The primary mission of Nevada Health Centers Inc. (NVHC)—and that of other FQHCs
(Federally Qualified Health Centers)—is to provide healthcare services to everyone,
regardless of their ability to pay. As such, operating cost-effectively and efficiently,
while also maximizing federal funding opportunities, is critical.
NVHC faced challenges tracking payments and appropriately billing claims due to its
outdated management software, which at the time was the only solution available for
Community Health Centers (CHCs) and FQHCs. Cathy Roe, Director of Billing for NVHC,
explains, “When we changed a patient’s financial class, their charges and payments sat
in different accounts. Not all claims were billed, and not all the necessary statements
were generated. We faced numerous customer service complaints. Also, once children
turned 18, it was hard to remove them from the family account. We needed an
integrated EPM and EMR solution that addressed these challenges.”
When it was clear that its existing solution was not delivering the ongoing functionality
that the clinic required, NVHC requested proposals from other vendors. It also elected
a committee to evaluate potential solutions consisting of the Director of Development,
the Chief Medical Officer, the Chief Financial Officer, a staff doctor, the Director of
Billing, the Regional Clinical Director, and the Director of IT.
Seeking an integrated database solution with proven results
It came down to two potential solutions. “We chose NextGen Healthcare because the
company delivered an integrated database. Its practice management software featured
WorkLog manager, which helps ensure that tasks are completed at the right time, by
the right person. Also critical, NextGen delivers claim scrubbing to search for errors/
missing information—and apply required edits—to ensure all claims are accurate and
complete,” says Roe.
NVHC kicked off its enterprise practice
management (EPM) implementation in
January 2005 and started with NextGen
electronic medical record (EMR) software
in September 2006. Roe comments,
“We employed a ‘train the trainer’
approach where NextGen Healthcare
brought a core group of our billing and
clinic managers up to speed on the
solution, and these individuals helped
roll out the implementation across our
enterprise over a five week period.”
The center is also using the NextGen
Image Control System (ICS), which
indexes, stores, and manages all scanned
documents within the NextGen system.
Enhancing patient care
through improved efficiencies
while gaining financial stability
With NextGen, NVHC positively
transformed key financial aspects of
its clinic while improving patient care
and reporting. Since implementing its
NextGen solution, NVHC enjoys the
following benefits:
Enhanced patient care—
Today, NVHC can better track patients
by key health indicators. Roe explains,
“By improving patient tracking using
the NextGen solution, we’re providing
higher quality care for a larger population,
without increasing our staff size. Doctors
can access patient information from
multiple locations. And better, faster
access to patient information also plays
a huge role in delivering improved care.”
Dr. Darren Rahaman, a family practice
physician with NVHC, comments,
“We are already working to track
patients with chronic conditions like
diabetes to make sure they are receiving
regular check-ups and taking the
necessary medications. I’m interested in
taking advantage of NextGen’s reporting
capabilities to better monitor these types
of patients moving forward.”
Dr. Rahaman is also impressed with
NextGen’s prescription templates. As he
explains, “A lot of our patients either
don’t take—or forget to take—their
medication. The templates help me better
manage patient care. Plus, we’re excited
to start using NextGen’s ePrescribing
capabilities down the road.”
Patient visits flow more smoothly since
the NextGen software installation. “I’m
thrilled that NextGen helps us expedite
patient visits. Our back office staff now
updates patient information before a
doctor enters the exam room so that we
have patient vitals at our finger tips. This
helps us spend more quality time with
patients and improve the quality of the
care we provide,” concludes Rahaman.
Upgraded documentation
and simplified reporting—
When using paper charts, NVHC could
not report on clinical quality measures.
Now, with NextGen, this type of
reporting is at the top of its priority list.
“We can quickly determine if patients
with a chronic illness like diabetes are
getting the proper exams and treatment.
And, because we can track clinical
outcomes—and quickly, easily report on
them—we’ve applied for grants that we
previously would not have been able to
pursue. In fact, NextGen recently helped
us win a $1.4 million dollar grant to
expand our EMR implementation across
our enterprise,” Roe comments.
Referral tracking is also made much easier
thanks to NextGen. Roe explains, “Our
previous method of referral tracking
involved keeping a stack of charts on
a doctor’s desk. Now, with NextGen’s
referral management capabilities, we
generate an automatic referral tracking
report.” Dr. Rahaman adds, “NextGen’s
referral process is outstanding. I especially
like that patient notes are automatically
attached to referral letters. We’re
delivering better patient care because
this process happens quickly, efficiently,
and automatically.”
Pre-NextGen, the NVHC claims process
was not efficient or effective. “We could
not manage front desk data entry well,
and statements weren’t being properly
generated, so claims would come back
incorrect. With NextGen, we can run a
report of payments received during the
time frame of our choice. We can use
NextGen’s canned reports—which meet
roughly 90% of our needs—or easily
create customized reports. It used to
take a month to manually pull together
our Medicaid reports. Now it takes 30
minutes,” says Roe.
Dr. Rahaman adds, “Using NextGen
software, we’re able to automate
messaging throughout our practice.
As a result, I receive messages regarding
my patients directly in my inbox in
real-time, which has solved a multitude
of communication-based challenges
for our practice, has enabled me to see
more patients, and has alleviated patient
complaints.”
Finally, NVHC is saving time and improving
patient satisfaction with patient education
tools. “These tools have saved me a
considerable amount of time, which I used
to spend looking up English to Spanish
translations. Now, patient information—
in the right language—is available at the
click of a button,” explains Dr. Rahaman.
Reduced costs and increased revenue—
NextGen enabled NVHC to eliminate
its commercial clearinghouse and begin
to execute direct claims. “As a result,
we’re much more efficient, and we
save $42,000 a year. We also save a
considerable amount of time—payment
lag time is down to nine days. Previously,
it was 30-45 days. What’s more, without
NextGen, we most likely would have
needed to hire more help to handle our
growing accounts receivable needs,”
explains Roe.
Dr. Rahaman adds, “NextGen’s coding
is great. Previously, it was more difficult
and labor-intensive to code a patient visit
because it took time to search for—and
enter—the proper codes for each
patient. Now, the system helps us code
automatically. I find that I’m upcoding by
one. Plus, automated coding makes the
checkout process much more efficient.”
Gained superior customer service—
“NextGen responds within a half hour
to our customer service requests. When
it comes to EPM support, NextGen
is one step ahead of its competitors
and demonstrates a high degree of
knowledge about CHC-related issues,”
says Roe.
A partnership focused
on continuing growth
“NextGen Healthcare delivers a dynamic
product that is always improving. With
each new release, and every knowledge
base template (KBM) upgrade, the
templates keep getting better. As a result,
we experience a real, positive impact in
how we practice medicine. It is exciting
to see things on our ‘wish list’ show up
in an actual upgrade,” explains Roe.
NVHC looks forward to continued
participation at NextGen Healthcare’s
Users’ Group Meeting. “We come away
from the Users’ Group Meeting with so
many great ideas regarding how we can
more effectively use—and enhance—the
NextGen system based on our needs.
We also have the opportunity to share our
customizations, such as the dashboard
we created to illustrate average patient
waiting times,” explains Travis Cox, IT
Director at NVHC.
