SummaCare Drives Performance with Advanced Reimbursement Software from Burgess

Eliminating Waste in Payments Helps Improve Healthcare Quality

May 19, 2015, 08:00 ET from Burgess

ALEXANDRIA, Va., May 19, 2015 /PRNewswire/ -- SummaCare, a regional, provider-owned health plan based in Akron, OH, recently presented positive outcomes from its partnership with Burgess, leader in healthcare information management solutions for payments and revenue cycle management. Representatives from each company discussed the success of implementing the Burgess Reimbursement System® and its software-as-a-service (SaaS) approach to payment integrity at the 2015 Spring Healthcare Users Group Conference, May 3-6, in Hartford, CT.

Greg Burgess, CEO of Burgess, opened the presentation to HUG's 250+ attendees. "No matter how good you are with data accuracy, if you can't get that data into production so you can pay claims right the first time, your organization is going to have a lot of costly re-work, compliance and provider issues. That's why we started reengineering our applications and internal processes in 2009 to move to a SaaS platform that could eliminate the internal deployment issues around mission critical updates and network payment terms."

Jared Lorinsky, Vice President of Product Development for Burgess continued, "Payment integrity is a key aspect of a health plan's financial stability. Our model offers a sustainable platform that minimizes the professional services required to integrate, customize, and maintain these systems internally. That in turn enables our partners to focus their freed up human and capital resources for other quality-driven investments."

SummaCare enlisted Burgess to leverage its model and achieve cost efficiencies in financial operations by eliminating burdensome administrative waste in key areas. Within a few months of implementation, the company saw increased automation of pricing and adjudication procedures, improved first-pass claims accuracy, less internal IT burden and improved provider relations.

"We've had a long-term relationship with Burgess and we can't say enough great things," stated Melissa Stoner, Director of Configuration at SummaCare. "The accuracy of the biweekly updates is tremendously beneficial to us. In 2014 we sent around 200,000 claims to BRS® software for pricing and editing." She described the transition from the BRS® Classic program to the web solution as quick and easy. Mr. Lorinsky also emphasized his appreciation for SummaCare's commitment to transparency and payment integrity, "SummaCare was dedicated to the value of SaaS as a means to achieve medical and operational savings."

Burgess estimates its SaaS model can save millions annually on internal IT expenses and first-pass accurately priced claims. In addition, with biweekly CMS regulatory and fee schedule updates, it significantly reduces errors and re-work that costs approximately $4 per claim. Mr. Burgess walked through the evolution of data in the healthcare space noting, "When we began our redesign, most health plans were hesitant to consider putting their proprietary data though the internet, but we knew it was the only way to solve this significant financial burden facing providers and payers. We hoped the healthcare industry would see the value of a better, more accurate delivery system. Fortunately today, SaaS has become a highly adopted standard worldwide in healthcare."

About Burgess

Burgess provides game-changing, integrated payer and provider network management solutions to streamline medical claims reimbursement in a way that establishes a new industry standard. The company's proprietary software applications and consulting services help organizations save millions through improved accuracy, efficiency and performance, while offering powerful analytics and automation.  Headquartered in Alexandria, VA., and with a regional office in Hartford, CT, Burgess serves payers/insurers, providers and other healthcare stakeholders. For more information, call 800-637-2004 or visit


SOURCE Burgess