager
  • Patient Appointment History
  • Patient Individual Calendar
  • Patient Notes
  • History of Injury
  • Unlimited and Server Based EMR Records
  • Patient HCFA Records
  • Exam Information
  • Prescriptions Data and Electronic Prescription History
  • Patient Family and Personal Insurance Information
  • Patient Charges
  • Web Integrated Map with the Patients Location and Directions to the assigned Clinic or Hospital Location that is Easily Emailed to the Patient
  • Data Auditing that Tracks all Field Changes to a Patient Record
  • Patient Ledger
  • And Much More…

Patient and professional tasks are calendared and with our alerting module, important tasks are not missed. The flexible calendar module is a unique calendar in that it allows you to filter by Professional, location, Patient, and of course by day, week or month. Because of FileMaker Pros excellent plug-in architecture, integrating our calendar to Outlook is easier than ever.
Image 1.5
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The Monthly Calendar view summarizes the types of appointments by day, number, type of event.
The calendar can by viewed by Day, Week, Month and List. All calendar events can be created and filter by patient, professional, staff and referrer and is conditional by name and type. The calendar is extremely flexible with many choices when reviewing or scheduling any activity.
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Filter the daily schedule by all or single professional, patients, staff or referrer views.
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The Appointments Dialog is easy to use and utilizes conditional menus for filtered lists making data entry a breeze. .
3. Document and Electronic Media Management (EMR)
EMR and Document Management Module
The full featured EMR Document Management Module was designed to easily add any digital media from PDF's, Word Documents, Spreadsheets, and Video etc. to any patient specific record. Another advantage is that all digital media is located to a single server location within a patient directory for multiple reasons. The advantage of localizing the digital media in one location on a secure server is as follows:
  • Media Security – All patient records are organized at the server in one location for security and backup management
  • PAll EMR and attached media are NOT embedded in the database but rather organized and located in one directory location
  • The administrator can open any digital media right from the FileMaker Pro "Records" portal in the application it was developed in
  • Organizing patient related digital content right on the patient record makes chart and other media easily available to the Administrator
  • Completely automated EMR and document management is secure, attached directly to the patient record, not embedded into the record unburdening the database size and performance, open any media right from the patient record portal

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4. iPad-ization Mobilizing Patient Information
iPad-ization of the FileMaker Medical Database
Mobilizing the NAHI Medical Database was a breeze with FileMaker's Go for the iPad and iPhone. The new FileMaker Go for the iPad application is simple to deploy, just go to the online Apple App Store, download the FileMaker Go app and open it on your iPad, connect to your local network and open the database right to your iPad or iPhone. Yes, it's that easy.
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In our initial testing, "FileMaker Go" performed well beyond our expectations and gives our doctors the ability to carry critical patient information with them right into the exam room. Accessing any patient record is easy, quick and convenient. Having that information readily available improves patient care. FileMaker iPad Go makes mobilizing patient data simple and without the high cost of developing a separate unique.

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