Hospital and Dialysis Charge Capture System: Charleston Nephrology Associates

Hospital and Dialysis Charge Capture

Lindsey Cornwell

Charleston Nephrology Associates

Charleston Nephrology Associates is a physician-owned premier nephrology group made up of nine providers in Charleston, South Carolina. They see over 2,000 patients per year at four hospital facilities and eleven dialysis units in the area. Charleston Nephrology is committed to utilizing the best and most advanced clinical technology available, and they looked to improve upon their charge capture system in June of 2013. The group started searching for a way to capture their hospital and dialysis charges more quickly and efficiently, and found their solution through pMD.

“pMD is the only change I’ve implemented in 15 years where there were absolutely no issues or negative consequences. It was the smoothest software rollout I’ve been a part of, and one of the best business decisions we’ve made!” - Lane Floyd, Practice Administrator

Existing Paper Process

When Charleston Nephrology first consulted with pMD in 2013, their current paper-based charge capture process for their hospitals was causing them a headache. Providers were turning charges into their billing office in a myriad of ways: on hospital rounding lists, index cards, and sheets of paper. Most providers did not give enough information for these charges to be turned into claims, so their billing team was spending valuable time combing through the hospital system to determine diagnoses, charge codes, and patient demographics. Illegible handwriting was another factor that added to the tedious process, as the team had to first decipher the information. They spent a great deal of time collating and organizing this information from each provider, and then transferring it to an Excel document that could be used as reference to key into Allscripts, their practice management system. Due to the time-consuming nature of this process, the billing team was only able to send out hospital claims every ninth business day.

The practice was also looking for a way to streamline their process for dialysis charges. The mid-level providers recorded their limited visits throughout the month in Excel spreadsheets on their phones and iPads. The physicians gave their comprehensive charges to the mid-level providers, who then sent the spreadsheet to the billing office at the conclusion of the month. The billing office would then spend hours comparing the Excel spreadsheet to their registered patients in Allscripts, registering new and transient patients, and calculating the correct charge code for the corresponding number of visits. These charges were often not ready to be sent out until the 10th or 15th day of the month.

This manual, paper-based charge capture process was costing the billing team an additional 25 hours a month. Lane Floyd, Practice Administrator of Charleston Nephrology for 15 years, knew there had to be a better way.

pMD Charge Capture System Solution

Floyd found pMD through a web search of mobile charge capture companies and reached out to learn more. After a consultative sales process and evaluation, Charleston Nephrology decided that pMD was the right fit to help streamline their charge capture needs.

The providers are now able to keep track of the patients that they are rounding on with shared, real-time patient lists for both their hospital and dialysis units through the pMD mobile application. They submit their charges daily to the billing office, eliminating the need for faxing in the different sheets of paper or making extra trips back to the office to drop off their billing. pMD’s nephrology-specific functionality in the dialysis units also allows providers to know at a quick glance where they stand for their monthly capitation visits throughout the month. “With pMD, I don’t worry about losing my charges anymore or having the billing team track me down with questions,” says Dr. Eric Pride. “The application helps me note who I’ve seen and stay organized on a daily basis. The dialysis functionality is great, and I feel more confident that we’re capturing all of the charges at those facilities. I have transparency on the patients that I need to see.”

Now, instead of compiling a separate document with all the charge information, the billing office is able to log on to the pMD website portal and review the charges. They electronically send over the information to Allscripts through their charge interface with pMD, saving time and reducing errors from manual data entry. Additionally, all of the information needed for charge entry is required by pMD, so incomplete charges and indecipherable handwriting are no longer an issue. “pMD has made a world of difference. The stuff that I had to chase down before took so much of my time. It’s made my life so much easier,” said Valerie Tyler, lead coder at the practice. The billing team now submits claims for hospital charges daily, and they can register new and transient dialysis patients throughout the month, minimizing the amount of work to be done at month-end. The billers process dialysis charges through pMD’s automatic capitation functionality, which generates the correct billing code for each dialysis patient based on the number of limited and comprehensive visits. These charges are now billed out within the first four days of the month, dramatically shortening the reimbursement cycle.

Charleston Nephrology also utilizes other pMD tools to streamline their practices’ workflow. They keep track of their call schedule through pMD, allowing the providers to see which facilities they and their colleagues are assigned on any given week. This replaced a static Excel document that was emailed out every month, and would need to be frequently updated by a staff member. Now, all changes to the call schedule are adjusted in pMD and immediately available on each providers’ phone.

The practice uses pMD’s secure text messaging and alerts functionality to communicate to one another about patients in a HIPAA-compliant and efficient manner. The providers utilize pMD’s automated SMS text message and voice call reminders to ensure that they don’t miss a message, which can contain critical patient information. The secure messaging is integrated in the same application the providers use to capture their charges.


Charleston Nephrology’s goals in implementing pMD were to streamline and standardize their charge capture process across hospital and dialysis units, increase transparency and communication between physicians, and reduce charge lag and days in Accounts Receivable. The practice has been able to achieve these goals over the past two years, as well as capitalize on other added benefits of using pMD.

Providers now submit all hospital and dialysis charges through pMD on the same day as the patient encounter. Floyd estimates that the practice saves approximately 25 hours per month that were previously allocated to tracking down information on charges, re-typing them into their spreadsheet, and hand keying them into Allscripts. Only one full time employee is now needed for both the hospital and dialysis charges.

Communication and transparency for the practice as a whole has improved as well. The billing office is able to utilize pMD’s secure text messaging to communicate inquiries on charges and receive timely answers. They also benefit from the shared, real-time census at each facility. This allows them to clearly identify patients that have yet to be seen for the month, ensuring that patients aren’t missed.

Charge lag has dropped from up to nine days down to one business day. The average days in AR for hospital charges has also dropped from approximately 45 days to approximately 15 days due to the real-time charge capture by the providers. Floyd notes that their cash flow is also much more consistent as they are able get charges out the door quickly and receive multiple payments from carriers each month.

Charleston Nephrology has drastically streamlined its practices’ workflow with pMD’s mobile charge capture and clinical tools. “pMD makes my team more efficient every day,” Floyd said. “The time my providers save by using the software goes back to what they love doing: caring for their patients. The pMD charge capture system has been a win-win for our practice from day one, and we can’t recommend it highly enough!”

About pMD Mobile Software

pMD’s mobile charge capture, secure messaging, care coordination, and HIE services support doctors across multiple specialties and improve patient care. Doctors use pMD to enter their billing charges into Android, iPhone, iPad, and iPad Mini devices at the point of patient care. pMD increases efficiency and security in a practice through automation and secure, HIPAA-compliant text messaging. Doctors using charge capture are increasing their ROI in a time where Medicare cuts, ICD-10, PQRS, and other costs are significantly impacting profitability. pMD provides free interfaces with most major electronic medical records, hospital information, and medical billing systems, including Allscripts Pro PM, Allscripts Tiger, athenaCollector by athenahealth, Cerner, eClinicalWorks, Epic, GE Centricity (formerly Millbrook and IDX), MEDITECH, MobileMD, NextGen, and Vitera Intergy (Sage). For more information, contact pMD.

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