"About Sphere Health"

Full-Service Hospital Information Systems (Financials and Clinicals)

Problem

A 125-hospital company lacked an integrated system that properly linked patient-care activities to the hospital’s accounts payable department.  The financial department was unable to bill for up to six percent of in-patient services and up to 26 percent of outpatient services – a substantial loss of revenue.

Background

The Client approached Sphere Health Systems after noticing a loss of billable services and experiencing difficulty in capturing comprehensive patient-care activities.  As requested by the CFO of the 125-bed hospital, management was interesting in summarizing both in-patient and out-patient reports and integrating these activities into patient accounting and into the billing process.  As a result, management was unable to bill for up to 6 percent of in-patient services and up to 26 percent of outpatient services – a substantial loss of revenue.  Sphere Health's proposed solution had to efficiently and effectively track these activities that were costing the hospital the loss of billable services.

Sphere Health Systems Solution 

The client’s team proposed an integrated – and customized – system that would reliably link patient-care activities with the current process that generated invoices to the responsible payors.  The system would not only document the delivery of all in- and out-patient activities, but it would also perform medical necessity checking prior to the delivery of those activities, generate an appropriate electronic invoice, forward it to the appropriate payor, and generate reminders if the payment were not received within the appropriate billing cycle.  Most importantly, it all happened automatically!

Client Results

Several months after Sphere Health Systems implemented the new system, the hospital’s CFO was able to see impressive results.  The amount of non-billable services had been reduced to less than 1.5 percent on an in-patient basis and less than 3 percent for out-patient services. Equally important, his A/R days have been reduced by 35 percent, resulting in not only increased revenue, but an efficient and improved cash flow.