The Challenge
For more than two decades, Montgomery County Hospital District (MCHD) relied on a self-hosted billing system that demanded extensive manual effort and frequent double-checking by staff. Every action in the billing process required verification by one or more people to avoid errors.
“We had been on the same platform for 22 years,” said Michael Wells, EMS Data Reporting Analyst at MCHD. “Half of the process was done in spreadsheets, and the other half in the billing system. It was an incredibly manual process.”
The outdated system lacked validation rules, automation, and reliable reporting tools. With increasing call volumes, the billing team faced mounting challenges keeping up and was preparing to hire additional staff to meet the workload.
The Solution
MCHD implemented ImageTrend’s Billing Bridge™, a cloud-based solution designed to integrate seamlessly with Elite™, their existing EMS reporting platform with ImageTrend. The team was drawn to the automation tools within Billing Bridge, particularly validation rules and triggers that automatically identify and flag errors before claims are sent.
“As we started using the system, we built payer-specific validation rules,” Wells explained. “When we found a claim rejection, we were able to figure out why it happened and build a new validation rule so that exact error wouldn’t happen again.”
These configurable rules now automatically handle payer requirements, reducing the burden on staff to memorize or manually check multiple submission standards. Billing Bridge also connects to Experian Insurance Discovery, helping verify patient information and ensure the accuracy of claims.
“Before, our billing manager had to review every single claim before it went out the door,” said Wells. “Now, we’ve built rules for that, and our supervisors can spot-check instead of reviewing everything manually.”
The Outcome
Since adopting Billing Bridge, MCHD has seen dramatic improvements in efficiency and accuracy:
- Reduced billing lag from six weeks to five days: The team now works in near real time, with a five-day hold only to allow hospital outcome data to populate before bills are processed.
- Enhanced efficiency without increasing headcount: MCHD was preparing to hire up to three new billing staff but found it unnecessary after go-live.
- Achieved significant drop in claim denials: Continuous refinement of validation rules ensures that the same error never happens twice.
- Improved morale and flexibility: With a cloud-based system, most of the billing team now work from home, while IT demand has decreased substantially.
Wells shared that guiding the team through new workflows was key to success. “Once they saw how much time automation saved, they quickly embraced it. They’re putting in less manual effort every day and accomplishing more,” he said.
Connecting Data Across Systems
Through the integration between Elite, Billing Bridge, and ImageTrend’s Health Information Hub (HIH), MCHD can now use hospital outcome data to improve both billing accuracy and continuity of care.
“When the patient’s record is updated in Billing Bridge, that information is automatically sent back to Elite,” Wells said. “So, the next time we run on that patient, we have the correct data, it stays fixed.”
This integration has also allowed MCHD to align billing automation with its Healthcare Assistance Program, identifying eligible patients based on income level and automatically mailing applications when they qualify.
“It’s even leading directly to improved care,” Wells shared. “We’re able to identify patients and get more people access to insurance coverage.”
The Results
| Metric | Before Billing Bridge | After Billing Bridge |
| Billing Lag | 6 weeks | 5 days |
| Staffing | Planned to hire 2-3 new staff | Met demand without adding staff |
| Claim Denials | Frequent denials and rework | Reduced through automation |
| Claim Reviews | Every claim manually reviewed | Automated validation rules |
| System Hosting | Self-hosted, IT-intensive | Cloud-based, minimal IT needs |
| Team Flexibility | In-office operations | Remote work enabled for staff |
Looking Ahead
For MCHD, implementing Billing Bridge wasn’t just a software upgrade, it was a transformation of mindset. By building trust in automation and designing workflows around technology, the agency has drastically improved accuracy, acceleration reimbursements, and empowered staff to focus on higher-value work.
“We’ve moved from being six weeks behind to operating almost in real time,” said Wells. “It’s a huge improvement, and we’re only continuing to refine the process.”
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