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ISM Article

Electronic Workflow for Paperless Ambulance Billing

1 Jul, 2012 imageSource

Ambulance billing company, HSI, began using DocuWare’s electronic workflow to drive its business processes paperless. As a result, requests for guidance on individual claims can easily be addressed by management, transport document sets can be routed through complex workflow algorithms efficiently, and trip document sets are easily compiled; all streamlining a very comprehensive, complex flow of documents.

Initial Situation

Health Services Integration (HSI) is a revenue management service providing ambulance billing and revenue management for clients throughout the United States. HSI concentrates on optimizing ambulance accounts receivable (AR) by maximizing the collection rate and minimizing the cycle time through the use of highly sophisticated proprietary technology and expert team leadership.

Health Services IntegrationThe billing process workflow of patient transport document sets is complex. For every patient transport, a document packet of 7-20 pages is created by the transporting ambulance crew and sent electronically to HSI for billing processing. Historically, HSI printed these trip document sets, completed the billing process and then scanned them back into DocuWare for storage. However, once HSI made the commitment to go paperless they were ready to also implement a completely electronic document workflow.


HSI had DocuWare in place as a repository, but was not utilizing its full capabilities. Their Authorized DocuWare Partner helped them to expand their use of DocuWare and to take advantage of the software’s powerful workflow and automated indexing features.



Client: Health Services Integration

Industry: Ambulance Billing

Location: United States

Application: Healthcare Coding and Claims Management

Document Types: Ambulance Transport Documents, Insurance Submittals


With DocuWare’s electronic workflow functions activated, transport documents are received via encrypted fax or extracted out of an ambulance provider’s software system. They are imported into DocuWare where they are routed, using an electronic routing stamp, to their next appropriate destination in the claim process.

The claim processing algorithm results in the electronic routing of document sets to several different departments prior to being considered “complete.” Use of DocuWare’s electronic routing capabilities eliminated the need for
documents to physically move from point to point, improving the efficiency of document set transit time as well as document set security.

“Our processes have been streamlined, allowing us to add volume without adding staff.”


Expected Tasks

  • Create electronic workflows
  • Make all processes paperless
  • Streamline coding questions and facilitate learning

Expected Benefits

  • Electronic process resolves coding questions, educates staff
  • Improved coding results in quicker payments
  • Electronic workflow allowed HSI to add volume without adding staff

Applied Modules


In addition to the above benefits, HSI takes advantage of DocuWare’s electronic editing tool. If at any point in the process an employee has a question or desires to convey additional information about the claim, they

have the ability to make an electronic note on a document set. This creates a workflow for claims needing manager input and keeps claims moving efficiently through the process.

“Our processes have been streamlined, allowing us to add volume without adding staff,” said COO, Jennifer Hardcastle. “This new efficiency combined with the fact we were able to integrate DocuWare’s workflow into our own in-house system without intensive custom programming, has allowed us to focus our internal resources on providing measurable results for our clients.”


HSI produces results for its clients by utilizing proprietary technology and embedding electronic workflows in their custom-designed claims management application that guides, prompts, and alerts their highly trained staff to do the right thing at the right time, every time, and to report process variances immediately to management.

HSI is relentless in their pursuit of operational efficiency and their desire to optimize the quality of their clients’ experience with their service. DocuWare provides HSI with the technology to streamline the collaboration, communication and flow of trip document sets. The software is an integral part of HSI’s endeavor to be the leading source of high-quality, efficient, customer-oriented revenue management services for the healthcare community.

* Implementation Partner: Scott Technology Group

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