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TRACE Provides a Return of Over $1 Million in Less than a Year at Health First

Rockledge, Fla., May 8, 2008

Less than a year after licensing TRACE by the White Stone Group, Health First has experienced a return of over $1.25 million in total charges, nearly seven times its investment in the system. Health First has used TRACE data to overturn nearly $400,000 in denials and prevent the loss of nearly $900,000.

"We now have a record of every piece of communication – web, e-mail, phone and fax – in one central location," said Michelle Fox, Director of Patient Access. "Tracking our correspondence, internally and with payers and physicians, has given us tremendous gains in quality, productivity and reimbursement."

Health First is using the TRACE communication event management system to capture, index and archive records of all phone, fax and electronic communications across the revenue cycle. The system is currently used in the Access, Registration, Case Management and Precertification departments.

TRACE has prevented denials at Health First by providing evidence of authorizations and notification of admissions. For example, Health First used a call recording to prove a payer's approval despite receiving notice that charges had exceeded the patient’s insurance outlier. With this evidence, the payer reversed its denial for charges incurred over more than 50 days, a total of $691,362.40.

Health First is also using TRACE data to overturn denied claims. In one instance, a call recording gave proof of a payer’s approval of a request for inpatient certification for a continued stay. After rescinding approval for the claim, the payer overturned the denial for nearly $400,000 when given evidence that the patient was certified without clinical information.

TRACE has helped Health First accomplish the following, among other initiatives:

Quality: build accountability with staff, payers, physicians and patients by using communication records as proof of information exchanged; select call records to playback and discuss with employees for customer service and quality improvement; enhance physician and staff interactions

Productivity: use system as central reference for all departments; reduce calls and e-mails and eliminate duplicate efforts; pull records from web-based system at computer instead of searching for paper files; increased call volume by 20 calls per day by reducing hold time

Reimbursement: document patient eligibility from payer web sites; capture electronic image of clinical and supporting documents sent to payer; establish accurate record of events as they occurred

Health First will continue to expand its use of TRACE with the goal of going completely paperless in areas using FaxCert and PixCert. The hospital is considering the use of VoiCert to record all inbound and outbound calls including verbal orders from on-call physicians, calls with patients over the nurse help-line and calls that take place in the Emergency department.

Health First is located in Brevard County on Florida’s Space Coast and includes three not-for-profit hospitals: Cape Canaveral Hospital in Cocoa Beach, Holmes Regional Medical Center in Melbourne, and Palm Bay Community Hospital in Palm Bay. The partnership offers a comprehensive range of services and is committed to integrating all components of care into a seamless delivery system under single governance and leadership.



About The White Stone Group

The White Stone Group builds and delivers software solutions that improve the management of healthcare communication events. Nearly 400 hospitals are licensed to use the company's TRACE and OptiVox® products that automate managed care, administrative, and clinical communications for healthcare providers. Proven results include improved revenue cycle processes, greater management capabilities, and expedited patient throughput. For more information, visit TWSG.com.

Contact: Erin McCarty, (865)705-1622, Erin.McCarty@twsg.com

© 2010 The White Stone Group, Inc.