Cornerstone Behavioral Health

Streamlined Billing and Processes

PIMSY significantly enhanced overall operational efficiency through automation by eliminating unnecessary steps, reducing bottlenecks, and optimizing the billing process. For example, by utilizing the 835-posting procedure, we reduced manual paperwork, enhanced billing accuracy, and promoted efficient communication with insurance companies. The results were faster reimbursement, reduced errors, and improved financial management for healthcare providers, which resulted in cost savings and improved profitability.  

Interoperability- Maine HIE (Health Information Exchange)  

PIMSY and Cornerstone successfully integrated with Maine statewide HIE, facilitating effortless patient information exchange between providers. The integration is automated and runs in the background while agency staff performs typical day-to-day operations. 

This has offered several benefits for Cornerstone, including these key advantages: 

• Improved Care Coordination – allows a comprehensive view of client health data to enhance care coordination and make well-informed patient care decisions. 
• Enhanced Client Safety – reduces medical errors, and providers can make safer and more effective clinical decisions. 
• Faster Access to Critical Information – immediate access to patient data through the HIE ensures that healthcare providers can quickly retrieve crucial information. 
• Reduced Redundancy – reduces the duplication of tests and procedures, saving time and resources. 
• Enhanced Interoperability – connects different healthcare systems, EHRs, and providers while enabling seamless data exchange across various healthcare facilities. 
• Data Accuracy – ensures that patient data is accurate and up to date to provide high-quality care. 
• Improved Efficiency – easy access to health information reduces administrative burdens and frees more time for direct patient care. 
• Cost Savings – reduces redundant tests, enhancing efficiency, and improving patient outcomes.
• Compliance with Regulatory Requirements – satisfies regulatory requirements and promotes incentives (i.e., MACRA, MIPS). 

Denial Rate Decrease

PIMSY software solution reduced Cornerstone’s denial rate by 50%. This is attributed to factors contributing to enhanced efficiency and improved financial health. Below are key reasons behind the notable reduction in denial rates: 

• Accurate Documentation – providing detailed and standardized documentation makes it less likely for denied claims due to insufficient or incorrect information. 
• Utilization Management – managing authorizations resulting in fewer denials.
• Eligibility Verification – insurance eligibility is verified in real-time, reducing the risk of providing non-covered services. 
• Claim Validation – provides error validations before submission. 
• Compliance Support – adheres to Maine’s state-specific and federal regulations. 
• Integrated Billing – automatically generates claims and complies with Maine-specific requirements for MaineCare.  
• Electronic Claim Submission – claims are submitted electronically, reducing the risk of manual errors. 
• Efficient ERA Handling – electronically receive and process Electronic Remittance Advice (ERA) from insurance companies.  
• Financial Reporting – allows providers to track and analyze financial data. 

Increased Reporting Functionality

Through automation and advanced reporting features, PIMSY significantly helped save time and increase efficiency and accuracy while reducing the likelihood of errors associated with manual reporting.  

• Comprehensive Data Integration – seamlessly integrates with various data sources. 
• User-Friendly Interface – users can easily navigate reporting tools. 
• Adherence to Compliance Standards – ensures reporting features adhere to compliance standards and regulations. 
• Automated Report Generation: automating the process streamlines reporting, saving time and reducing errors. 
• Scalability – reporting capabilities scale to meet needs.