SOURCE: Boston Software Systems

June 20, 2005 08:30 ET

UPMC Selects Boston WorkStation to Significantly Improve Revenue Cycle Management

Leading Healthcare Delivery System Sets Industry Standard for HIPAA Health Care 276/277 Claim Status Request and Response

SHERBORN, MA -- (MARKET WIRE) -- June 20, 2005 -- Boston Software Systems™, the leader in workflow automation technology to the healthcare market, announced today that the University of Pittsburgh Medical Center (UPMC), a leading healthcare delivery system for western Pennsylvania, has implemented Boston WorkStation™ to improve its electronic patient insurance eligibility and electronic claim status process with all major payers. UPMC is among the first hospitals in the country to implement the electronic 276/277 claim status transactions with Blue Cross, Medicare, Medicaid and WebMD.

Eligibility and Coverage Transactions

Historically, hospitals have manually contacted third-party payers to obtain eligibility and coverage information. Currently, many payers offer Internet access on a single patient inquiry basis or use service bureau firms that provide these transactions in a batch or real-time mode. However, these transactions have a cost associated with them, which are billed to the hospital.

"In the short term, UPMC will use the Boston WorkStation software to go directly to the payers' Web sites to electronically obtain insurance eligibility, and then automatically post that information to the patient accounting system," said Don Riefner, vice president of finance at UPMC. "This eliminates the service bureau costs and provides an alternative if the service bureau cannot support a payer. Given that UPMC has annual visit volumes of approximately 1.5 million (6,000 per day), we will see significantly greater efficiencies by using Boston WorkStation. In the next few months, UPMC will implement this automated workflow system for Medicare, WebMD and Pennsylvania Medicaid."

Claim Status Inquiry

Additionally, new HIPAA transaction sets, labeled "276/277," require a hospital to obtain the current status of a claim within the adjudication process. "This extremely valuable information will allow UPMC to focus its claims status follow-up efforts with laser-like precision and optimize the productivity of our staff," said Reifner.

"Presently, very few payers support processing these 276/277 transactions in a Web-based and/or batch mode," said April Langford, director of revenue cycle at UPMC. "Using the Boston WorkStation technology, UPMC is implementing an automated electronic claims status process for commercial payers, Medicare and Pennsylvania Medicaid."

"UPMC continues to set the standard for commitment to clinical excellence, education and research, and the application of innovative technologies. For the past six years, it was recognized as one of the most technically savvy hospitals by Hospitals and Health Networks. As a leader in revenue cycle management, it's no surprise that this organization is deploying innovative approaches towards process improvement and revenue enhancement," said Sara McNeil, president of Boston Software Systems. "Boston WorkStation has a proven track record of offering healthcare organizations a successful way to improve workflow efficiency through automation. We are confident that UPMC will not only continue to lower accounts receivables but also materially reduce operating expenses."

About Boston WorkStation

Boston WorkStation is a workflow automation and integration technology that provides an environment for on-demand process innovation and development. Boston WorkStation allows healthcare organizations to dynamically respond to changing business and compliance requirements by automating common tasks, creating complex processes, automating interaction with Web sites, or integrating new applications, systems and devices.

About UPMC

The University of Pittsburgh Medical Center (UPMC) is the largest integrated health care delivery system in Pennsylvania and one of the leading nonprofit medical centers in the country. With more than 39,000 employees, it is the largest employer in western Pennsylvania. More than 4,000 physicians have privileges at UPMC hospitals including about 1,950 employed physicians. UPMC spans the full spectrum of health care delivery with its network of 19 tertiary, specialty and community hospitals and 400 outpatient sites and doctors' offices.

About Boston Software Systems

Boston Software Systems is the leading standard for workflow automation and system integration software, enabling healthcare organizations to streamline complex business processes and improve productivity. Hundreds of healthcare organizations worldwide respond to regulatory and business initiatives by using Boston WorkStation technology to automate and improve processes throughout their facilities. Boston Software Systems' customers include HCA-Midwest, Stanford Medical Center, Charleston Area Medical Center, Lutheran Health Network and Tenet Healthcare. Boston Software Systems partners with leading application and systems vendors such as McKesson, Siemens, Quovadx, Orion International and WebMD. For more information, please visit the Company's Web site at or call 866.653.5105.

Boston Software Systems and Boston WorkStation are trademarks of Boston Software Systems, Inc.

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