BPM Healthcare

Cardiff White Paper
The Business Process Management Guide for Healthcare

Implementing Proven Solutions for the Most Demanding Business
Processes in Healthcare
Proprietary and Confdential to Cardiff.
The Business Process Management
Guide for Healthcare
Implementing Proven Solutions for the Most Demanding
Business Processes in Healthcare
January 2006
Table of Contents
Foreword 2
Streamlining Healthcare Organizations with BPM Technology 3
Benefts Derived from BPM Technology 3
High Return BPM Projects in Healthcare 3
Payer: Insurance Claims Processing 3
Provider: Patient and Treatment Data Collection 4
Provider: Doctor Surveys 4
Provider: New Hire On-boarding Process 4
Research Institutions: Clinical Trials Automation 4
Overview of Cardiffs BPM Solutions for Healthcare 5
Gaining Control over Paper-based Processes with Cardiff TeleForm 5
TeleForm Process Flows 5
TeleForms Return on Investment Potential 5
Typical Customer ROI Scenario 6
Before TeleForm: 6
After TeleForm: 6
TeleForms Advantages over Other Content Capture Solutions 6
Typical ROI Calculation for TeleForm 6
Before TeleForm 6
After TeleForm 6
Financial Beneft 7
TeleForms Beneft and ROI Summary 7
Eliminate Manual Data Entry for Medical Claims Processing with Cardiff MediClaim 7
Achieving Faster Processing and Greater Accuracy with MediClaim 8
Protecting Patient Privacy and Ensuring Compliance with MediClaim 8
MediClaim Offers Straightforward Deployment into Any IT Environment 8
Streamlining Processes with eForm Technology from Cardiff LiquidOffce 8
LiquidOffce Process Management 8
LiquidOffces Return on Investment Potential 8
Typical Customer ROI Scenario: 8
Before LiquidOffce: 8
After LiquidOffce: 8
LiquidOffces Advantages over Other eForm and BPM Solutions 9
Typical ROI Calculation for LiquidOffce 9
Before LiquidOffce 9
After LiquidOffce 9
Financial Beneft 9
LiquidOffce Beneft and ROI Summary 9
Conclusion 10
About Cardiff 10
Appendix: Case Studies for Cited Customer Testimonials 10
Moorestown Visiting Nurse Association 11
Riverside County Department of Mental Health 15
SERV Centers of New Jersey 19
Sonic Innovations, Inc 23
South Carolina Area Health Education Consortium 27
American HomePatient 31
Publishers Note: Information contained in this document is intended for guideline purposes only Cardiff product documentation supersedes information contained in
this document The situations described in this document are offered as examples; actual confgurations and results will vary from system to system
Foreword
The goal of this document is to help corporations of all sizes and across indus-
tries to identify areas where business process management (BPM) technology
can offer the greatest return for their available resources today while providing a
technology foundation to support future initiatives.
Perfectly suited for organizations with limited IT resources and budget, this guide
offers recommendations for advanced technology solutions that dont require
wholesale changes to legacy systems or a brand-new enterprise-wide strategic
technology direction. To the contrary, this guide delivers explicit advice on the
kind of projects that can be embarked upon quickly, that provide a quantifable
and well-established return on investment, and that feature a technology frame-
work that supports organization-wide growth and expansion.
You can rely on Cardiff for expert advice in this area. We have over 8,000 custom-
ers who have benefted from our solutions for more than 10 years. This guide
contains real customer stories, complete with a discussion of the benefts they
have achieved and the forms and processes they have implemented.
Cardiffs adaptive BPM solutions can deliver quantifable ROI to healthcare orga-
nizations of all sizes, including payer organizations, providers and labs. We can
deliver that value by our unique approach of thinking big, starting small and
delivering results quickly. The following paper will show you how.
Best regards,
Mark Seamans
General Manager, Cardiff
Streamlining
Healthcare
Organizations
with BPM
Technology
At the heart of any healthcare organi-
zation lies a set of critical processes
upon which the business is utterly
dependent. These include processes
such as patient and insurance enroll-
ments, medical trials records, hospital
administrative functions, procurement
processing, HR forms and insurance
claims processingmost of which
have been, and continue to be, paper-
based. While this patchwork of paper
processes can work, it lacks effciency
and distracts resources from the pri-
mary mission of providing patient care.
IT executives struggle with achieving
effciency in these processes because
many IT systems are not integrated,
process-centric or easily adaptable.
This is where business process man-
agement (BPM) technology can help.
In addition to effciency gains, the pas-
sage of the Health Insurance Portabil-
ity and Accountability Act (HIPAA) is
also driving widespread adoption of
BPM technology. For the past three
years, organizations have improved
record-keeping, implemented tech-
nology and put the means in place
to ensure compliance. Organizations
have now begun to shoulder the
ongoing burden of the management
of manual processes and reports
required by HIPAA.
By automating the work and the fow
between functions using BPM technol-
ogy, employees do not need to learn
the details of regulation compliance.
They perform tasks assigned to them,
and the system handles the procedure.
Negligent or intentional violations of
procedure are not possible. This eases
the burden of regulatory changes on
employees and eliminates the possibil-
ity of accidental violations.
By means of defnition, BPM describes
the entire business process, including
the key issue of integrating all the peo-
ple, processes and systems involved,
both internal and external, for maxi-
mum effciency. BPM is fully applicable
for all types of healthcare organiza-
tions, including payers, providers and
research organizations. Utilizing BPM,
processes are automated, progress
can be tracked, and compliance with
best practices is ensured and proven
through a detailed audit trail. Reduced
operational costs and improved fnan-
cial metrics are the end result.
By its nature, BPM usually involves
the integration of many different
systems, functional groups, custom-
ers and document formats. As such,
BPM projects can become quite
complex and can require the integra-
tion of diverse systems. The key is to
implement a solution that is powerful
enough to accommodate complex
processes, fexible enough to handle
ongoing change, easy enough for
users to embrace and simple enough
to be implemented within available
time and budget.
Benefts Derived from
BPM Technology
Healthcare organizations are increas-
ingly looking to BPM not only as a
solution to specifc, immediate pro-
cess improvement objectives, but as a
platform that gives them the ability to
tackle diverse process improvement
initiatives. BPM technology can enable
healthcare organizations to achieve
the following:
Increase quality of service delivery
Economically streamline the end-to-end
patient management process and enable
the providers employees to make deci-
sions based on best practices
Improve revenue cycle management
initiatives Automatic work routing and
notifcations across groups, networks
and external partners reduces the time,
errors and complexity of executing pro-
cesses such as claims processing
Extend value of core healthcare systems
Leverage existing applications and legacy
healthcare systems by flling in the gaps
with more effcient Web-based forms,
interfaces and reporting
Ensure that the process that is docu-
mented is the process that is executed
Process models that actually run the
process provide consistency, adherence
to standards such as HL7 and audit trails
to ensure compliance with regulations
like HIPAA
Decrease overall administration costs
By automating and controlling how pro-
cesses are managed, costs are reduced
and productivity is signifcantly improved
High Return BPM Projects
in Healthcare
This guide will help you identify cer-
tain low risk and high reward process-
es that can be effectively implemented
by healthcare organizations. Since IT
budgets are not projected to improve
for several years, the challenge is to
distribute fat or shrinking resources
creatively, focusing on projects that
return rapid ROI, and only adding tech-
nology that is scalable, has a long track
record of success and is well support-
ed. Cardiff can deliver these solutions.
The advice in this paper is based on
experience spanning over 10 years of
delivering highly effective and proven
solutions for this market. We have
tackled and solved some of the most
challenging problems in healthcare,
and we can help with yours as well.
Payer: Insurance Claims Processing
Fundamental for healthcare payers
is the ability to rapidly and effec-
tively process the thousands of claims
received daily. Most organizations
are forced to rely on large numbers
of claims processors to manually
process claims. Typically, manual
claim processing creates huge delays,
decreased processor productivity,
increased paper routing and mishan-
dled claims.
Ripe for BPM solutions, insurance
claims processes that fail to meet pro-
ductivity goals may result in substan-
tial penalties or loss of business. To
compound the problem, the changes
in claims rules and regulatory require-
ments may not be captured quickly
enough to avoid additional problems.
While it may take several weeks to
receive reimbursement for a correctly
coded claim, an incorrect claim may
take months to resolve. By streamlining
expensive and time-consuming coding
processes, BPM solutions can dra-
matically improve claim payment turn-
around time and increase data accuracy.
This is a clear winner for automation,
as noted by the following real-life
example1:
State Fund Mutual has cut the time
it takes to process and pay bills to
both providers and claimants by 84
percent. The industry standard is
typically 90 days to gather all the
bills and associated records, approve
claims and issue payments. Prior
to implementing BPM, State Fund
Mutual took 51 days to process claims
and issue payments to providers.
That time is now down to 8 days.
Provider: Patient and Treatment
Data Collection
Many healthcare organizations need
to report on client satisfaction and
treatment outcomes to demonstrate
accountability and justify expendi-
tures of public healthcare funds. This
requires the implementation of sophis-
ticated processes to collect, analyze
and report on treatments. In most
cases, due to lack of connectivity to
electronic forms, paper-based pro-
cesses must be used. BPM can offer
clear ROI for these processes through
the use of content capture technology.
For example1:
The Riverside County (California)
Department of Mental Health
used BPM to administer a survey
to analyze the success of treatment
strategies for many of its 42,600 cli-
ents. BPM helped the agency develop
clinical feedback that would provide
immediate trend data in graphical
format. As a result, service providers
and clients could establish treatment
goals and see progress from one visit
to the next.
Provider: Doctor Surveys
Many specialties within medicine need
to collect provider treatment practices
to optimize and improve patient out-
comes, reduce costs and understand
patient satisfaction. For most felds,
the methods of collecting this data
have not changed in 40 years. That is,
they record a patients demographics
and statistics on non-standardized,
hand-written documents, which are
often incomplete and may be illeg-
ible. Further complicating matters, the
information is then fled away with
the patients chart. As a result, the
information collected is highly under-
utilized. From an information process-
ing and analysis standpoint, the infor-
mation is essentially dead. However,
BPMs content capture capabilities can
rescue this information and make it
useful, without wholesale changes to
provider practices. For example
1
:
Using BPM, Cardinal Healthcare
System has employed sophisticated
handprint recognition technology to
extract data from doctor treatment
summaries to analyze treatment
strategies and patient outcomes.
Generating this information was
practically impossible without the
use of content capture technology.
Provider: New Hire
On-boarding Process
Healthcare organizations are often
plagued by high turnover. Staffng chal-
lenges place a tremendous administra-
tive strain on an organization, as the
process for on-boarding an employee
can be extremely complicated and
protracted. On-boarding for healthcare
workers includes initial provisioning,
HR and benefts forms processing,
drug testing, and background employ-
ment checks. Without automated pro-
cesses, these tasks can be overwhelm-
ing and are prone to error and compli-
ance violations. Healthcare organiza-
tions can save hundreds of thousands
of dollars by eliminating paperwork,
redundancy, and the lack of integration
across departments. For example
1
:
GlaxoSmithKline has implemented
employee on-boarding processing for
over 120,000 employees in 200 dif-
ferent locations, saving millions of
dollars in employee processing.
Research Institutions: Clinical Trials
Automation
Pharmaceutical and biotechnology
companies can spend more than $800
million and 12-15 years in bringing
a drug to market. The clinical tri-
als process is the longest and most
expensive component of the drug
development process. With increasing
industry pressure to develop, test and
market greater numbers of new drugs
faster, competitive advantage will go
to pharmaceutical companies that
best control their clinical trials costs.
Drug companies stand to lose
between $600,000 and $1 million
each day a clinical trial delays a drugs
development. Keeping clinical trials on
time and on budget is imperative. 75
percent of clinical trials are conducted
using paper data collection; the
remaining 25 percent are conducted
electronically. The ability to capture
data from paper case report forms is
still the cornerstone of a clinical trials
solution. Because of the many parties
involved in the clinical development
process from investigators, to CRAs,
to data monitors, to data entry techni-
ciansprocess standardization and
workfow enhancements are key for
accelerating clinical trial timelines.
BPM helps healthcare achieve this
objective. For example1:
The University of California at San
Francisco (UCSF) is involved in
nearly 40 different health studies
being conducted in more than 50
remote sites around the globe. Each
study involves thousands of par-
ticipants. Before automated content

Comprehensive case studies are included in the appendix
Scan Station/
Remote Capture
Station
TeleForm
Reader
Data Storage
Repositories
TeleForm Verifier
1 2 3 4
capture solutions, this level of com-
plexity was impossible to manage.
However with BPM, UCSF is able
to quickly and accurately capture all
the incoming data with far fewer
resources.
Overview of Cardiffs
BPM Solutions for
Healthcare
Cardiffs content capture and busi-
ness process management solutions
provide healthcare institutions with
powerful tools to effciently, effectively
and expeditiously handle the primary
business problems described earlier for
payer, provider and research organiza-
tions. Using Cardiffs content capture,
electronic form and adaptive BPM tech-
nology to automate manually intensive
process, these organizations can deliver
better service with fewer resources.
Easily incorporated into existing pro-
cesses, Cardiff offers the only solution
that can accommodate both paper
and electronic forms and documents.
Cardiffs versatile BPM and content
capture technology enables institu-
tions to leverage the advantages of
online processes, while maintaining
similar processes and effciencies for
the thousands of paper documents
that are received via traditional mail
or fax.
For most healthcare institutions, their
specifc business problems revolve
around answering the following ques-
tions: How do I gain control over my
paper-based processes, and then how
do I leverage the ubiquity of the Web
and electronic processes to gain fur-
ther effciencies?
Below, Cardiffs BPM solutions are
described in that context.
Gaining Control over Paper-
based Processes with Cardiff
TeleForm
Cardiff
TeleForm
enables health-
care institutions to quickly and easily
capture and convert paper-based and
electronic forms into digital data that
can be used throughout the organi-
zation. A versatile and comprehen-
sive software solution, TeleForm is
designed to accommodate even the
most demanding business needs.
The only content capture solution
capable of managing both paper- and
electronic-based forms, TeleForm
offers healthcare organizations the fol-
lowing benefts:
Dramatically reduces operating costs
associated with manual data entry
Increases operating effciency
Serves as an on-ramp for Web-based
content and document management
systems
Leverages existing technology invest-
ments
Scales to meet ever-growing process
requirements
TeleForm Process Flows
The following section describes a typical
fow of data made possible by TeleForm:
1 ScanningDocuments, such as insur-
ance claim forms and doctor or patient
surveys, can be scanned at any scanner,
multifunction device or digital copier This
process can occur remotely or at a cen-
tralized location The scanned images are
placed in a network folder or at the local
workstation where they are then picked
up and processed by the TeleForm Reader
2 TeleForm ReaderThe reader grabs the
document images and begins processing
The Reader then recognizes and converts
a multitude of inputs (ie handwriting,
computer text, barcodes, bubbles, signa-
tures) into an electronic format
3 TeleForm VeriferAny characters that
are considered ambiguous by TeleForms
industry-leading RecoFlex engine are
sent to a verifcation station for manual
review and correction
4 Data StorageData is loaded into a
back-end database or sent for further
processing
TeleForms Return on
Investment Potential
By enabling healthcare organizations to
do more with less, TeleForm offers an
excellent return on investment. The fol-
lowing is a typical customer scenario
The Business Process Management Guide 5
The fact that TeleForm has reduced the time it takes a data
entry clerk to input data from 5-page OASIS forms, from
0 minutes down to only two minutes, enables us to stream-
line processes more than we had expected.
Janet Scheffer, IS supervisor, Moorestown Visiting Nurse Association
that demonstrates how TeleForm can
dramatically improve business pro-
cesses while reducing expenses.
Typical Customer ROI Scenario
A healthcare payer organization
receives thousands of insurance
claims per week that need to be pro-
cessed, evaluated and paid.
Before TeleForm:
Prior to implementing TeleForm, the
organization was required to manually
enter the information on each form.
The image above indicates the process.
A highly ineffcient process, it took
more than three hours to process each
application, the data quality was poor
due to the errors associated with man-
ual data entry, and staffng challenges
were constant.
After TeleForm:
By incorporating TeleForm, the appli-
cations are scanned and then auto-
matically converted to electronic for-
mat, with only a small portion of the
forms needing manual verifcation.
The diagram at the right illustrates
the new process.
With this process, the number of data
entry clerks is reduced from 20 to 5, data
quality has improved from 10 errors in
100 forms to 1 error in 1,000 forms, and
the time to process is reduced from 3
hours per form to 10 minutes.
TeleForms Advantages over
Other Content Capture
Solutions
TeleForm has signifcant advantages
over other products in the market.
Most notably:
Superior RecognitionAt the core of
TeleForm is a state-of-the-art voting
system that leverages advanced RecoFlex
technology, an award-winning and neural-
based recognition system TeleForms
RecoFlex technology offers superior
recognition for hand print, machine print,
check box, barcode and other input
formats, thereby eliminating manual
interventions
Enterprise ReadyTeleForm is built
for handling mission-critical business pro-
cesses in complex IT environments From
advanced administrative capabilities,
such as LDAP support and single sign-on
to enterprise-strength security, TeleForm
can handle any size job in a wide range of
IT environments
LiquidOffce IntegrationTeleForm is
integrated with LiquidOffce, Cardiffs
enterprise-class BPM application, allow-
ing customers to seamlessly manage the
transition from paper-based processes to
electronic ones
Typical ROI Calculation for
TeleForm
Return on investment can be calcu-
lated by comparing the cost of manual
data entry with automatic form pro-
cessing powered by TeleForm. The fol-
lowing example demonstrates the ROI
that an organization can achieve by
reducing the amount of time it takes to
process each form.
Before TeleForm
Number of forms per day: 200
Data entry time per form: 15 minutes
Total data entry time per day: 50 hours
(200 forms x 15 minutes)
Daily labor cost: $1,000/day
(50 hours x $20/hour)
Labor cost per year: $250,000
(250 work days x $1,000/day)
After TeleForm
Number of forms requiring verifcation: 66
(33% of 200)
Time to verify forms: 6 min
Total data entry time per day: 66 hours
(66 forms x 6 minutes)
Daily labor cost: $132/day
(66 hours x $20/hour)
Labor cost per year: $33,000
(250 work days x $132/day)
Total technology investment: $98,600
(software, hardware, implementation
services, training, support/maintenance)
Total technology and labor costs:
$131,600
Original
Forms
Received Forms
Waiting for Entry
20 Full-time
Entry Clerks
Data
Stored
Original
Paper
Archived
FA
X
Original
Forms
(Paper or
Electronic)
O
n
lin
e
Received
Forms
Processed
Daily
15 Fewer Data
Entry Clerks for
75% Reduction
Immediate
Access
to Data
F
A
X
Financial Beneft
First-year savings: $118,400
($250,000 in labor costs vs $131,600 in
TeleForm technology + labor costs)
Second-year savings: $208,900
($250,000 in labor costs vs $41,100 in
TeleForm-assisted labor costs)
Payback in months: 55
(based on labor cost-savings)
Two-year ROI: 207%
(based on a two-year total investment of
$106,700 yielding a savings of $327,300)
The above example highlights the
hard-cost labor-savings from automat-
ing the processing of a relatively small
number of paper-based forms. A full
analysis of TeleForms ROI would also
include soft cost-savings stemming
from reduced errors, higher worker
productivity and improved responsive-
ness. Upon request, Cardiff can pro-
vide you with an ROI calculation based
on your existing processes.
TeleForm Beneft
and ROI Summary
Most healthcare organizations are
struggling to gain control over the
massive infux of paper forms and
documents that can overwhelm and
impede their productivity, resulting in
increased costs and higher error rates.
TeleForm can play a major role in eff-
ciently managing the increased volume
and complexity of business processes.
By replacing manual data entry tasks
with automatic processing, TeleForm
has enabled healthcare organizations to
achieve the following benefts and ROI:
Up to 90% reduction in manual data entry
costs
Up to 500% and greater improvement in
processing time
Increased staff productivity
Lower labor costs from decreased staff-
ing requirements
Reduced fnancial risk from regulatory
infractions with improved accountability
Increased data quality with automatic
data cleansing and validation
Accelerated delivery of data and docu-
ments to back-end systems
Improved service levels with immediate
access to data and faster response times
Better return on investment in current
systems through easy integration with
existing applications and databases
Accuracy, speed, scalability and
versatility make TeleForm an ideal
document capture, data collection and
information processing solution for
healthcare organizations of all shapes
and sizes.
Eliminate Manual Data
Entry for Medical Claims
Processing with Cardiff
MediClaim
Available as a value-add option to
TeleForm, Cardiff
MediClaim
is
deigned to easily automate medical
claims processing. MediClaim pro-
vides a comprehensive, high-volume
enterprise solution for scanning insur-
ance claim forms (HCFA (CMS) 1500
and UB-92) and automating the collec-
tion and processing of claim payment
data. Leading insurance third-party
administrators, HMOs and medi-
cal organizations have shown that
MediClaim expedites claim payment
workfow, reduces costly errors and
payment disputes, minimizes claim
adjudication costs, and increases cus-
tomer satisfaction.
By providing access to system infor-
mation and original documentation,
MediClaim allows greater effciency
for claims examiners. Pre-made Medi-
Claim Connect Agents automatically
pass data to database and back-offce
applications, and process images and
index information to most document
and knowledge management systems.
Cardiffs advanced recognition and
Software Re-Scan technologies
work together to replace manual
entry with automated recognition of
hand-print, machine-print, dot-matrix,
check mark and bar codes. Unparal-
leled accuracy is further accomplished
via MediClaims ability to validate
form feld entries, including updated
For the most part, the data [from hand-printed forms] just fies through, with little need to verify.
TeleForms recognition rate is that good.
Lynne Becker, director of IS Technology, South Carolina Area Health Education Consortium
Incoming Forms Scan HCFA/UB Forms &
Attachments Together
MediClaim Readers
Automatically ID and
Evaluate Forms
MediClaim Verifiers
Validate Data
Claims Data Exported
to Back-end Claims
Payment System
Customer Service
Can Pull up
Claims on Screen
8 Proprietary and Confdential to Cardiff.
ICD-9 and CPT codes. MediClaim can
convert up to 98 percent of form data
automatically, with exceptions pro-
cessed by easy-to-use verifer stations.
Most organizations free 90 percent of
their data entry staff with MediClaim.
Achieving Faster Processing and
Greater Accuracy with MediClaim
MediClaim processes unsorted
scanned and faxed forms faster than
any software in its class. Using power-
ful OCR and recognition technologies,
MediClaim can process medical claims
in a fraction of the time required for
manual data entry.
Protecting Patient Privacy and Ensur-
ing Compliance with MediClaim
MediClaim features TeleForms suite
of enterprise-strength security capa-
bilities that enhance the end-user
experience and reduce administrative
overheadwithout sacrifcing the pro-
tection of captured content.
MediClaim Offers Straightforward
Deployment into Any IT Environment
MediClaims fexible architecture, adher-
ence to industry standards, pre-con-
fgured form templates and business
rules provide a rapid, straightforward
deployment into the IT environments of
any size or complexity. MediClaim can
also be integrated with leading docu-
ment management systems, database
and XML applications, automatically
archiving completed forms and docu-
ment attachments for customer service
and HIPAA requirements.
Streamlining Processes with
eForm Technology from Cardiff
LiquidOffce
After gaining control of their paper-
based processes with TeleForm, orga-
nizations can quickly realize even great-
er effciencies by transforming relevant
paper forms into electronic formats, or
eForms. This can offer signifcant ben-
efts in terms of reduced printing, dis-
tribution, postage and overall handling
costs. Cardiffs
LiquidOffce offers
the perfect solution.
LiquidOffce is a powerful and adap-
tive Web-based business process
management solution for creating,
deploying and automatically manag-
ing the routing, tracking and approval
processes for electronic forms.
LiquidOffce is simply the fastest way
for organizations to put all of their
corporate forms online to automate
the critical processes they drive. Plus,
its integration of market-leading enter-
prise search from Autonomy makes
LiquidOffce the frst and only BPM
solution that enables real- time access
to, and use of, time-sensitive content
throughout the process lifecycle.
LiquidOffce offers the following fea-
tures and benefts:
Advanced support for tracking, routing
and electronically signing online forms
Rapid deployment for eForms through an
intuitive point-and-click designer tool,
making it easy to convert existing forms
and create new forms, add intelligence
and publish
A central repository offers easy and
secure access to all corporate forms
LiquidOffce forms meet government
specifcations relating to Section 508,
GPEA and ESA
LiquidOffce offers tight integration with
TeleForm to accommodate the automation
of paper-based forms
LiquidOffce Process
Management
LiquidOffce manages every aspect
of a forms lifecycle within your orga-
nization. From creation, deployment,
approval and tracking, LiquidOffce
does it all. The illustration below illus-
trates LiquidOffces process manage-
ment capabilities.
Healthcare is a data, regulatory and process intensive industry,
and LiquidOffce is going to be a critical asset to help the hospi-
tal streamline form processes so we can stay focused on our core
goal to help patients.
Laura Davis, business development manager, Rush Foundation Hospital
1 2 3 4 5
LiquidOffice Designer
LiquidOffice Designer
publishes in PDF, InfoPath or
HTML to the LiquidOffice Server.
Internet
Users access
LiquidOffice forms
through a secure
login.
Internet
Users access
LiquidOffice forms
through a secure
login.
Accessed Online
Electronic forms are
accessed online.
Corresponding paper
attachments are scanned
into the users personal
inbox and electronically
attached to the form.
Initiate Routing
Completed forms with
attachments and digital
signatures are then
deployed to initiate routing,
tracking and approvals.
Repository
The image and data
are exported to a back-end
repository.
LiquidOffces Return on Invest-
ment Potential
As a full-featured BPM solution,
LiquidOffce offers healthcare orga-
nizations substantial ROI opportuni-
ties by reducing costs, increasing
productivity and eliminating errors.
Using LiquidOffce, organizations have
achieved a 75 percent reduction in the
costs associated with shipping, paper,
supplies and storage.
The following is an example of how
LiquidOffce can dramatically improve
business processes.
Typical Customer ROI Scenario:
A large healthcare organization has
hundreds of forms for their business
processes, including time sheets, HR
forms, POs and time-off requests.
Before LiquidOffce:
Forms exist in different formats, some
on paper and some electronic. It is
diffcult for employees to fnd the
right form, and once found they need
different applications to open and fll
out the forms. To process the forms,
employees print and submit them via
expensive overnight mail. The overall
process is time consuming, ineffcient,
expensive and error prone. Plus, there
is no way to track progress in real time.
After LiquidOffce:
By incorporating LiquidOffce, all
forms are stored in a central reposi-
tory, thus saving the cost of printing
and distributing. Employees fll out
and submit the forms from their desk-
tops and track the signoff process in
real time. The organization saves mil-
lions of dollars annually on the cost
of printing, mailing and maintaining
paper forms.
LiquidOffces Advantages
over Other eForm and BPM
Solutions
LiquidOffce has signifcant competi-
tive advantages over other products in
the market. Most notably:
1) Robust eForm FunctionalityEffective
eForm management requires a full range
of functionality, from designing forms,
integrating with corporate environments
and providing the necessary security and
digital signature compliance LiquidOffce
leads the industry in providing such a
comprehensive solution, thanks to the
following features:
Centralized management through rich
client administration environment
Form design expression builder for
building rules and validations
Process monitoring of form signoff
status
Superior user interface and functionality
2) Enterprise ReadyLiquidOffce is built
for handling critical processes in complex
IT environments From advanced adminis-
trative capabilities, such as LDAP support
and single sign-on to enterprise-strength
security, LiquidOffce can handle any
form management task in a wide range of
IT environments
3) Integrated with TeleFormLiquidOffce
is integrated with TeleForm, Cardiffs
award-winning scanning and content
capture application, allowing customers
to seamlessly manage the transition from
paper-based processes to electronic
ones
Typical ROI Calculation for
LiquidOffce
Return on investment calculations for
LiquidOffce are based on replacing
manual and paper-based forms pro-
cessing with electronic forms and auto-
matic routing. Here is a typical example
with representative ROI results.
For an organization that manages 100
forms for its employees and clients:
Before LiquidOffce
Average labor and mailing costs to pro-
cess a single form = $50
(includes all aspects of paper forms pro-
cessing: printing/duplication, distribution,
associated labor costs, flling out, routing,
postage, automated capture and entry of
form data, approval and storage)
Number of forms processed each year:
10,000
(1,000 individuals x 10 forms each per
year)
Total cost for manual forms processing:
$500,000
($50/form x 10,000 forms)
After LiquidOffce
Labor and materials cost: $16 per form
(for completing, distributing, routing, and
storing forms with LiquidOffce)
Total cost for LiquidOffce forms process-
ing: $160,000
(based on 10,000 forms per year)
Total technology investment: $310,000
(software, hardware, implementation
services, training, support/maintenance)
Total frst-year cost: $470,000
Financial Beneft
First-year savings: $30,000
($500,000 in manual labor costs vs
$470,000 for LiquidOffce technology +
labor costs)
Second-year savings: $296,440
($500,000 in manual labor costs vs
$203,560 for labor costs and software
support/maintenance)
Payback in months: 11
(based on a labor cost-savings)
Two-year ROI: 92%
(based on a two-year total investment of
$353,560 yielding a savings of $680,000)
The above example only highlights the
hard cost-savings that can be obtained
by converting paper-based forms
into electronic ones. A full analysis of
LiquidOffces ROI would also include
soft cost-savings stemming from
reduced errors, higher worker produc-
tivity and improved responsiveness.
Upon request, Cardiff can provide you
with an ROI calculation based on your
existing processes.
LiquidOffce Beneft and ROI
Summary
LiquidOffce offers healthcare organi-
zations numerous ways to streamline
processes, increase productivity and
improve service. The following are just
some of the benefts that enable orga-
nizations to achieve a substantial ROI.
Eliminate ineffcient business processes
- Reduce lengthy cycle times
- Decrease manual and redundant
processing
Increase productivity
- Automatic database validation
eliminates need for manual checks
- Auto-fll functionality pre-flls
forms with information from exist-
ing databases
- Automatic routing of forms means
less running around for employees
Cut costs associated with creating and
managing forms
- Electronic forms eliminate paper
copying, faxing, mailing, fling
and storage costs
Improve customer service
- Automated processing and real-
time access to information accele-
ates decision processes and
response times
Facilitate employee retention
- Automated collection and process-
ing of paper and digital
forms facilitate a faster and more
accurate response to internal
requests
Comply with audit, security and regula-
tory requirement
- Maintain compliance and privacy
- Provide information access
- Support audit trails
Leverage existing technology invest-
ments
- Cardiffs commitment to open
standards ensures effortless inte-
gration with existing database,
content management and back-
offce systems
Conclusion
The healthcare industry faces many
intense challenges, including ris-
ing costs, declining proftability and
widespread ineffciency. In addition,
the industry has to deal with a fast-
changing regulatory environment
and a constant pressure to improve
quality, safety and access. Healthcare
professionals are bogged down with
paper-based processes, manual data
entry, a lack of mechanisms to track
and manage critical assets and data,
and isolated information systems that
are unable to share data.
That is why leading healthcare com-
panies use Cardiffs BPM solutions
to discover, analyze and process
information. Cardiff enables health
professionals to get accurate and
up-to-the-minute access to research,
regulatory interpretations, medical
histories, and the real-world experi-
ence of fellow physicians, nurses and
administratorsto quickly make better
decisions and drive better patient care.
And with Cardiff, medical care provid-
ers can respond faster to the public,
who are demanding higher quality
services online, over the phone and
face-to-face.
In short, Cardiff enables healthcare
organizations to improve clinical care,
enhance collaboration, maintain regu-
latory compliance and raise consumer
satisfaction.
About Cardiff
Cardiff (www.cardiff.com) is a leading
provider of adaptive business process
management (BPM) and content cap-
ture solutions that enable organiza-
tions to unify people, paper and pro-
cesses. Cardiff enables organizations
to capture data from electronic and
paper sources and adapt to existing
processes by managing structured,
exception and people-driven actions.
As a result, businesses achieve greater
agility, increase customer value and
reduce operational costs while short-
ening deployment time and improving
visibility and control of key processes.
Cardiff serves more than 8,000 cus-
tomers worldwide, including many in
the fnancial services, pharmaceutical,
healthcare, education, government
and manufacturing industries. Cardiff
is an Autonomy Group company (LSE:
AU or AU.L).
Appendix: Case
Studies for Cited
Customer
Testimonials
Customer testimonials cited in this
paper are derived from select Cardiff
case studies in the healthcare industry.
These case studies, along with cor-
responding examples of actual forms,
are provided herein to provide more
information on their implementations
and ROI scenarios. The following case
studies can be found in the appendix.
Case Studies
American HomePatient (Sales Order and
Billing)
Moorestown Visiting Nursing Association
(Patient Assessments)
Riverside County Department of Mental
Health (Treatment and Patient Surveys)
SERV Centers of New Jersey (Compliance
documentation)
Sonic Innovations (Medical Equipment
Procurement)
South Carolina Area Health Education
Consortium (Medical Program Analysis)
Case Study
Moorestown Visiting
Nurse Association
Moorestown Visiting Nurse Asso-
ciation collects critical data using
Cardiff TeleForm.
Moorestown Visiting Nurse Associa-
tion (VNA), a voluntary, non-proft home
health agency has been providing quality
health care to residents of New Jerseys
Burlington, Camden and Gloucester coun-
ties. With over 250 employees, Moore-
stown VNA serves 5,000 patients annually.
Moorestown VNA is one of the very few
home care agencies qualifed to provide
care for patients of all ages, including chil-
dren and newborns.
The Challenge
In 1999, home health providers were
required by law to monitor the quality of
home health care with a standardized,
reproducible assessment instrument. To
improve care and comply with the law,
the Health Care Financing Administration
(HCFA) instated the use of an instrument
called the Outcome and Assessment Infor-
mation Set (OASIS).
The resultant OASIS forms used to col-
lect all pertinent patient information can
range up to 25 pages, composed of dozens
of felds with hundreds of required data
entries. When manually entered into a
database, these forms typically can take an
experienced data entry clerk 18 to 20 min-
utes to key enter. To meet its obligations,
Moorestown VNA found itself employing
fve full-time clerical employees.
The Solution
After an initial investment in a wholly-elec-
tronic OASIS data collection system, which
proved unsuccessful, Moorestown VNA
reached out to PACE Business Solutions, of
Whitehouse Station, New Jersey, a leading
provider of offce automation technology
solutions, to consult with and potentially
provide a solution to their OASIS compli-
ance problem.
By combining valuable industry insight
and guidance (provided by Janet Scheffer,
Information Systems Supervisor at Moore-
stown VNA), with Cardiff
TeleForm
, a
network-based solution, PACE developed
a system to easily and accurately capture
information and convert existing paper
OASIS forms into digital data. This turnkey
automated data collection system drasti-
cally reduced the need for manual data
entry, while increasing accuracy and sat-
isfying the primary users at Moorestown
VNA. In short, the approach was to make
the paper smart, thus assuring buy-in
from the user community.
The Benefts of Cardiff
We are very pleased with the results we
have seen from the TeleForm System,
said Scheffer. The fact that TeleForm has
reduced the time it takes a data entry clerk
to input data from 25-page OASIS forms,
from 20 minutes down to only two minutes,
enables us to streamline our processes
more than we had expected.
In addition to collecting all necessary
OASIS information, the VNAs forms were
designed to also collect locator code infor-
mation from HCFA-485 Plan of Care forms.
The HCFA-485 form is used for Home
Health and Plan of Care Certifcation and
re-certifcation. The forms are flled in by
the nurses in the feld and returned to the
Moorestown VNA home offce, where they
are scanned using TeleForm and a Fujitsu
optical scanner. Powerful engines within
TeleForm allow for accurate recognition of
a variety of characters, including handprint,
Moorestown Visiting Nurses Association
Industry: Healthcare
Application: Claims Forms
Challenge: Streamline processes and
minimize expenses and simplify the way
data was entered into their systems
Solution: Cardiff TeleForm, TeleForm
AutoMerge Publisher, RightFax Server,
Fujitsu Scanner, Kyocera Multi-Functional
Device, Oracle Database
Partner: Pace Business Solutions
Results:
Processing time reduced 90% from 20
minutes to 2 minutes
80% reduction in full-time data entry
stafffrom fve to one
Easy to read merged forms
Processes streamlined into one logical,
user-accepted, effcient and cost effec
tive system
OI in less than one year
Customer at a Glance
The fact that TeleForm has
reduced the time it takes
a data entry clerk to input
data from 5-page OASIS
forms, from 0 minutes
down to only two minutes,
enables us to streamline our
processes more than we had
expected.
Janet Scheffer, Moorestown VNA
Cardiff (USA)
3220 Executive Ridge
Vista, CA 92081
Tel: 760.936.4500
Fax: 760.936.480
Email: information@cardiff.com
Cardiff (UK)
Cambridge Business Park,
Cowley Rd, Cambridge CB4 0WZ, UK
Tel: +44 (0) 1223 448 000
Fax: +44 (0) 1223 448 001
Other Offces
Cardiff has additional offces in Boston,
New York, Sunnyvale, Vista and
Washington DC, as well as in Amsterdam,
Beijing, Brussels, Hamburg, London,
Madrid, Milan, Munich, Oslo, Paris,
Rome, Shanghai, Singapore, Stockholm
and Sydney and Taipei.
www.cardiff.com
machine-print, bar codes and check marks.
After the TeleForm recognition engines
evaluate the scanned data, key entry
personnel working from a PC computer
simply review only the characters, which
are deemed questionable by the software.
This action has reduced the time to key
enter a 25-page OASIS document from 20
minutes to two minutes, and the number of
data entry clerks required to fulfll this work
has been reduced to one full-time person
instead of fve.
After the data has been validated and
accepted by the clerk running the TeleForm
Verifer, it is committed/exported to a cus-
tomized PACE application, which includes
300 plus edits of the collected OASIS MO
feld data to assure its acceptance by HCFA.
OASIS MO codes are critical data points,
which can directly effect reimbursement for
home healthcare providers.
The PACE system also provides for an elec-
tronic review of the collected HCFA-485
information prior to a data merge onto a
HCFA-485 Plan of Care form, which is then
automatically faxed to doctors for their sig-
natures. To accomplish this, Pace Business
Solutions integrated a RightFax Fax Server
with TeleForms AutoMerge Publisher and
PACEs 485 Interface application. The forms
that the doctors receive for approval are
clean, legible machine-printed documents.
According to Scheffer, Everybody really
likes the new format, including the state
fnding them easy to understand and read.
As an enhancement to the start of care
patient processes at Moorestown VNA,
PACE built an electronic intake module,
which allows for entry of potential patients
to the VNAs backend (Health Care Informa-
tion System) HCIS scheduling and billing
system. Tied to an Oracle database, the
PACE system at Moorestown VNA includes
a PACE Imaging/Document Management
Interface, which provides indexed storage
and retrieval of OASIS and other relevant
patient documents.
By incorporating an open modular design
with industry standard development tools
and databases, Pace Business Solutions
has been able to provide Moorestown VNA
with a scalable system, which is open for
enhancement by savvy end-users, (like Ms.
Scheffer). And the system has paid for itself
in less than a year. Data and images col-
lected with the system are exportable to any
system, which offers an ODBC (Open Data
Base Connectivity). The Moorestown VNA is
now in a position to simultaneously export
collected data and/or images to: HCFA, its
back-end billing software (HCIS); its payroll
software (ADP); and its patient records
systems (PACE). Processes that at one time
required separate redundant manual key
entry points and repeated instances of paper
handling are now streamlined into one logi-
cal, user-accepted, effcient and cost
effective loop.
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Copyright 2006 Cardiff All rights reserved Other trademarks are registered trademarks and the properties of their respective owners Product specifcations
and features are subject to change without notice Use of Cardiff Software is under license [AUT GO] 080 905
Case Study
Riverside County
Department of Mental
Health
Riverside County Department of
Mental Health implemented a
Web-based consumer outcome
data collection system. Cardiff
TeleForm and Hershey Technolo-
gies ImageNet enable immediate
graphical trend reports that show
client progress across consecutive
visits at multiple sites.
The Riverside County Department of Men-
tal Health provides effective, effcient and
culturally sensitive community-based ser-
vices to the residents of Riverside County,
the fastest growing and currently fourth
largest county in the state of California.
The department currently serves more than
42,600 clients per year, including severely
mentally disabled adults, substance abus-
ers, and children at risk of mental disability.
The Challenge
In 1991, the state of California passed the
Bronzan-McCorquodale Act, also known as
Realignment, which mandated that coun-
ties report data on client satisfaction and
outcomes to the director of the California
Department of Mental Health (DMH) in
order to demonstrate accountability for the
expenditure of public, behavioral health-
care dollars.
Assessing consumer outcomes is about
accountability and cost effectiveness, but
its also about helping people get better,
said John J. Ryan, director of Riverside
County DMH. In addition to addressing
state mandates, we wanted to implement a
clinical feedback system that would survey
a client and provide an immediate trend
report, in graphical format, so that our ser-
vice providers and clients could establish
treatment goals and see progress from one
visit to the next.
In addition, the solution had to be one that
the departments IT services could man-
age on its own, explained Dr. Stephanie
Oprendek, supervising research specialist
for the Riverside County DMH. We didnt
want to have to rely on an outside vendor
for modifcations, such as producing cus-
tom reports. And we needed a system that
would be able to keep up with our volumes
and produce near instantaneous reports
even from afar. Also, since services are
delivered at many sites, and clients may be
seen at several of them either simultane-
ously or over time, we needed an integrat-
ed system that would track progress for
each client even if they moved from clinic
to clinic.
The Solution
After determining that its legacy fax-based
data collection system could not meet cur-
rent needs, Riverside County DMH decided
to upgrade to a new solution from Cardiff
and its longtime partner Hershey Tech-
nologies. Hershey recommended Cardiff

TeleForm
with the eForm Option for form

design and data collection over the Internet,
along with Hersheys Web Validation and
Image Management system, ImageNet.
To implement the solution, Riverside
County Department of Mental Health used
TeleForm as the platform for survey devel-
opment and programmed its own reports
tailored to its specifc needs. Hershey Tech-
nologies worked in collaboration to opti-
mize the infrastructure within, which the
survey and report system would operate.
The department wanted the data to be pro-
cessed centrally from numerous remote
sites and a report generated within fve
minutes after turning the survey in, so that
Riverside County Department of Mental
Health
Application: Patient outcome data (Goal
Attainment and Treatment Evaluation
forms)
Challenge: Collect and verify data form
remote sites on client progress and pro-
vide timely trend reports to mental health-
care providers
Solution: Cardiff TeleForm, TeleForm
eForm Option, Hershey Technologies
ImageNet Suite, Kodak/Fujitsu scanners,
Castelle Fax Server
Partner: Hershey Technologies
Results:
Clinicians have immediate trend
reports showing client progress or
areas of concern.
Remote clinics have choice of data
collection methods (Image, FAX, Web
eForm) with Web-based verifcation.
Flexibility to use future data collec-
tion technologies.
With the TeleForm/Ima-
geNet solution we have seen
more accurate, timely data
and enhanced workfow
effciency.
Dr. Stephanie Oprendek, Riverside County DMH
Cardiff (USA)
Vista, CA 92081
Tel: 760.936.4500
Fax: 760.936.480
Cardiff (UK)
Tel: +44 (0) 1223 448 000
Fax: +44 (0) 1223 448 001
Other Offces
www.cardiff.com
the counselor could respond appropriately
as quickly as possible, Neal Fischer at
Hershey Technologies explained. To meet
all of the requirements, we integrated the
ImageNet document management product
and TeleForm in a way that would allow
for Web-based scanning, data collection,
verifcation and integration of the clients
reporting tool, along with an automated
repository for completed digital forms and
imaged documents.
At the time of treatment, clients complete
a survey, called the Goal Attainment and
Treatment Evaluation survey (GATE).
Developed by Oprendek and Dr. Larry
Ogilvie, Program Chief of Riverside County
DMH, GATE consists of questions designed
to track client progress and satisfaction,
and to alert clinicians to potential areas
of concern. After TeleForm scans and
processes the survey, ImageNets browser-
based Validation module allows the remote
departments to perform verifcation on the
data. Optionally, the outcome survey may
be flled out and submitted online through
the TeleForm eForm Option. The recogni-
tion rate of the TeleForm OCR engine is
very good, Oprendek commented. Since
the client is right there, in the same offce
where the data is being verifed, we can be
assured of data accuracy.
The end-result is a graphical trend report
based on the outcome data, which allows
Riverside County DMH to assess client
outcomes within fve minutes, no matter
where the client is being seen. In addition,
remote clinics can now handle the data col-
lection themselves.
Client visits often start at the same time,
for example, on the hour, which means
that surveys are being turned in simultane-
ously, Oprendek observed. Throughout
the County there can be as many as 150
surveys hitting the system at once, yet
were handling the volume and achieving
the turnaround that we need.
Oprendek expanded, Other systems often
have a centralized proprietary verifcation
and reporting architecture, or are stand-
alone PCs that will only track clients at a
single clinic. In the centralized, proprietary
types of systems, you might have to wait
hours or even days for a report to be faxed
or sent, and then wait again if an error is
found and you have to correct the data.
The stand-alone systems can sometimes
provide timely reports, but they cant fol-
low clients throughout a large system of
care. With the TeleForm/ImageNet solution
we have seen more accurate, timely data
and enhanced workfow effciency. Thanks
to Hersheys collaborative approach and
Cardiffs open-system product, weve
achieved our goals and are looking forward
to using the system for other surveys and
applications, such as with Windows-based
Tablet PCs and similar technologies.
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4. Recently, have you:
Felt blue, down in the dumps, or depressed?
Had trouble getting food, clothes, or a place to stay?
How much have your mental health problems been bothering you?
Heard or saw things that other people don't?
Had trouble controlling your temper or actions?
Felt afraid, anxious, or on edge?
Not at all A little Somewhat
Quite
a bit
Most or all
of the time
Were you arrested or did you serve any time in jail/prison ? Yes No
Were you the victim of a crime? Yes No
6. Recently:
Yes No
Were you in the hospital for a mental health problem?
5. Does your current alcohol and/or street drug use:
...keep you from doing any activities?
...make your mental health problems worse?
...make someone else upset with you?
Yes No I do not use alcohol / drugs
Felt like you had too much energy, racing thoughts, or were impulsive?
Had thoughts of hurting yourself?
Had thoughts of hurting someone else?
Goal Attainment and Treatment Evaluation - Initial Form
page 2 of 2
8. If you are taking medications:
...have they been helping you?
7. How easy has it been for you to get services
when you needed them?
Yes, Quite
a bit
Somewhat A little
Not
at all
I don't
take meds
Very
Easy
Easy
Average
Somewhat
Difficult Difficult
Thank you for completing this survey.
Please use the space below and the back of this form for comments
and any suggestions you would like to make.
Please answer the following questions regarding treatment you have received before
coming here.
Copyright 2002 by the Riverside County Department of Mental Health. All rights reserved. No part of this publication may be reproduced in any
form or by any means electronic or mechanical, including photocopy, recording, or any information storage without persmission in writing from the publisher.
50682
Case Study
SERV Centers of
New Jersey
SERV Centers of New Jersey uses
Cardiff TeleForm to streamline
paperwork and improve service
delivery. TeleForm has reduced
form completion time by 75%.
SERV Centers of New Jersey, Inc. is a non-
proft provider of behavioral healthcare to
adults, children and families as they work
to recover from and cope with mental ill-
ness and addictions. Established in 1974,
SERV Centers staff of more than 400 cur-
rently assists about 1900 people annually
by providing social, educational, residen-
tial and vocational services throughout
central and northern New Jersey.
The Challenge
To comply with Medicaid regulations and
monitor staff productivity, SERV Centers
must document all services provided to
clients regardless of whether or not the
service is billable. In addition, recorded
services have to match the hours logged
on each staff members time-sheet.
Existing SERV Centers procedures col-
lected the required information using client
service history, staff payroll and billing
documents. These manual processes
emanated from 43 separate locations that
adjudicated the data and then channeled it
to one central location for fnal data entry
into the billing and payroll systems.
These processes were redundant, confusing
and highly ineffcient, and in many cases
supported by inconsistent documentation.
SERV Centers required a fexible data cap-
ture workfow solution that would prevent
discrepancies and reduce the time being
spent on paperwork and data entry; time
that could be better spent on client services.
It was taking up to two hours a day per
employee to fll out paperwork, said Mark
Bensel, vice president of MIS at SERV
Centers. We needed a system that would
allow us more time to do our jobs and that
would stand up to a potential audit.
Two years prior, SERV Centers had piloted
Cardiff
TeleForm
, an automated con-
tent capture solution, for a survey project.
Accordingly, Mark Bensel contacted Pace
Business Solutions, a Cardiff channel part-
ner and member of Cardiffs President Club,
to help them utilize the TeleForm product
once again to streamline their processes.
The Solution
After analyzing workfows and Medicaid
requirements, the PACE Business Solutions
team implemented a turnkey solution to
address SERV Centers needs. The solution
integrates Captaris Rightfax fax servers,
Cardiff TeleForm content capture soft-
ware, and a PACE-customized workfow
and imaging system. The PACE-developed
workfow feeds into SERV Centers existing
billing database, provided by MS*Health
Software Corporation of Hackettstown,
New Jersey.
Being able to feed the workfow into our bill-
ing database was critical, Bensel explained.
We had a billing backlog of four to six
weeks, and we knew that once everything
was integrated, we would have the ability to
expand the system in other directions.
Joe Tornabene, president of PACE Business
Solutions, agreed. PACE employs a rapid
action development strategy and the tools
we use, like Cardiff TeleForm, are scalable,
which allows clients like SERV Centers to
hit the ground running and iteratively build
upon their successes as they implement
our systems.
SERV Centers of New Jersey
Application: Service Delivery Log Forms
Challenge: Streamline processes, improve
client service delivery, enhance productivity
Solution: Cardiff TeleForm, Captaris
RightFax Fax Server, InPACE document
storage and retrieval system, MS*Health/
CMHC
Partner: Pace Business Systems
Results:
75% reduction in form completion
time
75% productivity gain in adjudication
Elimination of billing backlog
Reduction in entry time of payment
datafrom eight days to 20 minutes
In the past, it took two
people four business days
every month to enter all the
payments. Now we can do
it in about 0 minutes with
no data entry errors. You
cant get much better than
that.
Mark Bensel, SERV Centers
Cardiff (USA)
Vista, CA 92081
Tel: 760.936.4500
Fax: 760.936.480
Cardiff (UK)
Tel: +44 (0) 1223 448 000
Fax: +44 (0) 1223 448 001
Other Offces
www.cardiff.com
PACE began the implementation by con-
solidating the Personal Care Assistance
Log, the Face-to-Face form and the Time
Sheet into a single smart Service Deliv-
ery Log (SDL) form. This SDL form is faxed
into the main SERV Centers offce, where
the hand-printed data is optically read and,
if necessary, verifed. As an alternative to
the fax-in method, paper SDL forms can be
scanned at appropriately equipped SERV
Centers satellite locations.
PACE designed the form with embedded
smart felds that alleviate workers from
having to repeat codes or explanations
when identical services are delivered to a
group. During the verifcation step, these
felds are flled in automatically. The Veri-
fer clerk simply has to enter only question-
able characters, after which the validated
data is exported to the MS*Health/CMHC
database. The corresponding TIFF image
is held for future retrieval in a PACE-devel-
oped document storage and retrieval sys-
tem called InPACE.
The MS*Health/CMHC system automati-
cally applies Medicaid billing rules to the
scanned detail services, aggregates them
into billable units, and prepares billing
documents, which are electronically trans-
mitted to Medicaid. In the past, Medicaids
payments were manually entered into the
MS*Health database from reports gener-
ated from payment data delivered on a CD-
ROM disk. MS*Health has since developed
a process that reads the fle on the CD and
automatically applies the payments.
In the past, it took two people four busi-
ness days every month to enter all the pay-
ments, Bensel said. Now we can do it in
about 20 minutes with no data entry errors.
You cant get much better than that.
According to SERV Centers Mark Bensel,
benefts of the new system include:
A 75 percent reduction in form completion time,
from two hours per person to the current time
of 30 minutes to fll-out the smart SDL form
The elimination of costly preprinted Time Sheet,
Personal Care Log, and Face-to-Face forms
A 75 percent productivity gain in the adjudica-
tion process Adjudicators at each of the 43
SERV Centers sites required one full day per
week to process their work the old way, which
now is accomplished in less than two hours
Elimination of the typical six-week data entry
billing backlogs The work now gets processed
and completed the day it hits the fax server
Reduced time to enter payment data received
from Medicaid, from 8 days per month to 20
minutes
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Services Size Minutes Client ID Client Name
Staff Signature
I attest that the above is an accurate representation of the services that I provided on this date.
Hour Hour Minute Minute
Begin Time End Time
Recording a service/interaction on this form does not mean it will be billed. P-6 (01-10-2002)
Page of
Time
For this Staff + Date of Services
Services Size Minutes Client ID Client Name
X
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Location Number
Vacation
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Case Study
Sonic Innovations, Inc
Sonic Innovations, Inc. realizes sig-
nifcant time and cost-savings with
Cardiff TeleForm.
An estimated 28 million people have some
form of hearing impairment, and more
than a million school-aged children have a
hearing loss that can signifcantly impact
speech/language development and educa-
tion. Sonic Innovations, Inc. is making a
difference in peoples lives by rehabilitat-
ing their hearing and re-connecting them
with the world around them.
Sonic Innovations, Inc. has established
themselves as the fastest growing hearing
aid company in the world. They specialize
in designing, developing, manufacturing
and marketing advanced digital hearing
aids and hearing aid components for a
worldwide customer base of physicians.
The Challenge
Sonic Innovations offers a variety of digital
hearing aid products that are designed to
meet each individuals needs by manufac-
turing each aid specifcally for each patient.
Along with the patients details, each physi-
cian also has their own set of preferences
that need to be taken into consideration. It
is critical to accurately track these complex
details throughout the manufacturing pro-
cess to ensure the integrity of the product.
After intense scrutiny of its operating
procedures, Sonic realized that it had
numerous manual data processes in place
that were time-consuming, ineffcient and
required change. Initially, the company
manually entered orders they received
at their primary manufacturing facility in
Minneapolis, Minn, containing detailed
ear impressions and specifc instructions
from the physician. Sonic Innovations had
numerous data entry rules that a clerk was
required to know and enforce as well as
consulting a separate database of prefer-
ences for each submitting physician.
At the completion of the data entry process
the order form was scanned and archived
for easy viewing and reference. The origi-
nal order form and any coupons were then
attached to a Work Traveler form then
released to the manufacturing foor to
process. Throughout the manufacturing
process, the traveler followed the product
and at each step of the process, notes were
made on the order form. After the hearing
aid was produced, the modifed order form
was scanned in, replacing the original.
In the spring of 2001, Brad Peterson, Sonic
Innovations IS Manager called Dane Meul-
er, VP of Business Development of Integra
Information Technologies (www.integrain-
fotech.com) to fnd out if there were faster
scanners available to reduce the manpower
required to scan the records. It became
apparent that this was not just a matter
of faster scanners but improving the data
entry process.
The Solution
Cardiff
TeleForm
was selected because

of the ability to reduce data entry time and
increase accuracy by reading barcodes,
machine print (OCR), and hand print (ICR).
TeleForm improves accuracy by using
these reading techniques combined with
a sophisticated verifcation process and a
viewer that enables the operator to easily
compare the original data with the inter-
preted data. A major beneft is the ability
to embed business logic and rules into
the verifcation process, reducing both the
required skill level for doing the work and
the rate of errors.
Sonic Innovations, Inc.
Application: Processing order forms
Challenge: Reduce data entry labor and
improve accuracy
Solution: Cardiff TeleForm Enterprise,
Automerge Publisher, eForm Option,
Remote Capture
Partner: Integra Information Technologies
Results:
Tripled order entry capability with
existing headcount
More effcient fow of information
Automation of order entry procedures
Data accuracy
We have improved qual-
ity and accuracy using
TeleForms built-in business
rules to eliminate the risk of
human error.
Brad Peterson, Sonic Innovations
Cardiff (USA)
Vista, CA 92081
Tel: 760.936.4500
Fax: 760.936.480
Cardiff (UK)
Tel: +44 (0) 1223 448 000
Fax: +44 (0) 1223 448 001
Other Offces
www.cardiff.com Copyright 2006 Cardiff All rights reserved Other trademarks are registered trademarks and the properties of their respective owners Product specifcations
We sought a solution that would auto-
mate the process of collecting, verifying
and exporting information from our order
forms, with an open architecture that
would easily integrate with our existing
ERP system. said Brad Peterson.
After implementing TeleForm, Sonic Inno-
vations has reduced the time and cost of
processing their incoming orders. The
orders are now scanned into TeleForm at
the manufacturing facility in Minneapo-
lis. The physician and patient data is then
generated from the built-in business rules,
validated and verifed. Using remote cap-
ture capabilities, the database look-ups and
access occur in real time and the informa-
tion is then exported to the ERP system,
MFG/PRO, at the headquarters in Salt Lake
City, Utah.
Once the data is submitted to the ERP
system, a work order traveler is printed in
Minneapolis. This document contains the
physicians selections, customer prefer-
ences, the custom confguration, serial
number, customer information, and war-
ranty information. The original order form
is then attached to the work order traveler
and transferred to the manufacturing tech-
nicians. Sonic Innovations then archives
the original order form in PDF format for
easy reference.
With TeleForm, they created those rules as
part of the form so that it would look at the
preferences database as well as a coupon
database. It also eased data entry for the
ERP data entry that they were doing sepa-
rately. This particular ERP had 50 different
screens that might require data entry,
Dane Meuler states. Using Cardiffs solu-
tion they can simply export the data for the
ERP system to import.
We have improved quality and accuracy using
TeleForms built-in business rules to eliminate
the risk of human error, said Peterson.
TeleForm was also used to create a new
and better form with all of Sonic Innova-
tions business rules imbedded into the
form. This same form can now be pub-
lished to the Web using TeleForm and the
submission of an order can happen from
the physicians offce, using all the rules
already written for the form and eliminat-
ing the paperwork all together.
The implementation of TeleForm has met
all of the established business goals. The
archiving process now takes one person
15 minutes, down from two full-time
processors. The total order entry pro-
cess now takes less than 50% of the time
that it required, prior to TeleForm. Sonic
Innovations testing showed that an order
that previously required six minutes to
data enter, can now be completed in two
minutes, tripling their order entry without
increasing headcount.
The solution paid for itself in the frst few
months, said Brad Peterson. Handling
orders quickly and effciently is essential
to our continued success, and by selecting
the Cardiff TeleForm solution we can easily
raise our level of service and simultane-
ously reduce our costs. If someone has a
data entry environment where you want
to reduce errors, improve throughput, and
a quick payback, this is the product to put
into your business.
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5 The Business Process Management Guide for Healthcare
S
S
O 3-year
O 2-year O 3-year
S S S S
S S S S S S S S
S
CUSTOM HEARING AIDS
RIGHT LEFT
S
S
S
NATURA 2 SE
ALTAIR
TRIBUTE
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S S
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IROS Sav 0.120" (3.0mm)
Large Sav 0.100" (2.5mm)
Medium Sav 0.085" (2.1mm)
Small Sav 0.065" (1.6mm)
Pressure 0.050" (1.25mm)
Small Pressure 0.040" (1.0mm)
No Vent
S
Right Serial #
#13
#312
#10 (Req'd for ITC Dir)
Ship To: 8ill To:
As Marked on Impression
Deep - at 2nd Bend
Long - before 2nd Bend
Medium - at 1st Bend
Short - before 1st Bend
Shipping
Overnight (standard)
48 hrs. from receipt of order
24 hrs. from receipt of order
TMJ
Loss/Damage Model Upgrade
(Affirmation Required)
HLAP|NG A|D
OPDLP POPM
La gandale Tech Center, Suite l00
l303 Cor porate Center Drive
La gan, Minnesota 55l2l
Toll Pree 888-4-8LST-P|T
( 888-423-7834 )
Pax 65l-452-5262
Left Serial #
Shell Color: Pink(std) Tan Brown Red/Blue Lt Brown
Clear Shell
Satisfaction Pewards #
Speech Data
MCL
UCL
Discrimination Score %
Right Left Binaural
For optimum accuracy, please print carefully
and avoid contact with the edges of the box.
Age MI Patient First Name
PUPCHASL OPDLP
Not Like This-->
Faceplate Color:
Date
/ /
S
Patient Last Name
FM00022 Rev R
Special Handling Options (additional charge)
Shade Circles Like This-->
COLOR
Cerumen Barrier System (CBS)
Belled Canal (rep CBS)
Ext. ReceiverTube (rep CBS)
CANAL LENGTH
BATTERY SIZE
SWITCH (default is omnidirectional & no switch)
OPTIONS
vENT
S
S
NATUPA 2 SL:
HEARING AID ORDER FORM
Canal Lock
Soft Coat
Removal Cord
Please send open- and closed-mouth impressions.
0
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Frequency (Hz)
DIRECTIONAL (N/A with TRIBUTE)
OP
P1/P2 (N/A with TRIBUTE)
On/Off
Mic/T-Coil (N/A with P1/P2)
(max 2 for ITE / max 1 for ITC)
WAX SYSTEM
1-year (standard)
1-year (standard)
Loss & Damage Lxtended warranty
2-year (std)
ALTA|P & TP|8UTL:
1-year (std)
Company Name
Address
City, State, Zip
Fax Phone
S S S S S S S S S S S S
This is a 1-time Ship-to Address
Pink(std) Tan Brown Lt Brown

Case Study
South Carolina Area
Health Education
Consortium
South Carolina AHEC reliably
tracks effectiveness of its pro-
grams with Cardiff TeleForm.
TeleForm, which improves data
quality and timeliness for the
healthcare catalyst program.
The South Carolina Area Health Education
Consortium (AHEC) is a state-funded pro-
gram with a mandate to improve health care
to medically under-served areas in South
Carolina and to encourage groups of indi-
viduals who are under-represented in the
healthcare professions to enter these felds.
AHECs four regional offces coordinate
grass-roots efforts with academic
institutions and community organizations
to encourage underprivileged students to
pursue education in healthcare at all levels
of studymiddle school, undergraduate
and graduate level, and continuing
educationand to place these individuals
in areas of South Carolina where more
healthcare professionals are needed.
The Challenge
The funding of programs such as AHEC
depends on the quality of data that is avail-
able to track their effectiveness. To be a
viable organization, AHEC has to show
that their efforts help launch under-repre-
sented groups into healthcare professions
in certain areas of the state, for example,
that the placement of medical students
in mentored assignments in medically
under-served areas helps reduce the lack
of healthcare in these regions.
Historically, AHECs 25 regional and local
coordinators manually collected data on
individuals who participated in its outreach
programs. Because the offces used differ-
ent data collection and processing methods,
the data was inconsistent and incomplete.
When it came time to consolidate the data,
everyone would have to pull all-nighters,
trying to ft the data into a master report
by hand, said Lynne Becker, Director of
Information Technology at AHEC. There
was no unifcation or uniformity and no
verifcation of the data. When I took over in
October 2001, a more rigorous and stream-
lined method of data collection became my
frst priority.
Fortunately, Becker had previously used
Cardiff
TeleForm
, an automated content
capture solution, for a clinical trials project
at the Medical University of South Carolina.
As a former TeleForm user who had earned
an advanced degree in public health
administration and statistics, she knew
the product was fexible in its functionality,
and she trusted its reliability.
Becker explained, My primary concern
was quality dataa centralized, uniform
data depot that would serve as our state-
wide IT application. Timeliness was second.
Previous consultants had estimated that
the job would require up to three years.
But I knew that we could do it in much less
time with TeleForm.
The Solution
Becker began the implementation by rede-
signing database structures and reports for
12 different databases and educating AHEC
staff on the basic requirements of data
collection and verifcation. Beckers team
also involved the AHEC coordinators in the
process of form design.
Becker and her team implemented the
solution with very little customization
South Carolina Area Health Education
Consortium
Application: User surveys
Challenge: Improve data quality and time-
liness to better track effectiveness
Solution: Cardiff TeleForm, fax servers,
Microsoft Excel and Access, Statistical
Package for the Social Sciences (SPSS)
Results: More valid data and more timely,
accurate reports. Dual export enables fex-
ible processing of the data into spread-
sheet format and relational database.
Data entry staff free to complete other
tasks.
For the most part, the data
just fies through, with little
need to verify. TeleForms
recognition rate is that
good.
Lynne Becker, South Carolina AHEC
Cardiff (USA)
Vista, CA 92081
Tel: 760.936.4500
Fax: 760.936.480
Cardiff (UK)
Tel: +44 (0) 1223 448 000
Fax: +44 (0) 1223 448 001
Other Offces
www.cardiff.com
required. She commented: As a statisti-
cian, I preferred to interview the people
who would be using the solution to fgure
out how to design the forms and data-
bases so they would match the inherent
strengths of TeleForm. In the long run, this
saved time because we didnt have to do
extensive programming.
Four months later, the frst phase of the
solution was already in place. AHEC coor-
dinators now use the newly designed
TeleForm forms to collect data. The hand-
printed forms are faxed to the AHEC Pro-
gram Offce in Charleston, South Carolina,
from all over the state. Operators at the
Program Offce take turns verifying data as
the forms are faxed in. For the most part,
the data just fies through, with little need
to verify, Becker commented. TeleForms
recognition rate is that good.
The TeleForm solution is set up to col-
lect data for dual export. The data on the
forms is captured into Excel spreadsheets
as well as to SPSS, a relational database
program designed specifcally for social
science project analysis, on the main AHEC
server. From Excel, the data is imported
into Microsoft Access databases. The
Access program is used because it offers
more readable reports for Beckers end
users, whereas Becker herself uses SPSS
for more in-depth statistical analysis.
TeleForm also captures images of the
forms that are faxed in, which are stored in
.TIFF fle format on the server for research
and backup purposes.
The second phase of the implementation
will add the ability for AHEC coordinators
to fll out electronic forms in PDF format
from a Web browser. A third phase, in
which all the smaller databases feed into a
master database, is also planned.
What had been estimated to take up to
three years was accomplished in four
months. With TeleForm, AHEC is able to
collect data from 12 different forms, plus
occasional special surveys. Data from
approximately 5,000 forms are placed into
the system each year, along with the cor-
responding images of the forms.
The end result is better quality, more accu-
rate data in much less time. We can gener-
ate our master report in a fraction of the time
that it used to take, and the staff who used
to do data entry are now freed up to do other
tasks, Becker said. We also have requests
to share our data process with other divi-
sions throughout the state and hope to
implement this system into a statewide dis-
tance education program with SCETV (South
Carolina Educational Television).
The diffcult task was setting up the database
structure and educating our users about
good data collection techniques. TeleForm
was the easy part, Becker concluded.
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1. SC AHEC Site
Lowcountry Mid-Carolina Pee Dee Upstate
7. Coordinator's First Name 8. Coordinator's Last Name
17. Total Participants
6. Canceled
Yes
9. Sponsorship Level
Sole Co-Sponsor / General Limited
10. Long-term Evaluation Method
Imapct 1 (Mod/360) Impact 2 (Follow-up)
13. Check the county in which the program is held
Abbeville
Aiken
Allendale
Anderson
Bamberg
Barnwell
Beaufort
Berkley
Calhoun
Charleston
Cherokee
Chester
Chesterfield
Clarendon
Colleton
Darlington
Dillon
Dorchester
Edgefield
Fairfield
Florence
Georgetown
Greenville
Greenwood
Hampton
Horry
Jasper
Kershaw
Lancaster
Laurens
Lee
Lexington
Marion
Marlboro
McCormick
Newberry
Oconee
Orangeburg
Pickens
Richland
Saluda
Spartanburg
Sumter
Union
Williamsburg
York
14. Formats Codes (check all)
Audio / Video Tutorial
Computer On-line
Course
Distance Technology/ Satellite
Laboratory / Clinical
Lectures / Seminar / Workshop
Multiformat
One:One Instruction
Selfdirected Instruction
15. AHEC Content Codes (check the PRIMARY code)
Access to Qual Hlth Serv
Adolescent Health
Alternative Medicine
Ambulatory Care
Am Indian / Nat Amer Initiative
Arth, Osteo, Chrn Bk Cond
Behavioral Medicine
Cancer
Chrn Kidny Dx
Cultural Competence
Diabetes
Diagnostic or Treatment Skills
Disabl / Secd Cond
Distance Learning
Domestic Violence
Ed Comm Based Prgs
Environ Health
Evidence Based Medicine
Family Plan
Food Safety
Geriatrics
Health Commun
Heart Dx Stroke
Hlth Promo / Dis Preven
Hispanic Initiative
HIV / AIDS
Home Health
Homeless
Immunz Infect Dx
Informatics / Medical Recs
Injury Viol Preven
Interdis Training
Long Term Care
Managed Care
Management Admin
Maternal / Infant
Medical Economics
Med Prod Safety
Mental Health
Minority Health Issues
Nutrition / Overwt
Occup Safety Hlth
Oral Health
Pediatric / Child
Phys Act Fitness
Professional Development
Pub Hlth Infra
Qual Imp in Hlth Prof Ed or Practice
Research
Resp Dx
Rural Health
STD
Sub Abuse / Preven
Tele Med / Health
Tobacco Use
Urban Health
Vision & Hearing
Women's Health
Other
23. Clinical
Yes No
24. Multidisciplinary
Yes No
CE Input Form
2. Program ID #
21. Total # of DE Sites
18. # Consortium mbrs
19. # Non-Consrti mbrs
12. Instructors
22. Total DE Participants
16. Where was the program held?
AHEC Center Church Community Center Health Dept Hospital Hotel
Other
Month Year Day
5. Program
Stop Date
Month Year Day
4. Program
Start Date
3. Title
hours minutes
11. Clock Hours
Live
Re-Broadcast
Video
NA
20. Distance Education
Info:
FAX back to 843-792-5342
25. Please identify the
Core Service:
I II
26.Licensure /
Certification:
Yes No
2. Program ID # 7191
7191
29
28. Primary Target Audience
Admin Personnel (01)
Advance Practice Nurse (02)
CHES (03)
CNA (03)
Counselors Fam Therapists (04)
Day Care Personnel (05)
Dental Assistants (06)
Dental Hygenists (07)
Dentists (08)
Dietary / Nutritional Science (09)
Emerg Med Care Services (10)
Home health Personnel (11)
Lab Professional (13)
Long Term Care Prof (14)
LPNs (12)
Med Recs (13)
Nursing Asst (14)
Occupational Therapists (15)
OT Assistants (16)
Pharmacists (17)
Pharmacy Techs (18)
PT Assistants (19)
Physical Therapists (20)
Physician Assistants (21)
Physicians (22)
Radiological Techs (23)
Resp Care Prof (24)
Reg Nurse (25)
Social Workers (26)
Speech Path (29)
Other (27)
Specify
29. Credit Hrs
.
30. CEUs
.
31. Please check the PRIMARY Accrediting Agency
Acdy Gen Dent 01
Acrd Cnsl CME 02
Am Acdy of Prof Coders 03
Am Assc of Crit Care Center 04
Am Assc of Diabetes Ed 05
Am Assc of Med Asst 06
Am Assc Marg Fam Conslr 07
Am Assc Nurse Anesth 08
Am Acd Phys Asst 09
Am Assc Psyc Trtg Adct 10
Am Assc Rad Tecs 11
Am Assc Resp Care 12
Am Col Dentistry 13
Am Cnsl Phrm Ed 14
Am Dietetic Assc 15
Am Hlth Info Mgmt Assc 16
Am Nrs Crdtlg Cntr 17
Am Occp Thrpy Assc 18
Am Phys Thrp Assc 19
Am Reg of Rad Tecs 20
Am Soc Clin Lab Sci 21
Am Spch & Lng Hrg Assc 22
Area Hlth Ed Cnst 23
Assc Surgcl Tecs 24
Athletic Trainer 25
Brd Lng Trm Hlth Cre Admn 26
Brd of SW Examrs 27
DHEC-Emgcy Med Srvs 28
Diet Mgrs Assc 29
Emgy Nrs Assc 30
Intl Assc CE Trng 31
Ntl Assc Hlth Unit Coord 32
Ntl Crtf Cnsl Actvty Prfs 33
Ntl Cmms Hlth Ed Cred 34
Ntl Recl Prk Assc 35
Prfl Acknwl Cont Ed 36
SC Acdy Crml Justc 37
SC Assc of Alc & Drg Abse Cnslrs 38
SC Brd Dntsry 39
SC Brd Marg Fam Thrp Psy Ed Spc 40
SC Brd Med Exmrs 41
SC Brd Occptl Thrpy 42
SC Brd of Phys Thrpy 43
SC Brd Spch Path Audio 44
SC Dentl Hygnst Assc 45
SC Dpt Alc & Otr Drg Abse Srv 46
SC Emplr Ast Prf Assc 47
SC Food Srv Supr Assc 48
SCHUMA 49
SC Med Assc 50
SC Ntl Fnrl Dir Assc 51
SC Nurs Assc 52
SC Phys Thrpy Assc 53
SC Rec Pk Assc 54
SC Soc Diag Songry 55
Other 56
OPTIONAL
Financial Revenues:
(please round to the nearest total dollar)
Financial Expenses
(please round to the nearest dollar)
For Additional Audiences; please use the codes listed in the Primary Target Audience block. For the SOURCE, use
the codes listed in the Primary Accrediting Agency. Complete the appropriate CEUs or credit Hours.
Admin Personnel (01) Home Health Personl (11) PT Assts (21)
Advance Practice Nurse (02) LPNs (12) Physical Therapists (22)
CHES (03) Med Asst (13) Physician Asst (23)
Counselors Fam Therp/ Psycosoc (04) Nurses (14) Physicians (24)
Day Care Personnel (05) Nursing Asst (15) Radiological techs (25)
Dental Asst (06) NP (16) Resp Care Prof (26)
Dental Hygenists (07) Occupational Therpa (17) Social Workers (27)
Dentists (08) OT Asst (18) Speech Pathologists (28)
Dieticians (09) Pharmacists (19) Other (29)
EMT (10) Pharmacy Techs (20)
Specify Other
32. Aud Code 33. Source 34. Credit hrs 35. CEUs
. .
. .
. .
. .
27. Core Service II
Measure A Code
Use the codes below for question #27
36. Non-Consortium Fee 37. Consortium Fee
39. Other Financial Suprt 38. Out-of-State Fee
40. Speaker Honorarium 41. Books
42. Speaker Travel 43. Postage
45. Brochure Dvlpmnt 44. Other Speaker Costs
46. Facility Expense 47. Brochure Printing
49. Handouts Printing 48. Meals cost
50. Break cost 51. AV Services
53. Supplies 52. CEU credit costs
54. Direct Personnel 55. Indirect Personnel
56. Other Expenses
. .
. .
. .
. .
Additional
32. Aud Code 33. Source 34. Credit hrs 35. CEUs
Continue
using the
additional
audience
code info
below.
2. Program ID # 7191
7191
Case Study
American HomePatient
Doug Gouy knows the challenges
of growing revenue in the tightly
regulated healthcare market. As
American HomePatients senior
vice president of revenue manage-
ment, Gouy wrestles with reim-
bursement cuts and issues with
the third-party payer system in
healthcare every day. Margins can
disappear overnight in our indus-
try, says Gouy. You always have
to be looking for opportunities to
reduce costs.
Opportunity knocked for American
HomePatient (AHOM) in 2003 through their
content management solutions provider,
AccuImage, LLC. In meetings over the
Christmas holidays at AHOMs headquar-
ters in Brentwood, Tenn., Gouy and some
of his trusted technology advisors devised
an ambitious plan to increase employee
productivity, cut costs and raise revenue
by automating the companys sales order
and billing processes.
I remember leaving those meetings shak-
ing with excitement, says C. Roy Payne,
president of AccuImage, a systems inte-
grator that works closely with AHOM on
strategic technology projects. We were
about to embark upon something that had
never been tried before in the home medi-
cal equipment industry.
AHOM replaced its most time-consuming,
labor-intensive and error-prone business
processes with a workfow software solu-
tion powered by Cardiff LiquidOffce. This
case study illustrates how AccuImage used
LiquidOffce to help one of the largest home
healthcare providers in the United States
achieve its business goals with 22% fewer
staff in branch offces on LiquidOffce.
The Challenge
At AHOMs 286 branch offces, customer
service representatives (CSRs) respond to
hundreds of sales orders every day. The
process is inherently complex.
CSRs collect patient demographic infor-
mation, medically qualify patients, verify
insurance eligibility, gather signatures, and
bill the patients and/or third-party pay-
ers. Errorseven onelead to processing
delays, claim denials, rebilling, and in some
cases, revenue that simply has to be
written off.
We are in probably the most complicated
rules-based industry that you will ever run
across, Gouy says. We have about 2,000
different third-party payers, all of which
have their own set of unique requirements.
With a high staff turnover rate of 40%,
AHOM found it challenging to equip cus-
tomer service personnel with the training
and expertise they needed to stay on top
of all of the third-party payer requirements.
Too many of our claims were being denied
because we werent qualifying revenue
correctly, Gouy says. The work that
needed to get done on our end wasnt get-
ting done at the level of detail required. We
left a lot of money on the table.
AHOMs extensive reliance on paper also
drove up costs. The company handled more
than 400,000 pages of sales order paperwork
every month, incurring the expense of over-
night deliveries to AHOMs regional billing
centers for inspection and processing.
The Solution
AHOM worked with its longtime informa-
tion management systems integrator,
AccuImage of Nashville, Tenn., to select
Application: Sales order and billing pro-
cesses
Challenge: Faced with reimbursement
cuts, AHOM targeted cost-cutting opportu-
nities at the branch level.
Solution: Cardiff LiquidOffce
Results: AHOM replaced its most
time-consuming, labor-intensive and
error-prone business processes with a
workfow software solution powered by
Cardiff LiquidOffce. LiquidOffce helped
AHOM pad its bottom line by more than
$2 million.
Since implementing
Cardiff LiquidOffce,
has reduced offce payroll
expenses by as much as
percent. We have almost
00 fewer employees in the
branches on LiquidOffce,
processing a higher volume
of business.
Doug Gouy, American HomePatient
Cardiff (USA)
Vista, CA 92081
Tel: 760.936.4500
Fax: 760.936.480
Cardiff (UK)
Tel: +44 (0) 1223 448 000
Fax: +44 (0) 1223 448 001
Other Offces
www.cardiff.com
Cardiff LiquidOffce for its high-volume
sales orders and billing automation project.
LiquidOffce is an enterprise-class business
process management software solution.
We recommended LiquidOffce to Ameri-
can HomePatient because the technology
is sound, Cardiff engineers were approach-
able and willing to help, and we felt we
would be able to roll this project out on
time and on budget, says Payne of AccuI-
mage. Another software alternative that
we considered would have cost 2 to 3
times more, and added another several
months to the rollout.
In a matter of months, LiquidOffce was up
and running at 115 AHOM brancheseffec-
tively reengineering the companys pro-
cesses so there is less reliance on CSRs at
the branch level.
As soon as a sales inquiry is placed at an
AHOM branch, a CSR kick-starts the order
process by opening a LiquidOffce-designed
electronic form to capture all of the patient
demographic information. Depending on
the data entered and the insurance com-
pany involved, LiquidOffce may launch as
many as nine additional forms during the
sales order process. LiquidOffce automati-
cally guides the CSR through each form
before the sales order is electronically
transmitted to one of 15 regional billing cen-
ters for revenue qualifcation.
Our customer care personnel no longer
have to worry about learning the rules from
2,000 different third-party payers, Gouy
says. CSRs have to know the product that
AHOM delivers and how to fll out the forms.
Everything else is taken care of by the busi-
ness rules that were built into LiquidOffce.
This means CSRs now have more time to
service the referral and the customer.
LiquidOffce, with logic programmed by
AccuImage and AHOMs IT development
staff, also raises red fags during the rev-
enue qualifcation phase that saves AHOM
money and keeps the company in compli-
ance with U.S. government regulations.
Medicare, for instance, has very specifc
medical coverage criteria, Gouy says. For
many services, patients must have a con-
frmed diagnosis to qualify for coverage.
We developed rules that say, If the patient
doesnt meet the Medical Necessity crite-
ria, then the product isnt covered. In the
past, we may have delivered our product,
without a high level of confdence that we
would get paid.
The value of Cardiff LiquidOffce has been
quantifed in many ways at AHOMfrom
reduced headcount and higher employee
productivity to accelerated revenue collec-
tions and better regulatory compliance.
Since implementing Cardiff LiquidOffce,
American HomePatient has reduced offce
payroll expenses by as much as 22 percent,
Gouy says. We have almost 100 fewer
employees in our branches on Liquid Offce,
processing a higher volume of business.
LiquidOffce also raised productivity at the
companys regional billing centers by elimi-
nating the need to handle and inspect the
mountain of paperwork from the branches.
Quality assurance personnel previously
assigned to pore over the hard copies of
sales orders have since been transitioned
to more strategic revenue qualifcation
roles within the company.
The quality of revenue qualifcation has
also improved since LiquidOffce has been
deployed. Company statistics show the
number of AHOM invoices denied by insur-
ance companies has fallen by 17% in the
past year. And year-to-date bad debt has
dropped to 3%, from 3.8% a year earlier.
The results have been so impressive
that AHOM branches that have not yet
deployed LiquidOffce cant wait to get
their hands on the software.
As soon as they lose an employee, the frst
thing they do is call headquarters and say,
Can we get on LiquidOffce? And, well
gladly schedule them in so we can shift that
workload to a central location, Gouy says.
About our VAR
Paperless Offce Solutions
AccuImage, LLC, a value-added Cardiff
reseller, was the system integrator for the
automation of AHOMs high-volume order
intake and revenue qualifcation system.
After recommending Cardiff LiquidOffce,
AccuImage, LLC designed and imple-
mented the workfow software across
AHOM in a matter of months.
AccuImage has been solving complex
business problems and streamlining labo-
rious paper-based processes for organiza-
tions like AHOM since 1996. AccuImage
specializes in designing, installing and
maintaining complete information man-
agement solutions: document and data
capture, indexing, archival and retrieval,
and distribution on portable media;
automated forms processing for medi-
cal EOBs, HCFAs, UB92s, among others;
enterprise report management; auto-
mated workfow; enterprise storage; and
invoice processing.
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Cardiff (USA)
Vista, CA 92081
Tel: 760.936.4500
Fax: 760.936.480
Cardiff (UK)
Tel: +44 (0) 1223 448 000
Fax: +44 (0) 1223 448 001
Other Offces
www.cardiff.com
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