Case Studies

University of Texas Medical Branch

UTMB at Galveston is a large teaching hospital that uses Siemen’s SIGNATURE® system to manage its physician billing. They, like many other facilities, have developed processes to leverage the use of Siemens OLIE™. For UTMB, OLIE™ is used to:

  1. Automate posting of pre-paid deductibles as well as posting other payments and adjustments.
  2. Integrate SIGNATURE® with other systems, including Claims Manager and custom, in-house database.
    Other miscellaneous tasks.
  3. While there were certainly savings in the handing of the miscellaneous tasks, this case study will focus on the first 2, as they are well defined processes that we were able to accurately determine the amount of time saved.

Payment Posting

UTMB uses a complex formula to determine how to post their pre-paid patient co-payments to the appropriate charges. They run ad-hoc reports that provide a list of all patients who have an un-applied co-payment, as well as the amount of that co-payment. This report is parsed by a custom program to convert it into a comma-delimited format.

These CSV files were then processed using an OLIE™ script to apply the payments appropriately.

BEFORE EMUE

Because of the volume of transactions and the fact that their SIGNATURE® application is taken off-line nightly at 8:00 for system maintenance, UTMB employees were required to break the reports into smaller files in order to run simultaneous batches on multiple machines. On average, one person, using 7 PCs would run OLIE™ scripts for about 40 different files per week. This would usually take 2-3 days of full time management. In addition, there were an additional 45 input files that would be created on a monthly basis, to be run on additional OLIE™ PCs. There was one person who’s sole job was to run prepare, start, and manage these scripts.

AFTER EMUE

EMUE helped save UTMB a significant amount of time preparing input files and managing scripts.

  1. EMUE was able to run the scripts 4 to 5 times faster than OLIE using Attachmate Extra. This is in part because we were able to remove the SLEEP statements in the script that were no longer necessary because of EMUE’s enhanced communication abilities. As a result, many of the large files no longer needed to be broken down into smaller ones to allow them to process in a single day. In fact, the number of files processed weekly has changed from 40 files to an average of 17 files. These monthly files have also been consolidated from 45 to 20.
  2. 7 PC’s were reduced to 1. EMUE is able to run multiple sessions simultaneously, which has allowed UTMB to repurpose the extra PC’s for new and more productive uses.
  3. Fewer PC’s to manage, fewer files to manage, and faster execution mean that employees have more time to spend on other projects. Once input files have been created, employees simply need to drop the files into the proper folder, and EMUE processes them. EMUE notifies the proper person via an email if there are any problems running the script. Time spent managing OLIE™ has been reduced by well over 50%.
  4. When business rules (or SIGNATURE® screens) change, and the scripts must be adjusted, UTMB can now use the interactive script debugger to find and fix scripts fast.
  5. As an unexpected bonus, EMUE’s tighter script parsing rules found some errors in the script. OLIE™ was ignoring the lines with the errors, however these lines were important to the logic of the script. Once these errors were corrected, additional payments were posted which helped pushed the department over it’s AR performance goals for the year.

ESTIMATED COST SAVINGS IN PAYMENT POSTING PROCESS.

Estimated Annual Savings

Consolidated 7 PCs to 1, eliminating 6 pc’s * $500/PC = $3,000.00

Reduced management time for managing scripts that have been automated (40 hours reduced to 20 hours at $20.00 per hour) = $20,800.00

Total = $23,800.00 /year

Claims Manager / CPT database

UTMB uses Claims Manager to process its insurance claims. It also uses an external database to store charge posting information and to send error information back to the departments that are keying charges. UTMB uses several OLIE™ scripts to support this process by

  1. Posting a batch of charges into SIGNATURE® and then submitting the batch to Claims Manager.
  2. Verifying if the batch was successful and if not then logging the error information.
  3. For batches that did not submit properly, removing the offending charges from the batch and then re-submitting the batch.
BEFORE EMUE

Each of the three steps above was performed with a separate script and the process had to be completed once for each of the 15 departments. The result was a total of up to 45 OLIE scripts to be run each day, and each script execution required input files to be moved and/or copied and renamed in order to create an audit trail for the day’s activity. The management of this process required the constant interaction and supervision of a single employee for 4-5 hours per day.

AFTER EMUE

Now, the process has been automated to minimize the amount of manual labor and supervision:

  1. The 15 files used as input files into Step 1 do still need to be renamed manually to include the date. However, all of the files are then simply dropped in to the appropriate folder, and then the operator is done!
  2. EMUE now automatically creates and renames copies of the files to move them automatically to the next step (if appropriate), so that no interaction or management is necessary.
  3. EMUE notifies the operator via email once each department has completed, and includes the error log for charges that need to be re-entered.
  4. A complex documented procedure has now been changed into an automated process, making it simple for other operators to perform with a minimal amount of training.
  5. Processing occurs faster, with no delays while waiting for the operator to prepare the next step. As a result, the data is available to production 3-4 hours earlier.
  6. Operators report that automating this process has saved them 4 hours per day.

ESTIMATED COST SAVINGS CLAIMS MANAGER/CPT PROCESS:

Estimated Annual Savings

Reduced management time for managing scripts that have been automated (4 hours per day, 5 days per week, for 52 weeks per year at $20.00 per hour) = $20,800.00

Total = $20,800.00 /year

Summary

EMUE has helped streamline several key processes for UTMB’s Physician Billing group.

This has helped UTMB see a significant savings of almost $45,000 in FTE hours and PC hardware, support, and maintenance costs. This measurement of savings is based strictly on the direct and measurable benefits of EMUE, and is conservative by most standards. It does not include a measurement of several other valuable EMUE benefits including.

  1. Data is available to sooner.
    1. Charge entry personnel have error information sooner, which allows them reprocess them sooner, which helps reduce AR.
    2. Pre-payments are applied sooner, which also helps to reduce AR.
  2. Employees no longer need to come in earlier in the morning to start scripts in order to meet data availability deadlines.
  3. Scripts run more accurately because of stricter parsing rules. This had a direct impact on A/R for UTMB.
  4. EMUE’s interactive debugging capabilities make creating and debugging scripts much faster and more reliable.

When taking these “intangible” benefits into account, UTMB’s savings would easily be over $50,000 per year!

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