A Case In Point—Turning Point Clinic, Baltimore, Md.
When CMDS was tasked by Turning Point with taking over “administration,” we found a fairly typical OTP in terms of its management. It used paper charts, had numerous layers of inefficient administration, and an extensive (and also inefficient) billing staff.
With 700 patients at the time, Turning Point was still losing money. In terms of collections, it recovered about 75 cents on the dollar. Patient charts were rarely audited, and in poor condition. State audits were always a cause of great trepidation, always resulting in a mandated “plan of correction.”
In other words, Turning Point was not much different than many OTPs today.
CMDS, using Topgallant Software, created electronic charts, replacing all paper charts. Custom software was created to deep audit every word of every chart. For example, to ensure that less diligent substance abuse counselors did not merely “copy and paste” chart entries from one chart to another, our software compares every word, of every chart in the database, with every other such chart. A “uniqueness score” is developed. Charts with an unacceptable score are highlighted by electronic report, requiring remedial action by the provider. All this happens, of course, before any medical claim is submitted. All charts for all services are similarly “deep audited.”
Custom dashboards direct virtually every activity, each day, for each patient in the provider’s caseload.
Detailed productivity reports are automatically generated. A counselor performance scoring system was developed, electronically evaluating each counselor on the basis of eight domains—timely attendance, chart completion, timely discharges, and so on. As new performance domains become relevant, the system is amended.
Scores of custom, electronic chart forms were created, ensuring that every such chart (documenting all clinical work to be billed for) is thoroughly complete and in total compliance with all rules, regulations, and “best practice” standards.
Redundant staff was eliminated; office space freed-up; more counselors were hired; and more patients admitted. In fact, Turning Point was able to grow to over 3,000 patients, making it the largest substance abuse program in the nation at that time. The idea that such could have occurred before Turning Point started using Topgallant software would have been absurd.
Today, Turning Point is surely the most efficiently run, rules-compliant, and highest quality OTP in the State. In fact, when CARF, the international accrediting body last audited Turning Point, the surveyor enthusiastically stated that Turning Point had “by far the most sophisticated management I have seen in 40 years of doing these surveys.” She added that Turning Point should be a national model.