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CAP TODAY Product Guides

Epic, Resolute

Epic, Resolute

Billing/Accounts receivable/RCM systems, May 2017

Contact Information

Epic
Nick Trentadue
ntrentad@epic.com
1979 Milky Way
Verona, WI 53593
680-271-9000
www.epic.com


Name of billing/accounts receivable/revenue cycle management system Resolute
Configuration of billing/AR/RCM system available as a dedicated module for Epic’s EHR and as a standalone product that can interface with other companies’ central LISs or EHRs
• Percentage of billing/AR/RCM system clients that use another company’s LIS 65%
Year company began selling billing/AR/RCM systems 2009
Most recent billing/AR/RCM system installation (based on March 2017 survey deadline) March 2017
Last major release or update of featured billing/AR/RCM system November 2016 (Epic 2017)
No. of contracts for sites operating billing/AR/RCM system 330
• No. of sales of billing/AR/RCM system between March 2016-March 2017
• No. of installations of billing/AR/RCM system between March 2016-March 2017
No. of sites operating billing/AR/RCM system (HL/IL/PP/PO/OL/FI)* 262 (—†/—†/—†/—†/—†/2–in UAE, Denmark)
Market billing/AR/RCM system outside the U.S. yes
Human languages (other than English) supported by system
No. of inpatient invoices handled by installed sites annually
No. of outpatient requisitions handled by installed sites annually
No. of user workstations in sites operating billing/AR/RCM system
No. of employees in company 9,700
• No. of employees dedicated to billing/AR/RCM system development, install, support 710
Provide list of client sites to potential customers on request yes (a complete list with no restrictions regarding its use)
Clients restricted from sharing with others their experience with company or software no
Features/modules
• Patient demographics transferred via interface from LIS to billing/AR/RCM system installed
• 1500 claim form generation (paper version) installed
• UB-04 claim form generation (paper version) installed
• Client invoice generation installed
• Patient or family invoice generation installed
• Generate reprints of claim forms and invoices on demand installed
• Key indicator tracking (online view of site-assigned key indicators) installed
• Billing by test profile installed
• Component billing installed
• Medical-necessity screening for Medicare installed
• Professional component billing installed
• Auto delete of nonbillable procedures installed
• Billing for technical component only installed
• Retain demographic data for repeating patients installed
• Account and patient payment posting installed
• Accounts receivable system installed
• Management and/or marketing report generation installed
• Automatic balance billing to patients installed
• Capitation billing plus billable tests installed
• Generate utilization reports for managed care installed
• Generate global charges for lab tests installed
• Unlimited user-defined fee schedules installed
• Track financial classes installed
• Allow open-item accounting (each line item on bill can be handled separately) installed
• User report writer installed
• User-defined collection system installed
• Client services or call tracking module installed
• Credit card processing available via third-party agreement
• Business analytics installed
• Patient Web portal installed
• Benefit eligibility checking installed
• Guarantor billing installed
Means by which billing/AR/RCM system tracks profitability test, payer, client (user’s choice)
Advanced system capabilities rules-based processing, claims scrubbing, bundling/unbundling, 72-hour rule
Standards and coding systems supported HIPAA transaction sets, X12 5010A1, IAIABC EDI guidelines, ICD-9-CM, ICD-10, CPT, HCPCS level II
System supports electronic data interchange with third-party payers and claims clearinghouses yes
• Electronic functions offered
Third-party rules and coding updates supported by system 3M, Optum360
Billing/AR/RCM system provides indexed field in each test definition for LOINC code yes
• Provides LOINC dictionary for each new installation no
Client receives copy of source code yes
Methods by which users can tailor billing/AR/RCM system in their own setting wraparound programming, ad hoc query tools, user-defined interfaces, dictionary settings
Billing/AR/RCM system received ONC-ATCB certification yes
Billing/AR/RCM functionality available via ASP or cloud-based data center available as a local server or an ASP or cloud-based product (client’s option)
Total cost for smallest standalone billing/AR/RCM system install**
Total cost for largest standalone billing/AR/RCM system install**
Total incremental cost for smallest install using billing/AR/RCM** as a dedicated LIS module
Total incremental cost for largest install using billing/AR/RCM** as a dedicated LIS module
Distinguishing product features (supplied by company)
* HL=hospital labs, IL=independent labs, PP=pathology practices (only surgical pathology/ cytology services), PO=physician offices, OL=other U.S. locations, FI=foreign installations †not tracked
** total cost includes hardware, software, installation, and training
Note: A dash in lieu of an answer means company did not answer question or question is not applicable.
All information is supplied by the companies listed. The tabulation does not represent an endorsement by the CAP.