Clearwave Corporation

Meaningful Use to drive Interconnectivity in Health care

2009-07-16T10:19:00.000-04:00

The Health Information Technology (HIT) Policy Committee began meeting June 16 to discuss the definition of “meaningful use” of electronic health records (EHRs). From this initial meeting, the committee released objectives to further define “meaningful use”. Among the objectives are the following requirements:

• Use CPOE for all order types including medications
• Generate and transmit permissible prescriptions electronically
• Provide patients with an electronic copy or electronic access to clinical information such as lab results, problem lists, medication lists and allergies
• Exchange key clinical information among providers of care
• Submit electronic data to immunization registries where required and accepted
• Provide electronic submissions of reportable lab results to public health agencies
• Provide electronic surveillance data to public health agencies according to applicable law and practice

A common thread of future interconnectivity in the health care industry is woven into each objective. In the current system, technology is built around “silos of information” where each silo is unable to communicate to another.

Providers, hospitals, medical centers suffer financially because of the time and money that is wasted due to inefficiencies in such a fractured system. As patients, we have accepted the consequential inconveniences such as receiving prescriptions by paper, picking up or faxing medical records to new doctors, and receiving unplanned invoices after a visit.

In order for the health care industry to move forward successfully, it must do so as a whole unit rather than individual silos. If all the silos are interconnected, it will greatly increase the efficiency at which health care transactions are processed and will reduce unnecessary expenditures – improvements that will benefit health care providers and patients. The HIT Policy Committee’s decisions will be the catalyst to drive this interconnectivity that is needed to provide true value.

Clearwave Supports MGMA's SwipeIT Campaign

2009-03-16T14:57:00.001-04:00

Clearwave supports MGMA’s SwipeIT campaign to promote the adoption of standardized patient identification cards containing HIPAA-compliant, machine-readable information. MGMA estimates that machine-readable patient ID cards will save practices more than $1 billion a year. Focusing on the same goal to reduce health care administrative costs, Clearwave provides real-time patient insurance eligibility information at the point of service.

Widespread adoption of magnetic patient ID cards alone will not solve all of the issues during the check-in process; redundancies must be built into the solution to address the following:

1. insurance companies adopt different standards
2. insurance companies decide not to issue magnetic stripe cards
3. patients don’t carry their card
4. patients’ magnetic stripe card is damaged
5. self-pay and uninsured patients

Clearwave has addressed all of the above items by creating a universal kiosk machine that allows patients with a magnetic stripe card, paper card or no card to successfully check-in without the assistance of office staff.

Once the information enters the Clearwave network, we perform a real-time eligibility check and return the payer’s response to the front desk’s computers. Front desk personnel can now accurately collect amounts for co-payments, co-insurance and remaining deductible before the patient leaves the office. Alleviating data entry errors, Clearwave also reduces a practice’s denied claims because the claim is submitted clean the first time.

Like MGMA, Clearwave is committed to advancing the health care industry by reducing costs and improving inefficiencies. Clearwave’s customers are able to collect more from the patient at the point of care, and on the back end, the office receives faster reimbursement from the payers.

What to expect in 2009

2008-12-15T16:53:00.003-05:00

During the past several years, healthcare costs for patients have risen steadily in the form of higher co-pays and deductibles, shifting the burden of payment to the patient. This becomes challenging for healthcare providers as this burden falls into their hands and becomes a serious and costly collection process.

With the cost of healthcare services predicted to rise by 10 percent in 2009, providers need to prepare their staff to collect the correct amount from the patient at the point of service so that higher healthcare costs don’t equal higher collection costs.

The IRS has already set the limits for high deductible health plans for 2009. The minimum individual deductible is $1,150 with the maximum set at $5,800. For family plans, it is $2,300 to $11,600. Healthcare providers need to ensure that they know not only what each patient’s total deductible is but most importantly how much of that deductible is remaining.

If the front desk staff does not have this information when the patient is in the office, then they will not be able to accurately gather payment. Therefore, the office’s collection costs and bad debt expense will only continue to rise.

Following these market trends, Clearwave has strategically positioned itself to help you prepare before you are loaded down with higher collection costs. Clearwave has done the research and is ready with the solution.

There are no surprises about the increase in healthcare costs and the rising number of high deductible health plans, so there is no reason to not prepare.

Breaking Down the Healthcare Barriers

2008-10-01T16:43:00.000-04:00

When Clearwave started, we looked at the healthcare industry as a whole, recognized the problems and created solutions to transform the established system. We have maintained this mentality during the past five years.

With established systems, it is easy to identify the problems but difficult to discover the solutions. People become trapped in the inefficiencies of the current system and ultimately become resistant to change because they are looking from the inside out.

Clearwave was formed to bring the necessary solutions to the market to improve the healthcare industry. Starting at the front desk, we have slowly chipped away at the current process and have initiated a more efficient system. With each day, we break down more barriers to change.

Because we realize people are hesitant to change what is familiar, we have taken the approach of “one doctor at a time,” which has been crucial to our success. We are willing to knock on each doctor’s door until the entire healthcare system is transformed.

Clearwave Adds Insight Imaging to Client List

2008-09-15T16:29:00.001-04:00

This summer, Clearwave rolled out 24 kiosks to various Insight Imaging locations in Texas and California and is quickly adding them to all of Insight’s 100 facilities. By the end of the year, Clearwave plans to install and to deploy 60 more kiosks for Insight across the country.

Adding Insight Imaging as a client means more than just adding 100 offices to our customer list. It expands our operations into new states and across different demographics. Our staff has been able to seamlessly adjust to any differences based on these new locations, breaking down any geographical barriers that may exist.

For example, we are in the process of adding a Mandarin and Cantonese language option to our kiosk because of the large population of Chinese using our product in California.

Through this installment, we also have enhanced our integration platform to normalize the process for each of Insight’s locations. This way, we know that each office will have the same functionality, service and quality of data.

Retailization of Healthcare

2008-08-14T10:57:00.002-04:00

In every other industry – fashion, food, retail – the customer pays when the service is rendered. The healthcare industry needs to shift to the same retail perspective of doing business in order to increase its cash flow and to reduce collection costs associated with tracking down payment.

In the current process, it is the front desk’s responsibility to verify eligibility, and only 30% of offices perform this task. So when the office then submits a claim to the insurance company, it is often times denied because of incorrect information or the patient has not met his/her deductible. Unfortunately, the patient is no longer there to correct the information or to make payment on the remaining deductible.

If doctors’ offices move toward a retail-based solution, they will no longer have to use valuable resources to track down patients. Patients will verify their eligibility and make payment according to their benefits and responsibilities at the time of service. Doctors will provide a service and get paid during the life cycle of the visit up to the point when a patient has met his/her deductible.

Clearwave’s kiosk solution allows for an easy transition from the current to a retail process. With Clearwave, the doctor has the right patient information at the right time and associated with the fee schedule can determine a patient’s amount due at the time of service. In return, front desk staff time is relieved and reallocated, cash flow is increased, and collection costs are reduced.

Patients Verifying Eligibility at the Time of Service

2008-07-31T17:20:00.000-04:00

Administrative costs already account for 30 percent of the $2 trillion healthcare industry. As the industry moves toward higher deductible plans, providers need to start implementing new technology to ensure the patient or payor makes payment.

To accomplish this, the healthcare industry must move toward a retail-based solution where payment is collected at the point of service. Providers and patients can no longer wait to receive information. Doctors need to know a patient’s benefits as quickly as possible with the least amount of effort.

The responsibility of verifying a patient’s benefits falls into the hands of the front desk staff. In the current system, less than 30 percent of offices check eligibility because of the high cost of staff time.

If a doctor’s office does not verify eligibility, it may submit a claim to an insurance company for reimbursement, only to have it denied because of incorrect information or the patient has not met his/her deductible. The office must now use valuable resources to track down the correct information to collect payment.

Verifying eligibility before an appointment is not an effective solution either. First, in the current method of batching, a staff member is still required to correct errors and to contact patients to correct them. Errors could occur because of incorrect information or the patient is no longer eligible. Second, a patient’s eligibility at the time of service may be different; the remaining deductible may have changed or the patient may no longer be eligible.

Because there is more pressure to determine a person’s remaining deductible at the time of service, 70 percent of doctors’ offices will have to facilitate a process change. For the 30 percent of offices that do verify eligibility, they will have to look for new ways to eliminate the high costs associated with the current process.

Clearwave is the most effective solution for eligibility verification. Through the Clearwave system, patients – rather than the front desk staff – check their eligibility at the time of service. Doctors are now able to grow their practice without hiring more front desk staff so that they can focus on patient care.

Getting Involved in Patient-Centric Healthcare

2008-06-26T16:51:00.007-04:00

For patients walking into any of our locations, they are no longer checked in by the front desk. The patient swipes a card or enters personal and demographic information into our kiosk that is recognized by the Clearwave system.

In return, the patient is checked in and his or her data is submitted to the insurance company and a verification response is received immediately by the front desk. For returning users, our system automatically matches the patient’s information. This prevents them from having to resubmit their information during each visit.

Because Clearwave is handling such sensitive information, it has developed a secure framework of transactions that complies with the strict privacy standards set by the Healthcare Insurance Portability and Accountability Act. So, patients can feel confident with the security of their medical records.

The check in process and eligibility verification is in the hands of the patient. Patients need to start recognizing that this is the beginning of a patient-centric healthcare system. Allowing patients to authenticate their insurance is the first step.

The next step is allowing the patient to unlock medical information and his or her online personal health record (PHR) or individual health record (IHR). Because Clearwave is connected in a real-time manner for eligibility, the architecture already exists to download patients' PHR or IHR at the time of visit.

With a solution that is customer-driven, patients have nothing to lose. They are able to check in in less than five minutes on a secure network that is proven effective. So, patients need to be asking their health care providers why they haven’t switched to using Clearwave.

Creating Better Cash Flow & Efficient Billing Processes in Healthcare

2007-07-20T13:00:00.001-04:00

The healthcare services industry represents one of the largest and most complex industries in the U.S. with annual total costs approaching $2 trillion. Over the past decade, healthcare spending increased by 69% per patient. Administrative costs account for 31% of spending due to inefficiency in healthcare transactions, causing practices to lose millions of dollars every year because of mismanagement of the billing process. Problems in this process occur in two areas: collecting payment from the patient and verifying eligibility.

Today’s rising costs of healthcare have resulted in a greater number of patients paying more for their healthcare with higher deductibles, co-payments and co-insurance. As more responsibility is placed on the patient, a greater burden is placed on the medical practice to collect from the patient. For example, in one of today’s high deductible plans, a physician may submit a claim only to find out weeks later that it has been denied payment because it is the patient’s responsibility. When this happens, the practice is forced to act as bill collector and to track down payments from its patients. The practice is not only inconvenienced but also short-changed.

Patient responsibility denials are on the rise, and this type of denial will cost a practice more than any other type of denial because it occurs more frequently than any other. It takes 30 percent to 40 percent longer[1] to get paid and is attributable to most of the bad debt write-off today. Most practices are not managing their denials effectively and efficiently. They are losing revenue on money that could easily have been collected at the patient point of service.
Clearwave has taken these problems and solved them. It has developed a solution to simplify healthcare transactions and information exchange to collect payment at the point of service and to eliminate eligibility denials before they occur. This is the secret to creating better cash flow and to having an efficient billing process. Below are the ways in which Clearwave accomplishes this.

Clearwave updates and verifies each patient's insurance coverage/eligibility when he/she schedules the initial appointment and at check in. Failure to check patient insurance eligibility results often in medical billing errors, insurance coverage concerns and delays. Humana, one of the nation’s leading insurers, ranks insurance ineligibility as the number one reason for denial of claims. Additionally, PricewaterhouseCooper estimates that it costs the average provider approximately $9 for each patient seen, utilizing the traditional methods of manual data entry and phone communication to check and to verify eligibility[2]. If a provider sees thirty patients per day, using traditional methods to verify eligibility, only sixteen patients would be verified.[3] Forty-seven percent of the patients seen would not be verified.

With Clearwave’s technology, there are no more billing errors, insurance coverage concerns or delays because insurance eligibility is checked 100 percent of the time. Before patients are even seen by the doctor, Clearwave allows a practice to efficiently and effectively verify eligibility. This is done at a cost of only thirty-two cents per patient. The verification process takes less than fifteen seconds per patient, and 100 percent of the patients would be verified for the same cost it takes to verify one patient using traditional methods.

Clearwave collects patient’s payment responsibility at point of service. Through Clearwave’s kiosk solution, patients can pay at check in. Having the ability to verify eligibility makes this process simple because patients and providers understand their responsibility. If payment is not collected at the point of service, it costs between $9 to $16 to send monthly statements to patients. Not only are these expenses eliminated with Clearwave but also waiting on EOB’s, the time a practice staff spends sending out statements, delinquent letters, making delinquent phone calls, and processing bad-debt information. Utilizing this simple process will have an immediate impact on a practice’s cash flow and front desk collections.

Incorporate new collection processes into financial policy with Clearwave’s professional services. Clearwave helps practices to make sure their financial policies reflect the new payment collection process. Patients need to understand in advance what their policies are toward their payment responsibilities to alleviate any misunderstanding later.
Clearwave eliminates eligibility problems and determines the patients’ payment responsibilities in advance. Practices are able to avoid costly administrative fees to collect it later, increasing their cash flow and reducing denials that drain practice revenue and resources. 

Underestimating the Patient

2007-02-26T14:01:00.002-05:00

Patients’ ability to use the Clearwave kiosk application has turned out to be better than we originally expected. Clearwave’s usability target was that 70% of patients would be able to successfully use the kiosk application. To Clearwave’s surprise, that number is actually more than 90%, and due to “Returning User” functionality and patients becoming more comfortable with the system after each visit, the success rate continues to grow.

To add to this success rate in the future, insurance companies are introducing into the market track 3 magnetic stripe cards that contain the necessary information to create an eligibility check. These cards are compatible with Clearwave’s kiosk application.

Because a large percentage of patients can successfully use the Clearwave kiosk, there has been a dramatic improvement in patient flow, as well as huge time savings for the office staff. Offices that had 3 resources checking in patients are now down to 1 resource, allowing 2 resources to be reassigned. The wait time and patient flow issues at the front desk have been totally eliminated, because the office staff now controls the patient flow. The office staff can call up one patient at a time, thus providing the individual attention that all patients want, which ultimately improves the overall patient visit.

One important factor to solving patient flow issues is moving the kiosk away from the front desk. We have found that if the kiosk is too close to the front desk, the patients will rely on the office staff to help. However, if the patients are responsible and don’t have immediate access to help, they can indeed successfully check-in.

The concerns for all doctors’ offices that are looking at installing the Clearwave kiosk application include the following:

Our patients are not smart enough to use the system.
Our patients are going to be angry about this process.
Our staff won’t be able to adapt to this process change.
If one patient complains, the doctors will be very upset.

Well, the patients are definitely smart enough to use it, as we have seen with our 60,000 check-ins via the kiosk. Yes, some patients get angry, but the majority of patients are happy to simplify their check-in process. The office staff loves the fact that fewer patients are in line at the front desk, and doctors are now more focused on the bottom line; therefore, doctors don’t mind a short term process change for the patient that has a huge long term financial impact.

Everyday each of us experiences more and more self-service devices such as ATMs, pay at the pump gas, airport kiosk check-ins, and self check-out at the grocery store. The first time we used these devices they were intimidating; however, we quickly adapted to them, and now we are expecting to see new and better functionality. The doctors’ offices that install the Clearwave kiosk now ensure their patients and staff will be more accepting of new technology in the future.