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Physicians in the Loyola Medical Practice Plan in Maywood, Ill., use a point-of-service billing system to help increase collections and third-party payments.

The plan, affiliated with Loyola Medical Center in Maywood, includes nearly 500 physicians.

The point-of-service system is made up of a mainframe computer network, with work stations placed in various hospital departments to provide patients with bins when they leave the hospital or a physician's office following treatment, according to Mark Plumley, systems analyst for the physician group and installer of the system. Patients receive a bill showing the amount their insurers will pay and the amount they must contribute.

SYSTEM GROWS. The system, implemented in the summer of 1989, began with eight stations. Four more stations were recently added.

Stations are located in various departments, including pediatrics, obstetrics and gynecology, orthopedics, medicine sub-specialties, psychiatry, general medicine, pediatric neonatology, and neurology/ ear, nose, and throat.

Through its pediatric billing station alone, the physician group estimates that it saves 1,700 per day, based on before and after comparisons of collections, Plumley said. He added that the group's daily savings will total more than $10,000 with all stations running.

The group spent more than $70,000 on dot matrix printers, protocol converters, and other computer hardware, which allowed the system's personal computers to be linked with the physician group mainframe.

"The physicians wanted small, quiet printers," Plumley said. "They wouldn't allow mainframe printers because they were too big and noisy. Laser jet printers were too big for the small work areas."

He estimated that the plan saved almost $100,000 by using smaller hardware and converters instead of buying larger printers connected directly to the mainframe system.

Initially, the system was used for physician office visit charges and certain outpatient pediatric, obstetrical, and gynecological procedures, Plumley said. Hospital charges for other outpatient procedures and inpatient stays in the neurology and pediatric neonatal units were added this fall.

"These [departments] are self-contained units, so point-of-service billing can be used," Plumley said. "Use for inpatient stays is much further down the road. Too much information would have to be scanned into the system and it wouldn't be a time-saver for [inpatient hospitalizations]."

PROMPT PAYMENT. Point-of-billing systems offer two advantages over normal collection procedures, Plumley said. First, patients are aware of how much their insurer or third-party payer will cover and how much they must pay out-of-pocket. Billing representatives also are available to answer patients' questions about their bills.

Bills are immediately sent to third-party payers instead of being forwarded first to health plan administrators and then to insurers.

The system eliminates the negative aspects of billing, such as "telephone tag" between physicians and patients, delayed payments, and other slow-downs, Plumley said. "This has increased collections. More people are paying on the spot," he said.

# posted by Medical Information : 3:52 AM