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Memorial Health
Managing That Matters
Located in Savannah, Memorial Health operates one of the most
active managed-health organizations in the Southeast. Memorial
Health provides managed health care services to approximately
thirty client companies with more than 55 thousand people while
also operating a tertiary-care teaching hospital. And when
decisions are made on matters of patient care, medical director Dr.
Richard Lachiver is there to see that they're made in an accurate
and timely manner. "When doctors have a patient on whom they want
to perform a procedure," he explains, "they tell us about the case
and the circumstances, and we make a judgment on whether the
procedure is permissible under the client's coverage plan. We also
have a disease management program, a new concept under which
patients with chronic complaints -- diabetes, asthma, and the like
-- are helped to get managed treatment that's both effective and
efficient."
Information moves through Dr. Lachiver's department in constant
streams - case histories, diagnoses, documentation of claims -- but
his staff never loses sight of the fact that there are real people
on the ends of each stream. So it's one of Dr. Lachiver's
priorities to ensure that claims are processed as quickly and
accurately as possible. "We'd been leasing proprietary claims
management software, a cost running between $100,000 and $150,000 a
year," he recalls, "but we had to generate claims management
letters by hand, typing the information into the system and then
printing out the letters. There were stacks and stacks of
paper."
It was an inefficient system from the company's perspective -- and
delays in approval for claims meant delays in care for patients.
But about a year and a half ago, Dr. Lachiver began to experiment
with FileMaker Pro. "I had been using FileMaker Pro personally for
years," he says, "and we were using the software elsewhere in the
organization for scheduling patients and other functions. I just
kept adding functions to it -- and ended up with the system we have
now. You name it -- we can do it on FileMaker Pro."
FileMaker Pro offers an approach that's more efficient -- and also
more cost-effective. Instead of spending up to $150,000 a year to
lease software, Memorial Health owns its FileMaker Pro system
outright. "The cost now is essentially $0 on an ongoing basis," Dr.
Lachiver comments. "The cost to us initially was about $2000 for
the software and another $1500 for a server. There are no recurring
costs."
Now, FileMaker Pro stands at the heart of Memorial Health's claims
management operation, and there's a staff of 15 to 17 people
working in a network of about 50 databases containing tens of
thousands of records relating to individual claims. "We collect
clinical information from the doctor on each case," Dr. Lachiver
explains, "and all the necessary documentation. Once entered into
FileMaker Pro, we can examine the documentation all at once -- and
if the case is approved, we just press the 'yes' button, and
FileMaker Pro automatically generates the letter authorizing the
procedure, complete with a unique authorization code that will
allow the claim to be paid. Now with FileMaker Pro, letters go out
in hours -- not in days. The procedure is smoother for doctors, for
patients, for clients -- and for us!"
Contact information
Contact Info for Customer:Dr. Richard Lachiver
Medical Manager
Memorial Health
912-350-6608
lachiri1@memorialhealth.com
http://www.memorialhealth.com
Filemaker Contact:
Kevin Mallon
Public Relations Manager
FileMaker Inc.
408-987-7227
kevin_mallon@filemaker.com
http://www.filemaker.com
- For Memorial Health, a busy managed-health organization in Georgia, claims information keeps moving at a healthy pace with a boost from FileMaker Pro.
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