It’s been a year since Providence-based LighthouseMD was acquired by Ingenix, a wholly owned subsidiary of UnitedHealth Group with a clientele that includes federal and state agencies, more than 1,500 health plans and insurance companies, and more than 200,000 health care providers.
For Ingenix, LighthouseMD was valuable for its CareTracker system, which combines practice management, billing and electronic medical records in a single software-as-a-service package. Joining Ingenix, in turn, has allowed the developers to rapidly boost CareTracker’s capabilities by leveraging the parent company’s vast health care and insurance expertise and resources.
Russell Keene, vice president of Ingenix CareTracker, former CEO of LighthouseMD, and creator of CareTracker, recently spoke about it all with Providence Business News.
PBN: What does CareTracker do for doctors’ practices?
KEENE: It lets them do all their practice-management functions – scheduling, patient registration, all the EMR functions, write prescriptions, get lab results … there’s a bunch of hospital interfaces, but it also has a clearinghouse function, so it connects you to many things you need to do, like scrub all your appointments for eligibility with the insurance companies, 300-plus insurance companies. We send the claims electronically. You don’t have to worry about those things – they just happen automatically.
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PBN: How is this different from all the software options out there for doctors?
KEENE: Most of the time if you got a practice-management or an EMR solution, it’s just a piece of software that you load on a PC in your office, and then when you need to do something like send a claim out or get a payment, all of that connection is usually very hard. With our environment, you don’t have any local software; it’s all Web-based, and we do all the connections for you. [There are also no updates or upgrades required because of this.] We had 13 releases last year, 14 the year before … we say it never gets old. It’s like a car that you get and all of a sudden there’s satellite radio and it just shows up in your car. New navigation features … and sometimes there are some features that you can try out, and sometimes people have to pay a little bit [extra].
PBN: You were acquired by Ingenix a year ago. How has that changed the company?
KEENE: I say way more good than bad. Ingenix has some great technology [to process claims for payers, analyze health care data and crunch numbers]. … They are the leader in coding books – there’s 200,000 providers that buy books from Ingenix … so we’re able to take this coding expertise, claims-scrubbing expertise, and they own some clinical connectivity concepts. … We work with providers, and historically, the payer was the enemy, because you’d always be trying to figure them out. With these tools … we’re able to take some products that Ingenix has and embed them [in CareTracker] to improve, for example, registry information.
PBN: Are you also using these tools with prescriptions?
KEENE: Yes, we do drug-to-drug interaction and drug-to-food, and we have access to formulary data, so if you have a particular plan and that drug that is being prescribed might have a higher copay, providing that to the physician is a lot better. But there’s also a whole bunch of tools … so the day we started, we snagged all the provider products that we could get into our solution: There’s a claims manager, there’s a contract manager to make sure physicians are getting paid what they’re supposed to … and there’s a whole host of knowledge that goes beyond what’s traditionally made available to providers. If you think about it, the best way to describe what we’re doing is we’re trying to reduce the friction in health care.
PBN: You operate in a very complex environment. Does your software-as-a-service model give you a competitive advantage?
KEENE: Yes, because these challenges don’t work inside the four walls of a physician’s office. It’s a many-to-many world, with all these stakeholders, all these [providers] and insurance companies. … I think we’re in a really good spot to help resolve that by having easy applications that are inexpensive, that are highly efficient, that are always up to date and aren’t old, that the software is always evolving, and we’re always working at connecting you. Our clients pay us every month. They pay us hardly anything upfront, and they have a monthly subscription. So we are completely committed to keeping that business.
PBN: How many users do you have?
KEENE: We have several thousand physicians, probably 5,500 active users in, I think, 18 states; in Rhode Island we have about 800. … Everybody uses CareTracker’s scheduling, patient registration, work flow, [etc.]. Then the EMR components, between 10 and 30 percent. It depends on what you consider using an EMR … all of the functions, more like 10 percent.
PBN: What are you working on now?
KEENE: We have a couple more releases this year. One of the more exciting parts is we’re working with UnitedHealth Group on a real-time [claims] adjudication system that we’ll launch this fall. So when you walk out of the doctor’s office with that or any plan, you’ll know exactly, as the patient, what you owe. That’s going to be great for physicians. … We also are releasing a referring-provider portal to allow our physicians to communicate with any other physician; we’ll be able to do secure communications to share clinical information. … We’re also starting a fax service, and there’s a lot of other things. •
