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© 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.1
Help Increase Patient Collections and Improve Patient Satisfaction
Best Practices for Keeping Patients Financially Engaged
2 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Our Speakers Today
Travis Mendenhall, FHFMA, MFASr. Systems Analyst, Gwinnett Hospital System
David DykeVice President, Revenue CycleRelayHealth
3 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Part 1: Market Dynamics• Patient• Market• Quality
Part 2: Case Study: Gwinnett Hospital System• About Gwinnett Hospital System• Strategies for Change• Results & Best Practices
Discussion & Questions
Agenda: Doing the Impossible
4 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Part 1: Market Dynamics
• The Patient’s World View
• The Market is Shifting at an Alarming Rate
• Qulaity Madters
Concept% of People who
THINK they understand the
concept
% of those that THINK they do, and ACTUALLY
understand
% of People (Total) who ACTUALLY
understand
Co-Pay 100% 72% 72%
Deductible 97% 81% 78%
Coinsurance 57% 59% 34%
Max Out Of Pocket 93% 59% 55%
Training: Patients
Source: Consumers Misunderstanding of Health Insurance, Journal of Health Economics & Washington Post, August 2013http://www.washingtonpost.com/blogs/wonkblog/wp/2013/08/08/do-you-understand-health-insurance-most-people-dont/
6 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Broad Consumer Mobile Internet Access
Trending
Americans90% Have Cell Phones
58% Have Smart Phones• 83% : Age 18-29 • 49% : Age 50-64 • 47% : In < $30k
Households• 81% : > $75k+
Activities• 82% : Pictures• 81% : Texting• 50% : Email• 49% : Location• 31% : Health• 29% : Banking
& Payments
Source: Pew Internet & American Life, January 2014
7 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Technology Adoption and Usage
Cell Phone
Internet
Broadband
0% 25% 50% 75% 100%
Internet & Mobile Phone Adop-tion
All Adults Adults +65
18-29 30-49 50-64 64+0%
10%20%30%40%50%60%70%80%90%
100%
Internet Use Frequency: By Age
Daily 3-5x WeekSource: Pew Internet Project, Older Adults and Technology Use Report 4/3/2014
8 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
• Seniors with annual household income of $75,000 or more, 90% go online and 82% have broadband
• Seniors with annual household income $30,000 or less, 39% go online and 25% have broadband
• 27% of Seniors own a tablet, e-book reader or both
• 18% of Seniors own a Smart Phone
On the Topic of Seniors and Technology
Source: Pew Internet Project, Older Adults and Technology Use Report 4/3/2014
9 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Online account management is growing across all demographics for all markets
Online Account Management
Source: Pew Internet & American Life Project, Generations 2010, 12/2010
18-33 34-45 45-55 55-64 65-73 74+0%
10%
20%
30%
40%
50%
60%
70%
Regularly Paying Bills OnlineBy Age Group
Growing 10-14% per year
Continued steady usage
10
1 in 5 Employer Sponsored Patients in HDHP
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
0%
4%
5%
8%
8%
13%
17%
19%
20%
29%
Conventional HMO PPOPOS HDHP
30% Growth
62% Growth
12% Growth
Source: Kaiser Francis Family Foundation, 2013 HEBS
5% Growth
ACA Impact?
11 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Collecting Critical Financial Information
• Helps improve efficiency• Helps reduce risk• Assists in increasing
Patient Satisfaction
See Patient Here
Take Payment Here
Take Payment Here
Your Past, Present and Future2011 2012 2013 2014 2015 2016 2017
Standard: 5010
Operating Rules: Claims
Operating Rules: Remittance
Operating Rules: Eligibility
Operating Rules: Claim Status
Operating Rules: EFT
Op. Rule: Referral/Auth.
Standard: EFT
Standard: Claim Attachment
Standard: ICD10Standard: ICD10
13 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Operating Rules
•Operating rules included in the ACA
•Defines common USAGE and CONTENT for HIPAA transactions
•Most obligations on health plans provide specific data
• If ANSI 4010/5010 defined HOW to communicate
• Then operating rules define WHAT to communicate
14 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Operating Rules for EligibilityCMS Adopted CAQH CORE Phase 1 & 2
Rule Areas Goals
SystemUp Time
• 86% availability per week (24 hours of down time per month)• Publish scheduled maintenance• 1 week advance notice for non-routine maintenance• 1 hour notice of emergency downtime
SystemResponse Time
• Real Time - Maximum 20 second “round trip”• Batch - In by 9PM, out by 7AM• 90% adherence
Benefit Response • Support 48 Service Types• Example: Medical, Physician , Hospital, Urgent Care, Mental Health
StaticFinancial
• Co-Pay, Co-Insurance, Base Deductible for most service types• Return In & Out-of-Network when different
Variable Financials • Return “accumulators” (Year to date)• Remaining Deductible, Out-of-Pocket
15 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Alerts Drive Action and Quality
•Alerts•Quick Confirmation•Other coverage alerts• Real-time alerts
within the HIS
•Registration Quality•Drive process
accountability
Patient hasMedicare but it’s actually an HMO!
The HMO is “Super Duper
Health”
DO SOMETHING
16 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Monitoring the Team
Team – 74%Registration QA Scorecard
• Alice91% (A)• Brett77% (C)• David45% (F)• Chris82% (B)
17 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Coaching the Individual
DavidRegistration QA Scorecard
• Pre-Admit88%• Lab24%• ER45%• Clinic31%
18 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Part 2:
• About Gwinnett Hospital System
• Strategies for Change: New Processes
• Strategies for Change: New Technologies
• Results & Best Practices
• Questions & Discussion
19 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Process and Technology
Using process and technology to empower staff to collect payments earlier and more often while ensuring patient satisfaction
20 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
About Gwinnett Hospital System
Lawrenceville Campus• Acute Care• 89 Bed Extended Care Center• Outpatient Centers• Neuroscience/Stroke Center• Open Heart• Trauma – Level 2• Pain Management• Clinics• FY14
Duluth Campus• Acute Care• Inpatient Rehab Center• Outpatient Centers• Bariatrics• Orthopedics• Orthopedic ASC• Concussion Institute• Clinics
553Beds
21 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
About Gwinnett Hospital System
• Employees 4964• Affiliated Physicians 850• Discharges 28570• ER Visits 140,308• Ambulatory Surgery 25,505• OP Diagnostics 217,057• Gross Revenue $2 Billion• Net Revenue $624 Million
FY 2014
22 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
23 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Our Challenges
•A need to increase overall POS collections High deductibles are the new normal
• Lost revenue/difficulty estimating patient bills• Confusing patient statements•High call center volume•Manual posting of credit card payments•Web savvy population expects consumer-friendly
payment options
24 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Our Goals
• Break down barriers to payment Inform patients of financial responsibility upfront Help patients understand their bills Provide convenient ways to pay Collect at multiple points during care process
• Reduce call center volume
• Increase cash posting efficiency
• Increase patient satisfaction and loyalty
25 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Strategies for Change
New Technology
New Processes
Staff is empowered to
collect payments earlier and more often
26 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Process Strategies
Patient Loyalty Program
Pre-Visit Calls with Estimates
FC Visits for All Self-Pay Scheduled Patients
Presumptive Charity Screening
Increase Collections and Patient Satisfaction
27 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Patient Loyalty Program
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Process Metrics
Financial Counselor Bedside Visits: 1673
Patients who made a payment: 23%
Patients who declined to pay: 58%
Requests for a payment plan: 17%
Requests for financial assistance: 2%
January 1 – June 30, 2013 *With 2 financial counselors
23%
58%
17%
2%
29 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Process Metrics
• Average collection per patient at the bedside$722
• Average collection per month from these same patients after insurance pays$100k
• Financial Advocate: average payment arrangements per month$350k
30 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Patient Satisfaction: Measuring the Impact
Did this new process give you a better billing experience than you’ve had with us before OR with another hospital system?
• Yes86%• No11%• Not Sure3%
31 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Agenda
• About Gwinnett Hospital System
• Strategies for Change: New Processes
• Strategies for Change: New Technologies
• Results & Best Practices
• Questions & Discussion
32 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Technology Solution Strategies
Bill EstimationAutomated POS
Collections
OnlinePayment Portal
Patient Friendly Statements
IncreaseCollections and Patient Satisfaction
33 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Automated Insurance Verification
34 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Automated Bill Estimation
35 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Automated Bedside Collections
36 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Online Portal Enrollment and Pay Now
37 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Adding Pay Now
•Adding Pay without enrolling feature brought: 15% Drop in enrollment
23% Increase in patient portal payments
•Reflects growing alarm over online security•Desire to keep personal information off-line
Pay Now
38 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Online Patient Portal/Enrolled Patient or Guarantor
39 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Pay by Account/Save CC Profiles
40 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Payment Plan Requests
41 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Printable Payment Coupon
42 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Online Provider Portal
43 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Provider Portal
44 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Patient View
45 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Account Details
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Processing Payments
47 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Processing Payments
48 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Processing Payments- Swipe Card and Real-Time Alerts
49 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Re-enabling Account/Disable Email Notification
50 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Provider Portal Reports
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Provider Payment Report
52 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Online Portal Enrollments
22,254 Total Enrollments (May 2010-Nov
2014)
$10,334,106 Collected
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Total Portal Collections
•$39,507,735 Total
•$8.4 million in the Last 12 Months
•Average Payments Per Month: $718,322
•Average Payment Amount: $200
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Online Portal Payments ̶̶̶̶ Since Go-Live May 2010
Pay Now$7 Million$18%
EnrolledPatients$10.3 Million26%
WebPay$22.2 Million56%
55 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Patient Friendly Statements
Helping patients understand what they owe
Clear and easy to read
Drive patients to online account management
Targeted messages by financial class
56 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Thinking Ahead…
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Ramping Up Adoption
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Agenda
• About Gwinnett Hospital System
• Strategies for Change: New Processes
• Strategies for Change: New Technologies
• Results & Best Practices
• Questions & Discussion
59 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Our Top 5 Best Practices
Implement Solutions to Automate Estimation/Eligibility/Presumptive Charity
Implement a Patient Loyalty Program
Implement/Optimize Patient Payment Portal
Implement/Optimize Provider Payment Portal
Automate All Patient Payment Cash Posting
P
PPP
P
Questions and Comments
60 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
• Reduce A/R days • Maximize claim and
remittance processing efficiency
• Reduce claim errors and denials
• Reduce Medicare rejections by more than 95%
• Reduce IT expense
• Increase revenue and reduce bad debt
• Increase patient satisfaction
• Decrease patient phone calls
• Reduce postage expense by 20-30%
• Improve patient experience
RelayAccount™ RelayAssurance™ RelayAnalytics™
• Assess operational and financial performance
• Increase financial visibility • Isolate root cause of issues • Accelerate positive
organizational change
Clears the path with patient financial visibility to help:
Efficiently manage patient accounts and make payments to help:
Assure the fastest route to remittance to help:
Analyze opportunities to determine action to help:
• Determine propensity to pay
• Increase self-pay collections and reduce bad debt
• Improve work flow efficiency and staff productivity
• Identify patients eligible for Medicare, Medicaid and charity programs
Revenue Cycle Solution Leadership
RelayClearance™
Improve Registration QA and Patient flow management to help:
• Increase patient registration data accuracy
• Reduce claim denials and rework
• Monitor patient flow throughout the visit
• Report on team performance and productivity
AhiQa and Ahi Lobby
End-to-End Revenue Cycle Solutions
61 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
Thank You for Your Time and Attention!Please contact us for further information or to request a copy of
this presentation
RelayHealth800-752-4143