Epiphany Healthcare Blog

How Epiphany Resolved an Enterprise Hospital’s Billing & Order Completion Issue

Posted by Allison Fawber on December 5, 2017 at 2:08 PM

An enterprise hospital using Cardio Server in Alabama contacted us to look for a way to improve their ECG billing workflow.


For ECG interpretations, there are two bill types: technical and professional. In this particular hospital’s case, the staff would manually change the study status in the EMR to generate the technical component of the bill.  

Of course, if any part of an organization’s workflow is manual, there is always a chance of inconsistency or clerical errors. At times, their manual process led to the hospital not billing the technical fee for performing an ECG. The hospital was losing revenue because, in their EMR, the trigger for dropping the technical charge required that the order status needed to change. In their previous workflow, this was a manual entry, it did not change automatically, and, therefore, the technical bill occasionally was not dropped. The hospital staff realized there was room for improvement and asked Epiphany if there was a way to automate this process. Epiphany’s answer was “absolutely.”



Epiphany now sends an order-status update message from Cardio Server automatically when the study is promoted to Unconfirmed. When Cardio Server sends the automatic update, the EMR changes the order status, which triggers the bill for the technical charge.

Patricia Brewer, an Epiphany Project Manager who worked with the hospital on the implementation, adds, “We are passionate about solving our customer’s problems here at Epiphany and this workflow fix is one of the many things we can do with Cardio Server’s flexibility to better the customer’s use and appreciation of our product.”

The resolution in Cardio Server for this hospital’s problem is not an uncommon request. This type of workflow improvement is what we at Epiphany work to achieve daily. When you calculate the time spent manually entering status change, in addition to lost revenue, automating the process with the help of Cardio Server and your EMR is substantial. If your EMR is able to accept an order-status update message, we can leverage that information to customize your Cardio Server configuration. Sign up for a complimentary workflow analysis to find out how Epiphany can improve clinical workflow for you.

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Topics: hospital billing, hospital billing issue, ECG billing, technical fee, technical charge, EKG billing

Buyer’s Guide 3:  Cardio Server — Resolve Your Healthcare Billing Challenges

Posted by Lisa Wolfenbarger on December 16, 2015 at 1:38 PM

Electrocardiograms are one of the most prolific examinations in a hospital. They may not be complicated to perform but the sheer number of them make ECGs a challenge to manage, particularly in hospitals working with paper-based ECGs.

We hear repetitive grievances from managers of paper-based departments. They typically state problems that relate to lost revenues from the ECGs as well as other study types. Problems include:

  • Late physician over-reads that delay billing;
  • Weekend/holiday orders and over-reads that get lost with weekend/holiday staff; and
  • Human error in processing studies resulting in missed charges and duplicate billing.

Epiphany has solved these problems for dozens of formerly paper-based hospitals. Here is how it works:

  • Configure Epiphany’s Cardio Server with orders, results, and billing modules;
  • Orders come to Epiphany from your EHR and match to completed studies using patient ID, first name and last name;
  • Completed studies promote to an unconfirmed queue for physicians to read;
  • Physicians read from anywhere at any time versus only in the Cardiology Department;
  • When they confirm the study, a result message automatically goes to the EHR along with a completion message that automatically goes to the billing system.

hospital_billing_statement.jpgBy having access to Cardio Server from anywhere, hospitals eliminate late physician over-reads; this happens daily and on weekends/holidays. By automatically linking orders to billing messages, human error in manual billing is eliminated; hospitals using Epiphany’s automated billing module no longer miss charges or double bill—they capture previously lost billing.

Additionally, we customize the billing workflow to your requirements. For instance, some of our customers want to separate technical from professional charges. We accomplish this by flexible triggers. In the separation instance, we trigger the technical charge once an order is linked to a study and promoted to the unconfirmed queue. The study is then read by the physician and confirmed. The physician’s confirmation triggers a second charge, the professional charge. (To learn more about Epiphany’s HL7 integration for automated billing, see our blog: “HL7 Integration Developments – Technical Charges, Professional Charges, and Credits.”)

On top of all the billing problems we solve, our formerly paper-based customers save money in the labor required to manually process ECGs. Many of them save enough money in the first year to pay for the entire system and enjoy the benefits of reduced labor costs forever. This also applies to other modality types, e.g., Holter, stress, PFT, and more. (See our blog: “Inefficient Paper Process Weighing You Down? Let us Analyze Your Workflow!”)

If you would like to improve efficiency and save money at your hospital or hospital system, contact Epiphany Healthcare today for a demonstration and see what Cardio Server can do for you!

Buyer's Guide 1:  Support, Training & Upgrades   Buyer's Guide 2:  Interoperability

Let Epiphany Help Solve Your Workflow Challenges

Topics: Cardio Server, Epiphany's Cardio Server, reduce costs, ECG, hospital billing, paper-based hospitals, healthcare billing challeges, healthcare billing, duplicate billing, healthcare workflow efficiency, automated billing

Epiphany Improves Workflow for A Critical Access Hospital in Cody, Wyoming

Posted by Allison Fawber on September 4, 2014 at 10:26 AM

Physicians learning Cardio ServerA critical access hospital in Cody, Wyoming implemented Epiphany’s Cardio Server three years ago to help manage their ECGs, stress, and Holter studies. We were able to speak to the Cardiopulmonary Manager about how the hospital’s workflow has changed since 2011. 

What was your organization's workflow like before implementing Epiphany?:
We would do the procedure and fax the results to the ordering doctors. When they were interpreted, we would re-fax a copy to the ordering doctors and send the originals to Medical Records to be scanned into the EMR. We also kept a copy in our office for comparison if the patient returned at a later date for ECGs. Then several days later the doctors’ offices would call and state they did not get them and we would pull the chart and fax once again.

What is your workflow like today?:
The ECGs are transmitted from the ECG machine to Epiphany at the time of service. When the order is entered, they attach to the order and go directly to the patient's EMR. All of our doctors’ offices have access to Epiphany and they can look at [the studies] there or in the EMR. We do not get calls to fax results any more. We deal with a Pediatric Cardiologist out of state and he is able to access and interpret all of his patients’ tests in Epiphany also. We also just started using Messenger and now all the doctors get a report of the interpretations from the Cardiologist. The process is the same for stress tests and Holter monitors. We do the procedure and transmit directly to Epiphany, which sends it to the EMR.

If you could tell other hospital organizations one thing about how Cardio Server has helped you and/or your organization, what would it be?:
Cardio Server has helped cut back the wasted steps of faxing reports over and over again due to offices misplacing them. It has saved our medical records department time since they don't have to scan all the reports in. Cardio Server also helps the billing office; we print out weekly reports of all the confirmed results. These reports tell who confirmed them and what site they were located at.

Any other comments you'd like to add?:
The staff at Epiphany is very helpful. If there is a problem, they handle it quickly. The support team has always worked with me to figure out a solution in my workflow and they're extremely nice.

Epiphany is constantly working with hospitals of all sizes to provide a solution to their workflow challenges. Cardio Server is scalable to meet the needs of critical access hospitals, community hospitals, university medical centers, and large independent delivery networks including physician practices and clinics. Want to see how Epiphany can tailor a solution to your organization’s needs?

Let Epiphany Help Solve Your Workflow Challenges

Topics: Cardio Server, stress workflow, Epiphany support, holter studies, ECG workflow, hospital billing

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