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Optimized Billing and Reimbursement from Electronic Medical Records

High impact organizations measure and improve their results when providing human and social services.  They assess consumer needs, track progress as well as medical history, and then seek reimbursement for the services provided, with appropriate approvals and all required documentation.  In order to make the most effective use of their time, high performers record their services just once, tracking participant progress toward outcomes, and using that same record for billing and reimbursement purposes. Health services organizations are also eager to reduce write-offs, interest expenses, reimbursement time requirements, and months on outstanding accounts receivable balances.

Automated Reimbursement Using Case Management Software

Social Solutions’ Efforts to Outcomes (ETO™) software was designed with these needs in mind. Using this case management software, you can automatically generate invoices for each funding source, track amounts received from each funder, and generate reports using electronic medical records and case files. Eligibility checks can be run prior to scheduling appointments, thereby eliminating expensive write-offs, which can consume five to ten percent of services provided in organizations without ETO software. Medical reimbursement requests can be submitted in paper or electronic formats, such as 835 and 837.

ETO Money: Integrated Case Management and Performance Management System

Human services today are focused on improving organizational performance, meeting strict government compliance requirements, and adapting to the constantly changing rules for the delivery of and billing for services. There is growing pressure on management to achieve the difficult objective of tightly integrating the clinical and financial operations of the business. ETO Money™ is a comprehensive electronic medical record and case management system designed to improve quality of life and organizational performance. ETO software helps organizations to quickly and easily track consumer intake and diagnosis, as well as services provided, in an electronic medical record.  All efforts, outcomes, and progress are tracked along with documentation regarding the services provided. Performance indicators can be viewed from almost any location in real time.

ETO Money Highlights:

  • Eligibility checks prior to scheduling of appointments
  • Automated reimbursement requests, based on services provided
  • Reimbursement requests submitted in almost any electronic or paper format
  • Organizational performance indicators
  • Tracking of amounts received
  • Integration with accounts receivable and general ledger
     

About Social Solutions

Social Solutions is the leading provider of performance management software for human services, connecting efforts to outcomes, people to social services, and service providers and communities to funders.  The company’s ETO software goes beyond case management, enabling public, private, and nonprofit organizations, such as Pressley Ridge, ViaQuest, Pyxis, Woods Services, and the Dr. Gertrude A Barber National Institute to reduce costs, save time, and improve quality and effectiveness.

“Before ETO Money, we kept a 20 percent reserve on Medicaid billings. Now our reserve is only 5 percent, and our turnaround on receivables is much faster.”

 - Gwen Koenig
Senior Director
Pressley Ridge

Write-offs Can Constitute 5-10% of Services Delivered

With ETO software, eligibility checks can be run prior to scheduling of appointments, thereby eliminating expensive write-offs.

High Impact Organizations that Use ETO Money Software:

  • Keystone Human Services
  • Woods Services
  • Lakeshore Community Services
  • Pressley Ridge
  • Pyxis
  • ViaQuest
  • Catholic Charities, Green Bay
  • Family Links
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