Case Study:  NextStep at Wentworth & Associates, P.C.: A Private Outpatient Psychiatric and Substance Abuse Clinic

Overview

Wentworth & Associates (W&A), P.C. is a private outpatient psychiatric and substance abuse facility in Utica, Michigan.   This practice is designated by Blue Cross and Blue Shield of Michigan as an Outpatient Psychiatric Center (OPC) and serves the tri-county area.  Wentworth & Associates provides psychotherapy, psychological testing, and psychotropic medication management to clients who struggle with a wide range of psychological disorders including depression, anxiety, substance abuse, Attention Deficit Hyperactivity Disorder (ADHD), and marital and family problems.   Clients range in age from three to 82.  The 17 multidisciplinary clinical staff at W&A are Clinical Social Workers, Licensed and Limited Licensed Professional Counselors, Licensed and Limited Licensed Psychologists, and Licensed Psychiatrists providing care to over 500 clients per year.  Teamed with the professional staff, Master’s level interns provide low-fee and free counseling to clients who do not have insurance or cannot afford to pay privately for psychotherapy.

Clients are referred to the clinic principally via their pediatricians and primary care physicians.  Services are paid by many different payers including Value Options, Blue Cross, PPOM, TriCare, and private pays.

Challenge

Like many behavioral health and substance abuse clinics, W&A has countless day-to-day requirements including ensuring that assessments are completed and sealed within 72 hours; and, treatment notes are completed, signed, and sealed within 24 hours, as well as preparing the documentation required from planning treatment, providing care, and billing.  The Medical Director must travel to different sites to review volumes of cases at private offices provided for his use.  Administrative staff must locate many charts and prepare them for professional review and signature.  Additionally, W&A conducts regular, ongoing research as required by Commission on Accreditation of Rehabilitation Facilities (CARF) and Blue Cross using Client and Referral Source Satisfaction Surveys, Clinical Chart Audits for accuracy, completeness and timeliness, and Clinical Outcome Research to show clinically significant treatment gains from intake to 90-day reviews.  This research is used to identify areas of improvements and to ensure the highest quality of care.  All of these time-consuming demands are required of a diverse staff in a growing clinical environment. 

The current process is extremely repetitious, tedious, and inefficient.  Information is documented and copied from sheet to sheet to comply with accrediting organizations, HIPAA, and payers in an earnest attempt to direct a first-class quality program.  Plus, adding the need to provide evidence-based care for better consumer outcomes and lower care costs, one can begin to understand the challenge in juggling data, shuffling paper, compiling useful information, and managing billing and collections.  This created the potential for therapists for billing for services that were not yet completed or overlooking invoices for services provided.   Collecting correct, complete information from providers for billing and administering claims to myriad payers is an immense, but necessary struggle.  Besides completing this program, implementing an effective disaster recovery plan, from a tornado or fire to a major unforeseen event is a real challenge.  The massive amount of records being retained caused them to outgrow their documents room and was forcing W&A to rent more space or purchase an expensive floor-to-ceiling filing system.

W&A needed an affordable solution that could do more than just maintain records.  It was essential that, instead of paying high costs for software that only contained static screens for entering data, Wentworth & Associates consider investing in a system that offered significant clinical decision support tools and would eliminate costly and repetitive administrative activities. In order to achieve these benefits, W&A required a program to make important day-to-day tasks quick and easy, to provide flexible no-hassle billing functions, allow them to obtain patient outcomes at the click of a button, manage medications, and required little to no internal technical support or hardware upgrades.  In addition to these features, it was also critical that the system be created and supported by a company with a history of responsive and attentive service and a commitment to ensuring that their clients received the most appropriate training in order to realize the total clinical benefit of time and money savings.

After evaluating several electronic medical records systems and companies, W&A selected NextStep Solutions, because of their proven success and experience in outcome-based automation software.

Solution

NextStep™ is a web-based automation software designed for care facilities, ideal for outpatient services, residential programs, and private practice clinics such as Wentworth & Associates.  NextStep Solutions is a Michigan-based company whose success is founded in providing the highest quality software, services, and training to ensure a successful, turnkey experience.

Wentworth & Associates selected NextStep for based on three crucial criteria:

Automated Clinical, Administrative, Billing, and Accounting Processes: NextStep’s integrated wizards for treatment planning, charting goals with direct billing, reminding clinical staff of upcoming assessments, plan reviews, medication reviews, and other important milestones, make day-to-day processes at W&A quick and easy.  Using EZClaim™, W&A  is able to automatically submit claims and generate invoices from service activity information without duplicate entries.  Information flows directly from chart note, to billing, to accounting in QuickBooks™.  Using Internet Explorer, the Medical Director, billing staff, and other key professionals, can continuously process, review, and endorse/sign important information without committing time to travel between offices.

Extreme Flexibility for a Changing Program:Using NextStep’s form builder and program templates ensures changes to W&A’s treatment program, forms, and other important tasks and documents, can be made without having to incur costs for “customizations” or to rely on technical support. 

Cost-Effective, Easy to Manage:   NextStep solves many problems addressed by cumbersome “form-based” systems that only can offer static forms to retain records without an automated process or evidence-based dashboard.  This low cost investment was realized within the first few months without having to pay to have upgrade to their hardware and software. NextStep is web-based, therefore all they needed were working computers that ran Internet Explorer and accessed a high-speed Internet. 

NextStep offered W&A an easy-to-implement, web-based approach to streamlining a paperless, computer-assisted workflow which helps to significantly increase organizational efficiency, facilitate team collaboration, and promote individual productivity.  Using NextStep’s built-in outcome model feature, treatment outcomes are presented by consumer, diagnosis, and program.  With this information, W&A continually identifies strengths and weaknesses in a consumer’s progress and treatment approach for particular diagnoses, refines the approach, and monitors the impact of these improvements – without any extra provider effort or data input.

“We no longer spend hours searching for a client’s or insurer’s chart and encounter the expected embarrassment for failure to immediately locate documents.  We can now have rapid access to all of our clients and their clinical records.  The Medical Director and I can review clinical information from anywhere and can easily make supervisory and clinical recommendations to our staff.  If a client sends me an email that I think is pertinent to their care, I can easily copy and paste it into their medical record.  Letters and psychological testing reports can be effortlessly uploaded into the program.  We have no need to expand our file storage nor continue investing in paper charts,”  said Dr. Lawrence T. Wentworth, President/CEO Wentworth & Associates, P.C. “I especially like the fact that we can customize this program for our practice and do not have to use a one-size-fits-all approach,” he added.

Results

At Wentworth & Associates, NextStep has produced many significant results in all of the needed areas, to include:

Easily Managing and Meeting Deadlines

1) Assessments are signed and sealed within 72 hours -- the program shows both the date the service was provided, and when the document was actually signed.

2) Treatment notes are signed and sealed within 24 hours -- the date and time stamp are shown as well, so that any insurance company can view when the work was completed.

Billing

With NextStep, billing is suspended until a document is actually completed.  Once finalized, a billing pop-up reminds clinicians to enter units-of-service.  From there, claims are automatically transferred to EZClaim which generates claims and invoices.  This billing process is most efficient and eliminates losses from unbilled procedures or late billing.  In reality, W&A’s return on investment has proven to far outweigh the initial funding for the NextStep program. 

Research

1) Client and Referral Source Satisfaction Surveys and phone interviews can now be easily administered as their database of client addresses expands.  Customers can also use NextStep’s Online Downlink to access designated information and complete satisfaction surveys.

2) Clinical Chart Audits are now performed by a team of trained clinicians who can access clearly written charts from home or other sites.  Insurance auditors are famous for not compensating providers for illegible records.  Wentworth & Associates’ internal auditors ensure clinical forms are completed and accurate, and, can quickly and easily give feedback to clinicians regarding info that’s missing or late.  Notes are made in the system giving reasons for missing or late information, without altering the original documents such as “the client has not attended treatment as they were in AZ for two months.”  These memos can be easily accessed with other treatment notes or extracted out separately.
  
3) Clinical Outcome Research is done by comparing the client’s results on the OQ 30, a validated 30 question clinical symptom survey, from intake to 90-day reviews to discharge.  Technicians can quickly retrieve this info from NextStep and generate reports.  This prepares clients to be able to access and input their own symptom data using NextStep’s Downlink.

Disaster Planning
 
NextStep comes with a complete “disaster planning and recovery strategy” that is currently implemented in other facilities and immediately available.  In the event of an emergency, no matter how large or small, there will be no interruption in billing or in client care.  Clinicians always have access to all records from any location (office or home). 

Storage
 
With NextStep, Wentworth & Associates, official medical records are paperless thus eliminating storage rooms of charts and missing documents.  Many of their clients have no paper charts at all.  Clinicians may decide to retain private notes in their file cabinet, but these are not part of the official medical record.  All official records, like an IEPC report or report card, is easily scanned into the system and then returned to the client or shredded.  W&A has saved thousands of dollars by not having to purchase additional file cabinets, and charts folders, paper, copies, and ink cartridges.
 
Oversight from their Medical Director

By using NextStep the Medical Director can access his work any time from his private practice or home to review charts.  This completely eliminates travel time and is a tremendous cost savings, allowing administrative staff to spend more time interacting with prospective clients rather than filing and retrieving charts.

Dr. Wentworth concludes, “NextStep is truly a state-of-the art software product.  It is now easy for my staff and insurance companies to quickly audit charts.  With the built-in reminders feature and evidence-based approach, treatment plan reviews are never forgotten or late.  One of my greatest joys is that we no longer have to reimburse insurance companies for services that they previously determined were late, illegible or not medically necessary!”

See how others have saved time and money and improved their services. Schedule an online demo today!
Email: sales@nextstepsolutionsinc.com or call 248.656.7504