46 / CAP TODAY May 2009 Billing/accounts receivable systems · Tabulation does not represent an endorsement by the College of American Pathologists. Billing/accounts receivable systems

Billing/accounts receivable systems

46 / CAP TODAY May 2009

Tabulation does not represent an endorsement by the College of American Pathologists.

May 2009 Page 46

Part 1 of 9 Cerner Corp.Jen Cisar [email protected] Rockcreek ParkwayKansas City, MO 64117816-201-1024

See accompanying article on page 42 www.cerner.com

Name of billing/accounts receivable system Cerner Millennium ProFit

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 2000/March 2009Last major release of this B/AR system February 2009

No. of contracts for sites operating B/AR system 35• Contracts signed since March 2008 4• Contracts gone live since March 2008 3No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 55

No. of inpatient invoices handled by installed sites annually —No. of outpatient requisitions handled by installed sites annually —Largest No. of hospitals/pathologists serviced by one B/AR system —Percentage of installations that are stand-alone B/AR systems 0

Staff to develop/install and support/other***• In entire company 7,300+ total• In B/AR systems division only 36/35 for support/7

No. of user workstations in sites operating B/AR system —• Average No. of user workstations in sites operating B/AR system —

Server platform Compaq, IBM RS/6000PC/workstation platform Intel PentiumInnovative peripherals image storageOperating system(s) Open VMS, AIX, UnixDatabases and tools used Oracle

Information systems/software interfaces MedAssets, Relay Health, Practice Insight, Emdeon, Oracle EBS, Lawson, others

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system installed• 1500 claim form generation (paper version) installed• UB-92 claim form generation (paper version) installed• Client invoices installed• Patient invoices installed• Reprints of above on demand installed• Key indicator tracking (online view of site-assigned key indicators) available first quarter 2010• Test profile vs. component billing not available• Medical-necessity screening for Medicare installed• Professional component billing installed• Auto delete of nonbillable procedures not available• Technical component only installed• Retain demographic data, repeating patients installed• Accounts and patient payment posting installed• Accounts receivable system installed• Management or marketing reports installed• Automatic balance billing to patients installed• Capitation billing plus billable tests not available• Utilization reports for managed care —• Global charges for lab tests installed• Unlimited user-defined fee schedules installed• Track financial classes installed• Allow open-item accounting (each line item on bill can be handled separately) installed• User report writer installed• Collection agency system installed• User-configurable dunning installed• Client services or call tracking module not available• Rules-based processing or claims scrubbing installed• Multi-lab or multi-company processing installed• Support all HIPAA transaction sets installed

B/ AR system supports electronic data interchange with third-party payers and claims clearinghouses?

yes

• Functions offered claims, payments, eligibility, referral/authorization• Third-party payers and claims clearinghouses with which system is interfaced — (will interface with any clearinghouse and payer)• Type of claim data generation UB-92, 1500, UB-04Third-party rules and coding updates supported by system Medical Necessity, Info-X, CPT-4, ICD-9

Complete ASP solution for B/AR system? yes• Method of charging for ASP service fixed fee• Client software required requires that software be installed on a client PC• ASP information conduit operates over the Internet• Client contracts supported from data center not operated by client 130+• How data center is operated by vendor

Indexed field in each test definition for LOINC code? noProvide LOINC dictionary for each new installation? no

Journaling?/source code? yes/noCost (hardware/software/installation and training/monthly maintenance)• Smallest stand-alone B/AR system —• Largest stand-alone B/AR system —• Smallest B/AR configuration for integrated lab system —• Largest B/AR configuration for integrated lab system —

Distinguishing features (supplied by vendor)

* B/AR=billing/accounts receivable** HL=hospital labs, IL=independent labs, PP=pathology practices (only surgical pathology/cytology

services), PO=physician offices, OL=other U.S. locations, FI=foreign installations*** other=sales, marketing, administration, other company functionsNote: a dash in lieu of an answer means company did not answer question or question is not applicable

• improves cash flow and reduces claims denials• simplifies billing statements and improves customer service• streamlines business operations and reduces labor costs

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May 2009 Page 48

Part 2 of 9 Computer Service & Support Cortex Medical Management SystemsJim O'Neill [email protected] Stan Gordon [email protected] New Rd., Building E6 2107 Elliott Ave., Suite 201Linwood, NJ 08221 Seattle, WA 98121800-336-4277 206-812-6981

See accompanying article on page 42 www.csslis.com www.cortexmed.com

Name of billing/accounts receivable system AR-2000 Lab Billing System Cortex Medical Billing

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1980/January 2009 1987/January 2009Last major release of this B/AR system December 2008 October 2008

No. of contracts for sites operating B/AR system 65 26• Contracts signed since March 2008 5 5• Contracts gone live since March 2008 3 5No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 62 (0/61/0/0/0/1 in Canada) 26 (1/1/23/0/1 ER billing service/0)

No. of inpatient invoices handled by installed sites annually 25,000–2,000,000 (avg., 750,000) 0No. of outpatient requisitions handled by installed sites annually 25,000–2,000,000 (avg., 750,000) 2,000–100,000+ (avg., 67,500)Largest No. of hospitals/pathologists serviced by one B/AR system — 4/15Percentage of installations that are stand-alone B/AR systems 60% 15%

Staff to develop/install and support/other***• In entire company 6/6/3 4/5/4• In B/AR systems division only 2/2/1 4/5/4

No. of user workstations in sites operating B/AR system 2–50 1–26 • Average No. of user workstations in sites operating B/AR system 10 9

Server platform IBM RS/6000 Windows 2000, XP, 2003PC/workstation platform Windows on PC Windows 2000, XP, 2003, VistaInnovative peripherals — —Operating system(s) AIX 6.0, Linux Windows XP, 2003, VistaDatabases and tools used LabBase Microsoft SQL server, Dynamics SL

Information systems/software interfaces Orchard, Allscripts, Aspyra, ClinLab, McKesson, GE, Emdeon, ADSC Cortex, Impac, SCC Soft Computer, Aspyra, Cerner

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system 100% 98%• 1500 claim form generation (paper version) 100% 100%• UB-92 claim form generation (paper version) — 0• Client invoices 100% 75%• Patient invoices 100% 100%• Reprints of above on demand 100% 100%• Key indicator tracking (online view of site-assigned key indicators) 100% 100%• Test profile vs. component billing 100% 98%• Medical-necessity screening for Medicare 100% 0• Professional component billing 20% 75%• Auto delete of nonbillable procedures 100% 0• Technical component only 20% 75%• Retain demographic data, repeating patients 100% 100%• Accounts and patient payment posting 100% 100%• Accounts receivable system 100% 100%• Management or marketing reports 100% 100%• Automatic balance billing to patients 100% 100%• Capitation billing plus billable tests 25% installed• Utilization reports for managed care 100% 100%• Global charges for lab tests 100% 100%• Unlimited user-defined fee schedules 100% 100%• Track financial classes 100% 100%• Allow open-item accounting (each line item on bill can be handled separately) 100% 100%• User report writer 75% 100%• Collection agency system 65% 100%• User-configurable dunning 100% 100%• Client services or call tracking module available third quarter 2009 not available• Rules-based processing or claims scrubbing 100% 100%• Multi-lab or multi-company processing 100% 100%• Support all HIPAA transaction sets 100% —


yes yes

• Functions offered secure Web portal claims, statements, payments• Third-party payers and claims clearinghouses with which system is interfaced Capario Zirmed, McKesson, Office Ally, direct to Medicare, Blue Cross Blue Shield

• Type of claim data generation 1500 1500Third-party rules and coding updates supported by system — —

Complete ASP solution for B/AR system? no yes• Method of charging for ASP service — fixed fee• Client software required — browser based, terminal services• ASP information conduit — operates over the Internet, requires use of a VPN or other dedicated

connection• Client contracts supported from data center not operated by client — 4• How data center is operated — by a third party (Adhost)

Indexed field in each test definition for LOINC code? yes noProvide LOINC dictionary for each new installation? no no

Journaling?/source code? yes/yes yes/escrowCost (hardware/software/installation and training/monthly maintenance)• Smallest stand-alone B/AR system $5k/$10k/$5k/$0.25k $—/0 (ASP)/$7k/$0.4k• Largest stand-alone B/AR system $15k/$75k/$15k/$1.5k $—/$200k/$42k/$3.6k• Smallest B/AR configuration for integrated lab system $5k/$10k/$5k/$0.25k $—/0/$7k/$0.4k• Largest B/AR configuration for integrated lab system $15k/$75k/$5k/$1.5k $—/$200k/$42k/$3.6k




• electronic Medicare claims (ANSI v. 4010) and transmission to over 2,100 commercial insurance carriers and each state’s Medicare plan; electronic Medicare, Medicaid, and commercial payment posting and reconciliation

• multiple fee schedules and flexible, automatic discounts by client• optional nursing home and Medicare Part A module available; full

financial reporting suite with commission reports; full suite of statistical reports

• one account per patient spanning multiple visits and multiple insurances

• all detailed data — charges, payments, and adjustments — kept online forever

• more than 130 Crystal Reports with source code




May 2009 Page 50

Part 3 of 9 Healthvision Solutions (formerly MediSolution) Hex Laboratory SystemsJim Schroeder [email protected] Susan Bollinger [email protected] Riverside Drive, Suite 300 1042B El Camino Real, Suite 308Irving, TX 75039 Encinitas, CA 92024480-834-0936 800-729-2085

See accompanying article on page 42 www.healthvision.com www.hexlab.com

Name of billing/accounts receivable system MediAR (formerly Revenue Cycle Management) Lab/Hex Billing & Cash Management

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1975/December 2008 1983/March 2009Last major release of this B/AR system December 2008 January 2009

No. of contracts for sites operating B/AR system 50 37• Contracts signed since March 2008 3 2• Contracts gone live since March 2008 3 2No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 102 (2/6/0/3/0/91 in Canada) 37 (0/33/1/0/3 veterinary, health department/0)

No. of inpatient invoices handled by installed sites annually 1,500–145,000 (avg., 40,000) —No. of outpatient requisitions handled by installed sites annually 1,500–5,200,000 (avg., 300,000) 10,000–1,300,000 (avg., 200,000)Largest No. of hospitals/pathologists serviced by one B/AR system 47/0 —/20Percentage of installations that are stand-alone B/AR systems 75% 2%

Staff to develop/install and support/other***• In entire company 99/159/59 4/9/2• In B/AR systems division only — —

No. of user workstations in sites operating B/AR system 2–200 3–64• Average No. of user workstations in sites operating B/AR system 25 16

Server platform any Windows or Unix-based servers Intel open platformPC/workstation platform Windows 2000, NT, XP, Vista WindowsInnovative peripherals bar-code readers, image scanners document scanningOperating system(s) Unix, Linux, Windows LinuxDatabases and tools used Oracle, Oracle Tools Thoroughbred Basic, 4GL, SQL

Information systems/software interfaces Cerner, Allscripts, Eclipsys, Clinibase, McKesson, Wyndgate Technologies, Orchard, Aspyra, Technidata, Meditech, Healthvision, proprietary

Allscripts, Cerner, CPSI, Experior, McKesson, Hearts, Medinformatix, MediPro, Medic, Medical Manager, PMSI, Practice Partners, Siemens, Sunquest, 4Medica, Emdeon, GE Healthcare, others

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system 100% 100%• 1500 claim form generation (paper version) 100% 100%• UB-92 claim form generation (paper version) 20% 100%• Client invoices 100% 100%• Patient invoices 100% 100%• Reprints of above on demand 100% 100%• Key indicator tracking (online view of site-assigned key indicators) 5% 100%• Test profile vs. component billing 80% 100%• Medical-necessity screening for Medicare 40% 100%• Professional component billing 100% 100%• Auto delete of nonbillable procedures 100% 100%• Technical component only installed 100%• Retain demographic data, repeating patients 100% 100%• Accounts and patient payment posting 100% 100%• Accounts receivable system 100% 100%• Management or marketing reports installed 100%• Automatic balance billing to patients 100% 100%• Capitation billing plus billable tests 60% 100%• Utilization reports for managed care installed 100%• Global charges for lab tests 100% 100%• Unlimited user-defined fee schedules 100% 100%• Track financial classes 100% 100%• Allow open-item accounting (each line item on bill can be handled separately) 100% 100%• User report writer 100% 100%• Collection agency system 100% 100%• User-configurable dunning 100% 100%• Client services or call tracking module 100% 100%• Rules-based processing or claims scrubbing 100% 100%• Multi-lab or multi-company processing 100% 100%• Support all HIPAA transaction sets 100% 100%


yes yes

• Functions offered insurance inquiry/response (270/271), claims primary and all secondary (837 I/P), claims inquiry/response (276/277), remittances (835)

claims, remittance, rebill, acknowledgement reports, medical necessity, eligibility, financial reports

• Third-party payers and claims clearinghouses with which system is interfaced Medicares, Medicaids, Highmark Blue Cross Blue Shield, Emdeon, Capario, Availity, THIN, McKesson, Post-N-Track, others

Availity, Anthem, Capario, RealMed, THIN, Medicare, states’ Medicaid

• Type of claim data generation UB-92, 1500 UB-92, 1500, ANSI 4010Third-party rules and coding updates supported by system 3M, CodeMap CodeMap, MCF compliance, Info-X, ADP, Ingenix, any tab-delimited file

Complete ASP solution for B/AR system? yes no• Method of charging for ASP service fixed fee or transaction based – user’s choice —• Client software required requires that software be installed on a client PC —• ASP information conduit requires use of a VPN or other dedicated connection —• Client contracts supported from data center not operated by client 0 —• How data center is operated by vendor —

Indexed field in each test definition for LOINC code? yes yesProvide LOINC dictionary for each new installation? no no

Journaling?/source code? yes/escrow yes/escrowCost (hardware/software/installation and training/monthly maintenance)• Smallest stand-alone B/AR system — $5k/$7.5k/$5k/$0.2k• Largest stand-alone B/AR system — $25k/$65k/$25k/$1.25k• Smallest B/AR configuration for integrated lab system — $1k/$7.5k/$2.5k/$0.1k• Largest B/AR configuration for integrated lab system — $10k/$35k/$5k/$0.5k




• user-configurable rules-based system design • exception-based processing integrated with online workflow

management• automated denial management integrated with online workflow

• extensive flexibility with custom invoices and statements for clients and patients; alternate pricing schedules and other user-definable features

• medical necessity with ABN printing and other tools to track missing information to assure correct billing for fast payment

• features that reflect experience in all lab markets, such as nursing homes, independent labs, specialty labs, clinics, and hospitals




May 2009 Page 52

Part 4 of 9 McKesson Medical Information Technology (Meditech)Joseph R. Stabile [email protected] Paul Berthiaume [email protected] 5995 Windward Parkway Meditech CircleAlpharetta, GA 30005 Westwood, MA 02090404-338-6000 781-821-3000

See accompanying article on page 42 www.mckesson.com/laboratory www.meditech.com

Name of billing/accounts receivable system Horizon Lab Financials (formerly Telcor Billing Information System) Meditech Revenue Cycle–client/server

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 2006/March 2009 1977/March 2009Last major release of this B/AR system May 2008 April 2008

No. of contracts for sites operating B/AR system 1 do not track• Contracts signed since March 2008 2 do not track• Contracts gone live since March 2008 1 do not trackNo. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 2 (2/0/0/0/0/0) 391

No. of inpatient invoices handled by installed sites annually — do not trackNo. of outpatient requisitions handled by installed sites annually — do not trackLargest No. of hospitals/pathologists serviced by one B/AR system 2/— do not trackPercentage of installations that are stand-alone B/AR systems 0 do not track

Staff to develop/install and support/other***• In entire company 32,000 total 642/1,597/507• In B/AR systems division only 23 total 48/103/8

No. of user workstations in sites operating B/AR system 4–50 do not track• Average No. of user workstations in sites operating B/AR system 20 do not track

Server platform Intel, Windows Hewlett-Packard, Dell, EMC, IBMPC/workstation platform any standard Windows any PC using Windows 2000 Professional or higherInnovative peripherals integrated fax, PDF, e-mail, Excel export speech recognition, PACS scanning, identity management, patient

monitoringOperating system(s) Windows Windows 2000, XP Professional, Vista on PCs; Windows 2000, 2003

on serverDatabases and tools used SQL server, Crystal Developer Meditech database management system

Information systems/software interfaces McKesson Lawson, Lynx

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system installed installed • 1500 claim form generation (paper version) installed installed • UB-92 claim form generation (paper version) installed installed • Client invoices installed installed • Patient invoices installed installed • Reprints of above on demand installed installed • Key indicator tracking (online view of site-assigned key indicators) installed installed • Test profile vs. component billing installed installed • Medical-necessity screening for Medicare installed installed • Professional component billing installed installed • Auto delete of nonbillable procedures installed installed • Technical component only installed installed • Retain demographic data, repeating patients installed installed • Accounts and patient payment posting installed installed • Accounts receivable system installed 100%• Management or marketing reports installed installed • Automatic balance billing to patients installed installed • Capitation billing plus billable tests installed installed • Utilization reports for managed care installed installed • Global charges for lab tests installed installed • Unlimited user-defined fee schedules installed installed • Track financial classes installed installed • Allow open-item accounting (each line item on bill can be handled separately) installed installed • User report writer installed installed • Collection agency system installed installed • User-configurable dunning installed installed • Client services or call tracking module available in summer 2009 installed • Rules-based processing or claims scrubbing installed installed • Multi-lab or multi-company processing installed installed • Support all HIPAA transaction sets installed installed


yes yes

• Functions offered paper and electronic claims submission, payments, eligibility, automatic reprints and rebills, customizable invoice

ANSI 278 for authorization requests, ANSI 837 for institutional claims, ANSI 837 for professional claims, ANSI 835 for electronic payment

• Third-party payers and claims clearinghouses with which system is interfaced — (can interface with any clearinghouse) HDX, NEHEN, Veriquest, SSI, Emdeon, MedUnite, Quovadx, others• Type of claim data generation UB-92, 1500 UB-92, 1500Third-party rules and coding updates supported by system CCI LCD/NCDs, CPT, NPI, ICD-9 3M, HANYS, HSS, IRP, QuadraMed

Complete ASP solution for B/AR system? yes no• Method of charging for ASP service transaction based —• Client software required browser based —• ASP information conduit operates over the Internet —• Client contracts supported from data center not operated by client 0 —• How data center is operated by vendor —

Indexed field in each test definition for LOINC code? yes yesProvide LOINC dictionary for each new installation? no yes

Journaling?/source code? yes/escrow yes/yesCost (hardware/software/installation and training/monthly maintenance) — —• Smallest stand-alone B/AR system — —• Largest stand-alone B/AR system — —• Smallest B/AR configuration for integrated lab system — —• Largest B/AR configuration for integrated lab system — —




• designed for the workflow and business of outreach and reference laboratories

• extensive decision support and business management tools, profitability analysis, utilization inquiry, revenue inquiry

• uses the latest technology with unparalleled data access

• 39 years of experience in developing and implementing health care software

• maximum revenue efficiency through an integrated revenue cycle and laboratory information system

• accurate, up-to-the-minute patient data and charge information




May 2009 Page 54

Part 5 of 9 Medical Information Technology (Meditech) Medical Information Technology (Meditech)Paul Berthiaume [email protected] Paul Berthiaume [email protected] Meditech Circle Meditech CircleWestwood, MA 02090 Westwood, MA 02090781-821-3000 781-821-3000

See accompanying article on page 42 www.meditech.com www.meditech.com

Name of billing/accounts receivable system Meditech Revenue Cycle–Magic Meditech Revenue Cycle–6.0

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1977/March 2009 1977/— †

Last major release of this B/AR system March 2009 April 2008

No. of contracts for sites operating B/AR system do not track —†

• Contracts signed since March 2008 do not track do not track• Contracts gone live since March 2008 do not track do not trackNo. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 581 —†

No. of inpatient invoices handled by installed sites annually do not track do not trackNo. of outpatient requisitions handled by installed sites annually do not track do not trackLargest No. of hospitals/pathologists serviced by one B/AR system do not track do not trackPercentage of installations that are stand-alone B/AR systems do not track do not track

Staff to develop/install and support/other***• In entire company 642/1,597/507 642/1,597/507• In B/AR systems division only 48/103/8 48/103/8

No. of user workstations in sites operating B/AR system do not track do not track• Average No. of user workstations in sites operating B/AR system do not track do not track

Server platform Hewlett-Packard, Dell, EMC, IBM Hewlett-Packard, Dell, EMC, IBMPC/workstation platform any PC using Windows 2000 Professional or higher any PC using Windows 2000 Professional or higherInnovative peripherals speech recognition, PACS scanning, identity management, patient

monitoringimage scanners, EDI interfaces

Operating system(s) Windows 2000, XP Professional, Vista on PCs; Windows 2000, 2003 on server

Windows server 2003 Enterprise x64 Edition or Datacenter 64 Edition

Databases and tools used Meditech database management system Meditech database management system

Information systems/software interfaces Lawson, Lynx Lawson, Lynx

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system installed available but not installed• 1500 claim form generation (paper version) installed available but not installed• UB-92 claim form generation (paper version) installed available but not installed• Client invoices installed available but not installed• Patient invoices installed available but not installed• Reprints of above on demand installed available but not installed• Key indicator tracking (online view of site-assigned key indicators) installed available but not installed• Test profile vs. component billing installed available but not installed• Medical-necessity screening for Medicare installed available but not installed• Professional component billing installed available but not installed• Auto delete of nonbillable procedures installed available but not installed• Technical component only installed available but not installed• Retain demographic data, repeating patients installed available but not installed• Accounts and patient payment posting installed available but not installed• Accounts receivable system 100% available but not installed• Management or marketing reports installed available but not installed• Automatic balance billing to patients installed available but not installed• Capitation billing plus billable tests installed available but not installed• Utilization reports for managed care installed available but not installed• Global charges for lab tests installed available but not installed• Unlimited user-defined fee schedules installed available but not installed• Track financial classes installed available but not installed• Allow open-item accounting (each line item on bill can be handled separately) installed available but not installed• User report writer installed available but not installed• Collection agency system installed available but not installed• User-configurable dunning installed available but not installed• Client services or call tracking module installed available but not installed• Rules-based processing or claims scrubbing installed available but not installed• Multi-lab or multi-company processing installed available but not installed• Support all HIPAA transaction sets installed available but not installed


yes yes

• Functions offered ANSI 278 for authorization requests, ANSI 837 for institutional claims, ANSI 837 for professional claims, ANSI 835 for electronic payment

ANSI 278 for authorization requests, ANSI 837 for institutional claims, ANSI 837 for professional claims, ANSI 835 for electronic payment

• Third-party payers and claims clearinghouses with which system is interfaced HDX, NEHEN, Veriquest, SSI, Emdeon, MedUnite, Quovadx, others HDX, NEHEN, Veriquest, SSI, Emdeon, MedUnite, Quovadx, others• Type of claim data generation UB-92, 1500 UB-92, 1500Third-party rules and coding updates supported by system 3M, HANYS, HSS, IRP, QuadraMed 3M, HANYS, HSS, IRP, QuadraMed

Complete ASP solution for B/AR system? no no• Method of charging for ASP service — —• Client software required — —• ASP information conduit — —• Client contracts supported from data center not operated by client — —• How data center is operated — —

Indexed field in each test definition for LOINC code? yes yesProvide LOINC dictionary for each new installation? yes yes

Journaling?/source code? yes/yes yes/yesCost (hardware/software/installation and training/monthly maintenance)• Smallest stand-alone B/AR system — —• Largest stand-alone B/AR system — —• Smallest B/AR configuration for integrated lab system — —• Largest B/AR configuration for integrated lab system — —










†product is not yet installed but company has contracted for nine licenses representing 20 sites

May 2009 Page 54


May 2009 55 / CAP TODAY


May 2009 Page 55

Part 6 of 9 Multidata Computer Systems Netlims NJ, LLCMichael Slater [email protected] Avi Allerhand [email protected] Broadway, Suite 1010 111 Town Square Place, Suite 700New York, NY 10038 Jersey City, NJ 07310212-967-6700 201-894-5300

See accompanying article on page 42 www.mul.com www.netlims.com

Name of billing/accounts receivable system MultiTech A/R AutoBilling

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1984/2003 2003/February 2009Last major release of this B/AR system September 2008 December 2008

No. of contracts for sites operating B/AR system 36 5• Contracts signed since March 2008 0 0• Contracts gone live since March 2008 0 1No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 36 (2/34/0/0/0/0) 5 (0/4/0/0/0/1 in India)

No. of inpatient invoices handled by installed sites annually 0 —No. of outpatient requisitions handled by installed sites annually 15,000–5,000,000 (avg., 400,000) 120,000–1,200,000 (avg., 580,000)Largest No. of hospitals/pathologists serviced by one B/AR system 1/— —Percentage of installations that are stand-alone B/AR systems 20% 0

Staff to develop/install and support/other***• In entire company 4/5/2 55/37/12• In B/AR systems division only 2/2.5/1 5/7/4

No. of user workstations in sites operating B/AR system 4–100+ 4–30• Average No. of user workstations in sites operating B/AR system 15–20 10

Server platform Intel x86 compatible, most Unix/Linux, HP Alpha open platformPC/workstation platform Intel x86 compatible Windows compatible

Innovative peripherals optional image input/output management images attachment, management

Operating system(s) Windows Vista, XP, 2003; Unix/Linux; HP VMS Windows, Unix

Databases and tools used Caché, Kofax, VSI-Fax any RDBMS

Information systems/software interfaces Siemens, Netsmart, GE Healthcare, Epic, Cerner, Psyche Systems, SCC Soft Computer, Aspyra

Siemens, Cerner, GE Healthcare, Allscripts, SCC Soft Computer

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system 75% 100%• 1500 claim form generation (paper version) 100% 100%• UB-92 claim form generation (paper version) 10% available but not installed• Client invoices 100% 100%• Patient invoices 100% 100%• Reprints of above on demand 100% 100%• Key indicator tracking (online view of site-assigned key indicators) 100% 100%• Test profile vs. component billing 100% 100%• Medical-necessity screening for Medicare 100% 100%• Professional component billing 40% 100%• Auto delete of nonbillable procedures 100% 100%• Technical component only 20% 100%• Retain demographic data, repeating patients 100% 100%• Accounts and patient payment posting 100% 100%• Accounts receivable system 100% 100%• Management or marketing reports 100% 100%• Automatic balance billing to patients 100% 100%• Capitation billing plus billable tests 100% 100%• Utilization reports for managed care 100% 100%• Global charges for lab tests 80% 100%• Unlimited user-defined fee schedules 100% 100%• Track financial classes 100% 100%• Allow open-item accounting (each line item on bill can be handled separately) 100% 100%• User report writer 25% 100%• Collection agency system 100% 100%• User-configurable dunning 100% 100%• Client services or call tracking module 100% 100%• Rules-based processing or claims scrubbing 100% 100%• Multi-lab or multi-company processing 25% available but not installed• Support all HIPAA transaction sets 100% 100%


yes yes

• Functions offered claims, payments, eligibility, service authorization claims, payments, eligibility, rebill, authorization• Third-party payers and claims clearinghouses with which system is interfaced Emdeon Emdeon, NEIC, Express Bill, Zirmed, ProxyMed, others• Type of claim data generation UB-92, 1500 1500, client bill, ANSI 837Third-party rules and coding updates supported by system — 3M, CodeMap, AMA


Indexed field in each test definition for LOINC code? yes yesProvide LOINC dictionary for each new installation? yes no

Journaling?/source code? optional/escrow yes/escrowCost (hardware/software/installation and training/monthly maintenance)• Smallest stand-alone B/AR system $10k/$50k/included/$0.75k —• Largest stand-alone B/AR system $100k/$200k/included/$3k —• Smallest B/AR configuration for integrated lab system $5k/$25k/included/$0.5k $10k/$100k/$25k/$8k• Largest B/AR configuration for integrated lab system $50k/$200k/included/$3k $15k/$200k+/$40k+/$16k+




• designed for commercial labs, with tools to address payer determination and patient eligibility in an environment where most specimens originate in nonlab facilities

• optional integrated imaging/management module for requisitions and other related source documents

• system can be customized for special requirements

• exceptions and denials automatic tools allow easy tracing and handling

• automation — travel algorithm, reinvoice, colliding panels • advanced service to tests logic allows accurate billing




May 2009 Page 56

Part 7 of 9 SCC Soft Computer Schuyler HouseEllie Vahman [email protected] Janet Chennault [email protected] Tech Data Drive 26027 Huntington Lane, Unit FClearwater, FL 33760 Valencia, CA 91355727-789-0100 800-706-0266

See accompanying article on page 42 www.softcomputer.com www.schuylab.com

Name of billing/accounts receivable system SoftA/R SchuyLab

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 1993/2008 1994/March 2009Last major release of this B/AR system 2008 March 2009

No. of contracts for sites operating B/AR system 73 184• Contracts signed since March 2008 5 5• Contracts gone live since March 2008 8 5No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 167 (156/8/1/0/2 large clinic, tribal health/0) 189 (12/134/0/21/17 veterinary/5 in Guam)

No. of inpatient invoices handled by installed sites annually — 100–2,000+No. of outpatient requisitions handled by installed sites annually 1,000,000–6,500,000 (avg., 4,300,000) 25,000–500,000+Largest No. of hospitals/pathologists serviced by one B/AR system 3/7 —Percentage of installations that are stand-alone B/AR systems — 0


No. of user workstations in sites operating B/AR system 3–50 1–60• Average No. of user workstations in sites operating B/AR system 10 6

Server platform IBM System p (AIX) PCPC/workstation platform Microsoft Windows workstations Dell recommended; can use any standard PCInnovative peripherals SoftMedia (integrated document management) voice inputOperating system(s) server: IBM AIX (Unix); workstation: Microsoft Windows Windows XP, VistaDatabases and tools used Oracle Pervasive, Btrieve

Information systems/software interfaces SCC Soft Computer, Cerner, McKesson, Eclipsys, Epic, Siemens, GE Healthcare, IntraNexus, QuadraMed, Meditech, CPSI, others

A4, Acer, Affinity, AMI, Allscripts, CA Linx, Cyber Ren, Healthland, Digital MD, GE Healthcare, McKesson, Siemens, others

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system 100%† 100%• 1500 claim form generation (paper version) 50%† 80%• UB-92 claim form generation (paper version) 2%† —• Client invoices 80%† 100%• Patient invoices 50%† 100%• Reprints of above on demand 50%† 100%• Key indicator tracking (online view of site-assigned key indicators) 100%† installed• Test profile vs. component billing 100%† 100%• Medical-necessity screening for Medicare 100%† 20%• Professional component billing 100%† 100%• Auto delete of nonbillable procedures 100%† 100%• Technical component only 30%† 100%• Retain demographic data, repeating patients 100%† 100%• Accounts and patient payment posting 80%† 100%• Accounts receivable system 50%† 100%• Management or marketing reports 100%† 100%• Automatic balance billing to patients 50%† 100%• Capitation billing plus billable tests installed† not available• Utilization reports for managed care —† not available• Global charges for lab tests 100%† not available• Unlimited user-defined fee schedules 100%† 100%• Track financial classes 50%† 100%• Allow open-item accounting (each line item on bill can be handled separately) 100%† not available• User report writer 100%† not available• Collection agency system 50%† not available• User-configurable dunning 50%† not available• Client services or call tracking module available through vendor’s general LIS or third party† not available• Rules-based processing or claims scrubbing 100%† not available• Multi-lab or multi-company processing 2%† not available• Support all HIPAA transaction sets 50%† not available


yes yes

• Functions offered claims, payments, secondary claims, acknowledgements claims, rebill, remittance • Third-party payers and claims clearinghouses with which system is interfaced Medicare, Blue Cross Blue Shield, Quadax, ProxyMed, MVP, Emdeon,

Zirmed, Gateway EDI, eProvider Solutions, othersOffice Ally, ProxyMed, Palmetto, Capario

• Type of claim data generation UB-92, 1500, 837 Professional and Institutional 1500Third-party rules and coding updates supported by system Quadax, 3M (Info-X) CodeMap



Journaling?/source code? yes/escrow no/escrowCost (hardware/software/installation and training/monthly maintenance)• Smallest stand-alone B/AR system $30k/$30k/$40k/$2k —• Largest stand-alone B/AR system $200k/$500k/$100k/$10k —• Smallest B/AR configuration for integrated lab system 0/$30k/$40k/$2k $1k/$5k/$1.5k/1% of purchase price• Largest B/AR configuration for integrated lab system 0/$500k/$100k/$10k $2k/$30k/$1.5k/1% of purchase price




• unlimited multi-tiered pricing, unlimited payer rules, carve-outs, billing edits, with full A/R functionality, centralized billing for multi-site, multi-company institutions

• modular product offering that can be tailored to accommodate many types of laboratory environments

• integrated with SCC SoftLab LIS and does not require additional servers; set-up/implementation hours required are greatly reduced; less FTE hours to build and maintain

† based on number of contracts, not sites

• direct Medicare and Medicaid billing in all regions of the United States

• reasonable prices with on-site training• full integration with LIS




May 2009 Page 58

Part 8 of 9 Seacoast Laboratory Data Systems Sunquest Information SystemsJim Whitehurst [email protected] Elinore Craig [email protected] New Hampshire Ave., Suite 140 250 S. Williams Blvd.Portsmouth, NH 03801 Tucson, AZ 85711603-431-4114 877-239-6337

See accompanying article on page 42 www.sldsi.com www.sunquestinfo.com

Name of billing/accounts receivable system SurroundLab AR Sunquest Clinical Financial (formerly Misys Clinical Financial)

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 2001/February 2009 1985/2008Last major release of this B/AR system November 2008 2008

No. of contracts for sites operating B/AR system 60 81• Contracts signed since March 2008 7 0• Contracts gone live since March 2008 5 0No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 67 (4/56/7/0/0/0) 225 (41/153/31/0/0/0)

No. of inpatient invoices handled by installed sites annually — 12,000 maximum (avg., 8,000)No. of outpatient requisitions handled by installed sites annually 1,200–3,000,000 (avg., 900,000) 5,000–4,000,000 (avg., 250,000)Largest No. of hospitals/pathologists serviced by one B/AR system —/8 8/45Percentage of installations that are stand-alone B/AR systems 40% —

Staff to develop/install and support/other***• In entire company 15/25/10 —• In B/AR systems division only 8/15/5 —

No. of user workstations in sites operating B/AR system 4–100+ 5–125• Average No. of user workstations in sites operating B/AR system 20 35

Server platform Intel x86 IBM, HPPC/workstation platform — Dell, HPInnovative peripherals digital fax —Operating system(s) Windows, Linux AIX, HP-UXDatabases and tools used Caché, M-21 Caché

Information systems/software interfaces — Sunquest, Cerner, Siemens, McKesson, Epic, Eclipsys, SCC Soft Computer, GE Healthcare, LabCorp, Impac, Meditech, others

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system 100% 100%• 1500 claim form generation (paper version) 100% 95%• UB-92 claim form generation (paper version) 30% 10%• Client invoices 100% 100%• Patient invoices 100% 100%• Reprints of above on demand 100% 100%• Key indicator tracking (online view of site-assigned key indicators) 100% 100%• Test profile vs. component billing 100% 100%• Medical-necessity screening for Medicare 100% 95%• Professional component billing 40% 95%• Auto delete of nonbillable procedures 100% 100%• Technical component only 40% 90%• Retain demographic data, repeating patients 100% 100%• Accounts and patient payment posting 100% 100%• Accounts receivable system 100% 100%• Management or marketing reports 100% 100%• Automatic balance billing to patients 100% 90%• Capitation billing plus billable tests 20% 20%• Utilization reports for managed care 30% 100%• Global charges for lab tests 100% 90%• Unlimited user-defined fee schedules 100% 100%• Track financial classes 100% 100%• Allow open-item accounting (each line item on bill can be handled separately) 100% 100%• User report writer installed 100%• Collection agency system installed 100%• User-configurable dunning 100% 100%• Client services or call tracking module 100% available through vendor’s general LIS or via third party• Rules-based processing or claims scrubbing 100% 100%• Multi-lab or multi-company processing 100% 100%• Support all HIPAA transaction sets 100% 100%


yes yes

• Functions offered claims, payments, eligibility submission, remittance• Third-party payers and claims clearinghouses with which system is interfaced many Per-Sé, Emdeon, Cydata, NEIC, Quadex, Regence, Medical Manager of

Ohio, others• Type of claim data generation UB-92, 1500 UB-92, 1500, customThird-party rules and coding updates supported by system CodeMap 3M


Indexed field in each test definition for LOINC code? yes noProvide LOINC dictionary for each new installation? no no

Journaling?/source code? yes/escrow yes/escrowCost (hardware/software/installation and training/monthly maintenance)• Smallest stand-alone B/AR system $10k/$50k/$10k/$1k —• Largest stand-alone B/AR system $40k/$300k/$50k/— —• Smallest B/AR configuration for integrated lab system — —• Largest B/AR configuration for integrated lab system — —




• designed exclusively for the commercial laboratory• real-time billing and accounts receivable data • complete access to data via ODBC connection

• modular implementation scales from start-up, client-only invoicing to full-scale insurance billing and accounts payable

• provides a seamless interface to leading LIS applications with extensive management-analysis capabilities

• extensive validation prior to claims submission reduces claim rejection rate

May 2009 Page 58


May 2009 59 / CAP TODAY


May 2009 Page 59

Part 9 of 9 Telcor XifinMitch Fry Bill Taylor [email protected] A St. 3394 Carmel Mountain Rd., Suite 200Lincoln, NE 68506 San Diego, CA 92121402-489-1207 858-436-2995

See accompanying article on page 42 www.telcor.com www.xifin.com

Name of billing/accounts receivable system Billing Information System Xifin Revenue Cycle Management

First ever/most recent B/AR* system installation (based on March 2009 survey deadline) 2004/February 2009 2001/February 2009Last major release of this B/AR system March 2009 February 2009

No. of contracts for sites operating B/AR system 24 21• Contracts signed since March 2008 14 7• Contracts gone live since March 2008 4 5No. of sites operating B/AR system (HL/IL/PP/PO/OL/FI)** 24 21 (8/10/3/0/0/0)

No. of inpatient invoices handled by installed sites annually — —No. of outpatient requisitions handled by installed sites annually 45,000–2,655,250 (avg., 535,000) 62,964–6,792,000 (avg., 1,000,000)Largest No. of hospitals/pathologists serviced by one B/AR system 4/26 —Percentage of installations that are stand-alone B/AR systems 84% 100%


No. of user workstations in sites operating B/AR system 4–200 19–209 • Average No. of user workstations in sites operating B/AR system 20 80

Server platform Intel-based Windows server SaaS (software as a service) Web browser basedPC/workstation platform Windows XP PC–Intel with Internet connectionInnovative peripherals integrated fax, PDF, e-mail, Excel export bar-code printers, image management, OCR readers, fax, archived

storageOperating system(s) Windows 2005, 2008 server Microsoft Windows 2000, XP, Vista with Internet Explorer 6, 7Databases and tools used Microsoft SQL 2005, .Net 3.5 platform, Crystal Reports 2008, Excel,

Adobe PDF readerOracle 10g Enterprise Edition, Business Objects Enterprise XI

Information systems/software interfaces Invision, McKesson, Cerner, Sunquest, Siemens, Orchard, others McKesson, Cerner

Features (listed as a percentage of live installations or based on availability)• Patient demographics transferred via interface from LIS to B/AR system 100% 100%• 1500 claim form generation (paper version) 100% 100%• UB-92 claim form generation (paper version) 20% 100%• Client invoices 100% 100%• Patient invoices 100% 100%• Reprints of above on demand 100% 100%• Key indicator tracking (online view of site-assigned key indicators) 100% 100%• Test profile vs. component billing 100% 100%• Medical-necessity screening for Medicare 100% 100%• Professional component billing 100% 100%• Auto delete of nonbillable procedures 100% 100%• Technical component only 100% 100%• Retain demographic data, repeating patients 100% 100%• Accounts and patient payment posting 100% 100%• Accounts receivable system 100% 100%• Management or marketing reports 100% 100%• Automatic balance billing to patients 100% 100%• Capitation billing plus billable tests 100% 100%• Utilization reports for managed care 100% 100%• Global charges for lab tests 100% 100%• Unlimited user-defined fee schedules 100% 100%• Track financial classes 100% 100%• Allow open-item accounting (each line item on bill can be handled separately) 100% 100%• User report writer 100% 100%• Collection agency system 100% 100%• User-configurable dunning 100% 100%• Client services or call tracking module available in December 2010 100%• Rules-based processing or claims scrubbing 100% 100%• Multi-lab or multi-company processing 20% 100%• Support all HIPAA transaction sets 100% 100%


yes yes

• Functions offered claims, remittance, rebill, automatic status update systems integration; payer and clearinghouse management; electronic submissions, remittance, eligibility, acknowledgement, status check; payer edits; secondary claims generation; others

• Third-party payers and claims clearinghouses with which system is interfaced Express Bill, Claim.MD, THIN, Epremis, e-Gate, GHN, McKesson, Medicare, Medicaid, Blue Cross Blue Shield, UHIN

Medicare carriers and FIs, Medicaids, Blue Cross, UHC, Aetna, Cigna, Capario, Per-Sé, Softrix, McKesson, Matrix

• Type of claim data generation UB-92, 1500, UB-04, state specific UB-92, 1500, nonstandard MedicaidsThird-party rules and coding updates supported by system allows import from CMS files—CCI, NCD/LCD rules, CPT, diagnosis LCD/NCDs, CCI, OCE, ICD-9, procedure codes by payer and year, others

Complete ASP solution for B/AR system? yes yes• Method of charging for ASP service fixed fee fixed fee, transaction based• Client software required requires that software be installed on a client PC browser based• ASP information conduit requires use of a VPN or other dedicated connection operates over the Internet• Client contracts supported from data center not operated by client 0 100%• How data center is operated by vendor by a third party (Savvis)


Journaling?/source code? yes/yes yes/noCost (hardware/software/installation and training/monthly maintenance)• Smallest stand-alone B/AR system $10k/$48k/$20k/$1k —/$1.25 per accession/$145k per site/included• Largest stand-alone B/AR system $50k/$348k/$149k/$6k —/$0.89 per accession/$300k per site/included• Smallest B/AR configuration for integrated lab system — —/$1.25 per accession/$145k per site/included• Largest B/AR configuration for integrated lab system — —/$0.89 per accession/$300k per site/included




• specifically designed for the workflow and business of outreach and reference laboratories, including the ability to collect payments at time of service from patients at patient service centers

• extensive decision support and business management tools, profitability analysis, utilization inquiry, revenue inquiry

• ICD-10 compliant

• services include ongoing programming, integration, database maintenance

• user-configurable, rules-driven workflow automation facilitating incorporation of lab procedures and best practices

• comprehensive error/denial management resources and correspondence capabilities

Documents

46 / CAP TODAY May 2009 Billing/accounts receivable systems · Tabulation does not represent an endorsement by the College of American Pathologists. Billing/accounts receivable systems