Corrections or additions?
Prepared for the September 20, 2000 edition of U.S. 1 Newspaper.
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Hot Times in Healthcare Software
Princeton seems to be a hotbed for software
entrepreneurs
aiming to revolutionize the healthcare industry. One of the latest
hot ideas is being put forward by Onehealthbank.com, which triples
its space this week in a move from Princeton Windsor Office Park to
20,000 square feet at Windsor Corporate Park, formerly the Lockheed
Martin plant, where it is the first tenant.
The company (www.onehealthbank.com) also just announced $42 million
in funding and a major partnership with a private label
card-processing
firm. It will use the funds to kick-start its new systems — to
efficiently and cost-effectively process medical claims and payment
information on the Internet. Its point-of-service settlement
technology
aims to connect the insurance company, the credit card company, and
the healthcare providers at the point of service.
Columbus Bank & Trust Company, a member of the Synovus Financial Corp
family of companies, will support Onehealthbank.com’s financial
settlement
system with merchant and private label card processing. Under the
patent-pending system, all participants — patient, care provider,
insurer, and financial institutions — come together at the point
of service to allocate the financial responsibilities of each party
and collect the proper amount. Instead of a 30 to 120-day lag in claim
payments, claims will normally settle within 48 hours.
James H. Blanchard, chairman and CEO of Synovus (NYSE: SNV) says that
one of his companies (Vital Processing Services) will provide the
point-of-sale and clearing and settlement processing services, and
another company (Total System Services) will take care of the
insurance
payor business-to-business debits for Onehealthbank.com clients.
Joseph Sebastianelli, chairman, CEO, and president of
Onehealthbank.com,
says that his firm “could not have asked for a better banking
partner.” Sebastianelli was co-president of U.S. Healthcare and
was instrumental in that company’s merger with Aetna Inc., where he
then held the office of president. He came to Princeton after serving
as CEO of Scripps Care, San Diego’s largest healthcare system, and
he has also been vice president of Blue Cross of Greater Philadelphia
and a litigation associate with Morgan, Lewis & Bockius.
Synovus (www.synovus.com) is a $13.7 billion multi-financial services
provider based in Columbus, Georgia. Columbus Bank and Trust has $3.4
billion in assets and is Georgia’s largest bank outside of Atlanta.
Synovus has an 81 percent stake in Total System Services
which facilitates payment exchange with a wide range of business
services.
Vital Processing Services (www.vitalps.com) is a joint venture of
Visa USA and Total System Services.
Simultaneously, Sebastianelli announced the four participants in a
follow-on round of $42 million in funding: a health insurance firm
(Empire Blue Cross and Blue Shield, www.empirehealthcare.com), an
Internet firm (Internet Healthcare Group, www.ihcg.com), the
venture
capital arm of a pharmaceutical firm (Johnson & Johnson Development
Corporation, www.jnj.com), and a venture capital firm (Prism Venture
Partners, www.prismventures.com). Empire is a 60-year-old firm that
has 4.1 million insurance subscribers.
Current board members of Onehealthbank.com’s board are Jesse Brown,
former secretary of the Veteran’s Affairs Committee, Brad Vale of
Johnson & Johnson Development Corporation, Phil Kiviat, president
of the Kiviat Group, Dean Boyer, co-founder of Onehealthbank.com,
and Sebastianelli. Scheduled to join the board are Ira Millstein of
Weil Gotshal & Manges (representing Empire Blue Cross Blue Shield),
Steve Shulman and Rene Lerer of Internet Healthcare Group, and Laurie
Thomsen of Prism Venture Partners.
Two other companies that can reduce doctors’ office paperworkare flourishing in the Princeton area. One, now known as SciNet, wasfounded by Joe and Gloria Coyne and bought by a mega firm. Anotheris a division of the mega firm, Empire Blue Cross/Blue Shield. Bothhelp train the staff in physician’s offices to work electronically,rather than on paper.Top Of PageSciNet: Medical ComputersIf you work in a medical office as a secretary,receptionist,or the member of the billing staff, there is a good chance yourcomputersystems came from SciNet Inc. SciNet is doing its part to reduce theadministrative costs of healthcare. It re-sells medical computersystemsfor offices with from 10 to 150 workstations, and it expanded in Mayfrom 2,300 feet at Lawrence Commons to 2,600 feet in Suite 103, 731Alexander Road so it could have space for a training classroom(www.scinetinc.com).”The advantage of our software is that it provides solution forall needs regardless of size,” says Chris Meola, East Coastimplementationmanager of SciNet. “Claims can be sent to all payers andincorporatedseamlessly, which helps reimbursement time and rate. The way we haveit set, it requires very little end-user interaction, but we haveenough auditing checks in place that — 99 percent of the time— claims get paid on the first run.””We are on the edge of technology. Our package runs on the Unixoperating system, and each office has its own server,” Meola says.The cost for one doctor and one user could be as little as $12,000,and a complete system for large groups could be $70,000 to $80,000.”If you buy a new system from us, you are looking at 8 to 11trainingdays to get the system fully functional,” says Meola. Mostcompaniessend one person to three days of management training. “We setup their system and come to an agreement as to how they want it towork in their office, and set protocols for training. We can buildthe database and transfer it to their phone lines and to theirinstalledserver. If they are on an existing system we can program theconversion.””It is a lot of upfront work, and if they want it to be right,nothing can be done to make it right but to put the time in,”he says. “We have written all our own manuals. New clients geta whole set, and new employees that attend our class get a personalmanual. As long as you have a valid support contract with us, oursupport lines (based in Sparta) are open 7 a.m. to 6 p.m. in any timeperiod, and for application support we are on call 24 hours aday.”Joe and Gloria Coyne founded this company as Enterprise InformationSystems and Services and were bought out by SciNet, an Arizonacompany,in 1998. Now the Coynes have moved to Scottsdale, where he is vicepresident of technical services — programming, hardware,electronicclaims.SciNet, in turn, was bought by Medical Manager, a Florida-basedsoftwaredeveloper that also purchased Physicians Computer Network (PCN).MedicalManager (Nasdaq: MMGR) also owns Care Insight, a provider ofelectronicclaims, and Porex, a plastics firm.In addition to its Alexander Road classroom, SciNet also hasclassroomsin Saddle Brook and Wilmington, Delaware. SciNet is the largestresellerof products of PCN Health Network — hardware, software, support,and training. Current Princeton area clients include PrincetonManagementServices and Princeton Internal Medicine. Competitive products formedical offices are Medical Manager, IDX, and Execuflow.Meola grew up in Morristown, where his stepfather was a policeofficer,and he has a brother and two sisters. He majored in businessmanagementat York College of Pennsylvania, Class of 1991, and worked forMorristownMemorial Hospital and the home health care division of HoffmanLaRoche,starting as a trainer, then doing applications support, and managingapplication and end hardware support. At SciNet he started as trainingand education director and after nearly six years is East Coastimplementationmanager.”When I got out of college, many companies were rewarding peoplebased on the time they had spent there. I started working for theCoynes when I was 25 years old,” says Meola, “and theyrewardedpeople based on talents, hard work, and what they were able to bringto the plate. I am in a position that I would probably not have beenable to obtain in a lot of other companies because of bureaucracy.I have had the opportunity to grow and expand and showcase some ofmy talents.”SciNet Inc., 731 Alexander Road, Suite 103,Princeton08540. 609-520-8320; fax, 609-520-8991. Home page:www.scinetinc.comTop Of PageEmpire MedicareSciNet isn’t the only area mecca for medical officetraining. Empire Medicare Services has opened a new training andinformationcenter on Brunswick Pike, replacing one that had been on FranklinCorner Road. With 10 employees, it doubled its space to 6,000 squarefeet and now has a training classroom.This division of Empire Blue Cross/Blue Shield took over the contractfrom a Harrisburg, Pennsylvania-based firm, Xact, which had been thestatewide call center for questions on Medicare plan part B for 12years. It serves 1.2 million Medicare recipients in New Jersey, isthe only such center in the state, and is the largest Medicarecontractorin the country. For consumers, it has a website and a tollfree number.For doctors’ office staff, it has classes (www.empiremedicare.com).”The kind of training we offer to physicians and their staff isunderstanding policies, regulations, and billing of theirservices,”says Gail Rounds, program manager. Her office can provide an almostfree software package that one-physician offices can use, or it canhelp staff members use commercial products, such as Medical Manager.Rounds offers specialty seminars for internists and specialists suchas surgeons and podiatrists on an ongoing basis. All seminars andpublications are free to physicians and staff members. Consumers cancome here to browse in the resource center and learn more about theircoverages.Rounds earned a nursing degree at Mercer County College and has healtheducation and psychology bachelors’ degrees from College of NewJersey.She began working in the insurance industry in 1982.”Other companies are selling seminars like ours, but we offera fantastic resource — our seminars and services are free,”she says. Her center can train doctors and staff members to completethe enrollment paperwork to acquire a billing number, to codeprocedures,and to provide the technical information needed for submitting bills.For instance, routine foot care by a podiatrist is not a covered —except for patients with systemic diseases, such as diabetes. “Weprovide, in writing, what the requirements are for the coverage, sothey can clearly understand the parameters and what would be thepatient’sresponsibility. It’s pretty easy to read,” says Rounds, “butthere’s nothing like having a person take you through it.”The most common mistake is for a physician to open a practice withoutthe proper training. “They don’t look first, they just jump intobusiness. Months later they are not sure why they are not gettingpaid, why their claims are not going through, and they don’tunderstandtheir statements.”All this computerization of health care billing may take longerthan everyone thinks, by the time it dribbles down to the one-doctoror two-doctor office. Says Rosalie Fox, executive director ofPrincetonManagement Services on Route 1 North by the Carnegie Center,”Doctors’offices are behind in the technology. Many, many doctor’s officesare not up to computerization. But that is changing.”— Barbara FoxNext StoryCorrections or additions?This page is published by PrincetonInfo.com— the web site for U.S. 1 Newspaper in Princeton, New Jersey.
