Defran Systems Issues Recommendations for Managing Complex Contract and Billing Requirements

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Company outlines human service provider’s urgent need for regulatory and reporting standardization in time of evolving healthcare reform.

"What the industry really needs now is universal support for electronic data interchange and a consistent set of reporting standards at the state, local and federal levels."

Defran Systems, Inc., a leading developer of web-based, enterprise-wide case, clinical and financial management software for human services organizations, today issued a set of recommendations to help human services providers of all types effectively manage multiple contracts and funders in an often inconsistent regulatory environment. This complexity, coupled with reduced government funding and upcoming Meaningful Use requirements as dictated by healthcare reform legislation, creates a significant administrative and financial challenge for providers.

States are reporting an increased demand for mental health services but the current economic climate has limited their ability to fund them. Today, providers are looking for ways to maximize their efficiency or face the potential of failure. Standing in their way are numerous administrative hurdles which prevent them from realizing their efficiency potential, adding to their costs and jeopardizing their financial stability.

“Human services providers report to numerous funding agencies, each with different data formatting requirements,” said Fran Loshin-Turso, president and CEO, Defran Systems Inc. “Whether its paper copies, spreadsheets, PDFs or proprietary database systems that don’t support electronic data interchange (EDI), it’s no surprise that the administrative costs associated with meeting all of the various standards are high. Electronic health records technology makes this type of work easier; however the industry is a long way from improvement because many funders still don’t accept direct imports from EHRs. What the industry really needs now is universal support for electronic data interchange and a consistent set of reporting standards at the state, local and federal levels.”

In a whitepaper entitled “The Other Side of the Continuum: Why the Rush to Modernize Leaves Human Services Behind,” Defran Systems outlines the specific challenges faced by human services agencies today and contextualizes recommendations for how providers can successfully manage regulatory complexity, advocate for change, and proactively prepare for changing trends in the industry.

EHR Adoption

Integrated clinical and financial management solutions reinforce a data-driven, outcomes-oriented structure that resolve many of the operational difficulties providers typically encounter. The financial and administrative benefits that EHRs provide automate manual data entry tasks, improve overall efficiency, and free up staff resources. This enables providers to grow and better adapt to industry trends, ultimately generating a positive ROI.

Bringing Funders into the Modern Healthcare Environment

The beginnings of a potential resolution to the problem would be an agreement among state and local payers about how to standardize electronic reporting requirements, which would greatly reduce the duplicative, administrative work of human services providers. Additionally, while a fully interoperable Health Information Exchange for primary care and human services is out of reach at the moment, the increased ability to communicate among human services funders would ensure that therefore valuable information about people being served is not lost or duplicated in their systems.

Inclusion of Human Services in the Meaningful Use Program

A 2009 survey of the behavioral health and human services industries indicates that providers’ main obstacle to adopting EHR software is financial in nature. Currently, many human services agencies are ineligible to qualify because they do not employ full-time psychiatrists or nurse practitioners. Expanding the definition of ‘Eligible Professionals’ to include caseworkers and licensed therapists would greatly increase the financial viability of EHR adoption for human services agencies.

“Non-profit human services organizations have been entrusted to care for so many of our most vulnerable citizens, more needs to be done to ensure they are able to do their jobs without compromising the quality of care they provide,” said Joe Naughton-Travers, Senior Associate, OPEN MINDS. “As healthcare reform legislation starts to become a reality, it is important that we not leave out critical parts of the care continuum. Something as simple as consistent information and support of electronic imports can be the difference between success and failure for these organizations.”

More detail, including background on the human services sector and how they came to be in the position they are today, can be found in the complete whitepaper on Defran’s website at http://www.defran.com/continuumpaper.

Additionally, to keep up to date on these relevant industry issues, subscribe to Human Services Spotlight, the leading news portal for behavioral healthcare, social services and developmental disabilities providers.

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Ben Jacoby
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