How Symbria Inc. Uses Laserfiche to Streamline Plans of Care for Patients

4 min read
  • Healthcare
  • Information Technology
  • Process Automation

Laserfiche Solution Contributed By: Hien Do, Software Development Manager; Boris Remus, Senior Software Engineer, Symbria Inc.

Symbria Inc. provides therapy services to hundreds of skilled nursing facilities. The organization was challenged with manual paper processing prior to implementing Laserfiche. One area that was especially paper heavy and inefficient was obtaining the required physician signatures and dates on the patient plans of care forms.

Within 30 days from the start of a patient’s care, their treatment plan must be approved by a physician or reimbursement for the treatment may be denied. Previously, the Rehab Program Manager printed a patient’s plan of care from the therapy software. The plan of care was then hand delivered or faxed it to the appropriate physician for a signature. Once the signatures were obtained, the Rehab Program Manager scanned in the plan and attached it to the patient’s record back into the therapy software. The program manager would also have to fax or hand-deliver the plan of care to the medical records department at the facility in order for the payments to be processed correctly.

Rehab Program Managers, who are highly trained therapists themselves, spent a lot of their time performing administrative tasks like tracking which documents haven’t been signed and following up with physicians who did not sign the plans of care. Facilities vary greatly in size which means some process a small number of documents a week, while others can process in excess of 100. This volume resulted in a significant amount of program manager time investment.

Symbria evaluated the entire process and decided to use Laserfiche to optimize it. The current process transfers most of the work from the Rehab Program Manager to the staff at the corporate office and uses Laserfiche Forms and Workflow to automate routing and faxing.

The Plan of Care is Routed and Faxed Electronically

The new process still starts with the Rehab Program Manager generating the plan of care document, but now, he or she uploads it to a Laserfiche form. From there, everything is handled by staff at the corporate office.

Once the plan of care is uploaded and the form is submitted, the plan of care is saved in the repository and Laserfiche Workflow creates and stamps a barcode onto the document. The barcode uniquely identifies the plan of care. Workflow then runs a series of checks to make sure that the information in the plan of care is correct. Workflow checks that:

  • The physician identification number has 10 digits
  • The patient name is valid
  • The therapy discipline is valid
  • The date is valid


If the plan of care does not pass all the checks, then it must be validated manually. The corporate processing staff performs the validation task in Laserfiche Forms.

Once the plan of care is validated, Laserfiche Workflow looks the physician up in the database to obtain his or her fax number. The document is then faxed digitally to the fax number using a faxing service.

When the physician signs and faxes the document back, Symbria receives an electronic version of the document from the fax service that is then imported into Laserfiche using the Import Agent. Workflow reads the barcode to associate the document with the original and routes it to the processing staff at the corporate office to verify the document is correctly signed and dated. Once that step completes, the processing staff attaches the document to the patient’s record in the therapy software and Workflow sends a copy to the medical records department at the appropriate skilled nursing facility.

If the physician doesn’t return the plan of care in a timely matter, the corporate staff member gets a task assigned to him or her in Forms to follow up with the physician. When opening the task, the staff member sees helpful information, such as the physician’s fax and phone numbers. The physician is also automatically notified through Workflow on a regular basis if he or she hasn’t sent back the signed plan of care.

Automation Saves Each Facility an Average of Five Hours a Week

On average, with this automation, each facility saves five hours a week by not having to manually fax and deliver plans of care. The largest benefit, though, is that the Rehab Program Manager no longer has to obtain physician’s signatures. Instead of chasing physicians down, the Rehab Program Manager can focus more on patient care. Laserfiche also gives the company stringent control over document access, which is a must in the heavily regulated healthcare industry.

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