Holy Name Hospital: Ten Years Later
A Customer Spotlight

Gaffey + Associates is pleased to spotlight a longtime customer of ours, Holy Name Hospital in Teaneck, New Jersey. Affiliated with New York Presbyterian Health System, Holy Name Hospital (Holy Name) is a comprehensive 361-bed medical center offering the most modern medical technology. The hospital provides comprehensive inpatient and outpatient services, as well as certified home healthcare services. Centers of Excellence at Holy Name include its new Regional Cancer Center that serves as a key resource for cancer patients in northern New Jersey.

Holy Name installed and implemented the GEMS billing solution over 10 years ago, and has worked closely with Gaffey + Associates over the years to make it a better and more viable solution for today’s hospital and physician billing office. GEMSNews recently spoke with Holy Name’s Patient Financial Services management team to discuss the last decade with GEMS.

Reflecting on your first 10 years with the GEMS billing solution, what has stood out most?

The first to come to mind is our CONFIDENCE in GEMS. “Gaffey + Associates" ("Gaffey”) and “GEMS” have become trusted names in our business office. Gaffey is “ahead of the pack” with regard to the industry and regulatory changes: we rely on their prompt response to these changes by keeping us informed and updating their software.

Secondly, is EASE OF USE. Our staff has come to rely on GEMS more then any other billing tool we utilize. GEMS is very user-friendly, and training new personnel is effortless. Whenever Gaffey offers a new module we are always willing to be a BETA site. We know that installations will go smoothly and cause little or no interruption in our day-to-day activities.

Also, the FLEXIBILITY of GEMS stands out. When we request changes to the UB92 we know our requests are handled with competence. Over the years, the ability for us to update our own Carrier Master has helped tremendously in our submission of commercial claims. Today we are submitting many more claims electronically than ever before.

Holy Name Hospital’s business office now uses GEMS on several desktops. Tell us about the ease-of-use for the billers. How does GEMS make their lives easier and workday more efficient?

When we started with Gaffey 10 years ago, six billers shared one GEMS PC. Billing schedules were established for each biller to allow ample time for claim editing and submission. However, with the installation of GEMS on the billers’ individual desktops, reports are now pulled early in the day and claims are edited and sent without delay. This still leaves time throughout the day to address other projects, such as collections and follow-up. Multiple desktops working with GEMS has ultimately improved the efficiency of our workflow, increased productivity, and positively affected our cash flow.

Can you share some thoughts on Gaffey’s Customer Support efforts?

Despite the 3-hour time difference between Gaffey’s location (in California) and Holy Name Hospital (in New Jersey), the response time is always prompt and professional whenever there are problems or inquiries. The entire staff is very responsive to our needs. Gaffey’s Customer Support Supervisor, Jason Singh, stands out as the person our staff has come to know and greatly appreciate. He is quick to respond to our issues and makes us feel like we are his priority. We feel Jason gives us his undivided attention until our issues are resolved. What a “GEM” you have in Jason!

Can you share any comments about Gaffey’s approach to Medicare Compliance?

Three words: MEDICARE COMPLIANCE REPORT! What a mixed blessing this is! In the beginning it was somewhat overwhelming to see so many CPT® coding errors, LMRP issues and ICD-9 invalid codes. But we can now qualify and quantify these errors. We can identify where the problems are coming from and work with respective departments to minimize future errors. Since implementing Gaffey’s Medicare Compliance tools, we have researched and corrected Medicare outpatient claims prior to submission, thereby reducing RPT claims and ensuring clean claims.

To learn more about Holy Name Hospital, please visit them on the Web at www.holyname.org.

Accelerated Secondary Billing
Fully Integrated into GEMS

Need some free cash? Gaffey + Associates has released Accelerated Secondary Billing (ASB) that fully integrates into GEMS. Our existing Secondary Billing product is a huge time saver when it comes to generating Explanation of Benefits (EOB) for secondary claims processing. Now we take it one step further by offering a turbo-charged version that, in addition to being a time saver, becomes a huge cash saver! We don’t simply wait for your Remittance data; instead our direct real-time interface to your Fiscal Intermediary allows us to query all your claims within 48 to 72 hours of submission and acquire all the necessary information to generate your secondary bill and EOB. Even better, we’ve fully automated the entire process and it’s free!

Consider these benefits:

• Reduce A/R days for Secondary claims by up to 12 days which is an 85% decrease in A/R days.
• Increase cash flow associated with accelerated claim submission.
• Fully HIPAA compliant.
• Saves valuable staff time by simplifying secondary and tertiary claim submission.

Give us a call (925-226-1800) or send us an e-mail (sales@gemsedi.com ) and we’ll get you signed up today.

Electronic Remittance Advice Services
Now Available for the Following Payers

Gaffey + Associates announces ELECTRONIC REMITTANCE ADVICE (ERA) SERVICES currently available for these payers, now offering 835 remittances:

• Medicare
• Medicaid
• Blue Cross
• Aetna
• CIGNA
• United Healthcare
• Horizon Mercy
• Independence Blue Cross
• AmeriHealth
• First Health

Daily or several days per week (depending on payer), services include data retrieval, staging, management, archiving and reporting. Detailed voucher reports are available, as well as data files for posting to your health information system. As payers continue to make 835 remittances available, Gaffey + Associates will continue to expand this offering.

GEMS and Horizon:
Send HIPAA Claims Direct

GEMS now allows you to transmit Horizon Blue Cross/Blue Shield claims directly to Horizon. The claims are downloaded in the HIPAA 837i format and sent directly to Horizon’s HIPAA secure FTP site. If you would like to send claims directly to Horizon, please send an email to hipaa@gemsedi.com. Our staff will mail out Horizon’s enrollment forms so a direct submission account can be set up for your offices!

Also, Horizon has made HIPAA compliant electronic remittance advice (ERA) available. We are finishing up testing now. ERA reports and/or posting files will be made available to providers who request this service.

GEMS All Payer Edits: Phase I
We're Helping Our Clients Reach a 99% Acceptance Rate

Our continuing goal at Gaffey + Associates is to ensure that all claims are processed timely by the payers, without delays or rejections. An initiative is underway to assist our clients in reaching a 99% Acceptance Rate. An “All Payer Edits” project will be rolled out in several phases. The following edits were implemented on November 19th as part of Phase I. These edits will help ensure Initial Claim Acceptance by the Non-Medicare payers.

Meet the Gaffey Team

Back Row L to R:
Mike Gaffey, Nagarajan Punaroor, Anatoli Mandelstam, Seth Masters, Scott May, Ken Torok, Jason Singh, Mike Brown, Margaret Bistrovich, Carlos Garcia

Front Row L to R:
Joe Gaffey, Michelle Merkel, Ralph Barsi, Kellie Gaffey, Suzanne Dusak, Jolane Romero, Sue Devoy, Khush Bodhan, Alan Butler

Not Pictured: Quyen Do, Alex Poloziouk

Employee Spotlight
Office Manager: Jolane Romero

This issue of GEMS News shines a bright spotlight on Gaffey + Associates employee, Jolane Romero. Jolane is our Office Manager and has worked with Gaffey + Associates just under 9 years. As Office Manager, she believes the role includes “a little bit of everything.” Jolane’s responsibilities are critical to the success of our customers, including direct administrative support to the President, Vice President, Chief Financial Officer, and Director of Information Technologies. She manages the company’s accounts receivable and accounts payable departments, and is our general liaison to major payers like Medicare, Medicaid, and Blue Cross Blue Shield.

GEMSNews recently sat down with Jolane to uncover exactly how she does it. She’s always shown strong organizational skills and has mastered the art of multi-tasking. “My main goal is to help us provide the best and most efficient service to our clients,” she shared. “With that in mind,” Jolane says, “I’m excited to see Gaffey + Associates move towards a more Web-based payer enrollment process, so our clients can focus less on ‘getting set up’ for electronic claim submission or remittance processing, and more on getting paid.” This customer-centric mentality is what drives Jolane’s workday.

Jolane’s hobbies include many different activities. When she is not at work she enjoys working out at the gym, quilting, and gardening. She also invests her time outside of work attending her 21 year-old son’s college baseball games and grading papers for her husband, who is an elementary school teacher. For vacations, Jolane says, “You will find me camping - either in the mountains of northern California or in the desert of southern Utah.”

We asked how many phone calls Jolane takes at work, and were surprised to discover “not as many as I used to, since Gaffey + Associates implemented a new phone system last year.” Jolane says she misses taking calls from clients and wants to “make sure they feel free to press ‘0’ when prompted,” for her role also includes the title of “Phone Operator”. When she does hear from clients, ironically, the most popular request is “Hi, I am trying to get a hold of Jason. Could you please transfer me to him?”

GEMSNews is pleased to highlight the roles and responsibilities of Office Manager, Jolane Romero. She’s a loyal and revered employee at Gaffey + Associates and, over the years, has helped make life easier for our customers. Though one may think Jolane keeps herself challenged with all her daily responsibilities, when asked what THE biggest challenge is in her department, she answers “Keeping the candy bowl full! We have a lot of people here with a serious sweet tooth affliction.”
Gotta love it…