Leverage technology to realize the full potential of your patient revenue

Every step can be fully integrated both vertically within an organization and horizontally across all organizations.
By Bird Blitch
08:37 AM
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To strengthen everything from their brand to the way they deliver their services, healthcare providers are consolidating and integrating at a furious pace, especially clinically. It's becoming increasingly commonplace for patients to be able to access their clinical records across multiple settings.

Today, a growing number of organizations are seeing the need to turn their attention to consolidating and integrating the business office side of their operations, specifically with respect to patient payments. There are good reasons for this, both financially for the hospital and experientially for the patient.

As patient payments constitute upwards of 30 percent of hospital revenues, leveraging technology that works across different healthcare information systems can streamline and maximize payment collections, while keeping patients happier and making them more likely to pay their medical bills on time. This ease-of-payment is "the norm" in other industries, like online retail or banking, so patients likewise expect it now in healthcare.

Indeed, every step, from preauthorization through final payment, can be fully integrated not just vertically within a given organization, but also horizontally across all the organizations. However, it takes open architecture technology systems to accomplish this.

Patient payments a big issue in health care

Such benefits would be a welcome addition to the business side of healthcare. Currently, confusion reigns supreme on both the patient and provider sides when it comes to patient payments. Patients' frustration is well documented, and on the providers' side, payment reconciliation and settlement are still largely tedious, manual processes that take place across multiple systems. As a result, neither patients nor providers get true visibility into where they stand financially.

Add to that the fact that the U.S. banking system, for the most part, is still not set up to work easily with clinical systems. The inescapable conclusion is that current healthcare payment systems, which have been designed around payer payments, need to be redesigned from the ground up to solve for patient payments, which constitute the fastest growing piece of the healthcare revenue pie.

The answer is technology

The good news is that innovative payment solutions are coming to help healthcare organizations to get the most out of their patient payment stream. These solutions enable hospitals and health systems to capture a bigger slice of the patient payment pie and to help patients keep better understand their healthcare bills.

These solutions work across multiple different practice-management and health information systems, promoting greater efficiency and effectiveness. For example, your technology should be able to automatically reconcile and post 100 percent of all payment types--cash, check, credit card, FSA, etc.--no matter where the payments come from or when they arrive. It should also be able to take the data out of siloed billing systems and holistically put it together in one place for improved access by everyone on the revenue cycle team.

Perhaps most importantly, it should be founded on solid technology, which can be managed to lower costs as well as influence patient and provider behavior and improve payment rates. Indeed, with these technology solutions, both the patient and provider can get--for the first time--a complete financial picture of the patient encounter.

Multiple benefits for providers and patients

Because both sides enjoy a clearer picture of what to expect financially from a given episode of care, providers and patients can openly discuss payment concerns and options that are good for both parties. The enterprise realizes more satisfied patients who are more likely to settle their financial obligations promptly and gets a clearer, more comprehensive and accurate picture of patient payment status. This institutional knowledge, in turn, leads to better revenue management and results.

The benefits don't stop there, either.

Enterprises get greater reliability on the payment collection side--technology never "calls in sick"--and the billing office comes to know and understand their patients' entire financial obligation for a given episode of care across all providers.

Delivering the 'retail experience'

Today's patients and providers alike are demanding the same simplicity and ease of payment processing that they have been getting for the past several years from online retailers. Providers who can meet those consumer demands will succeed in the increasingly competitive world of value-based healthcare, where delivering value on the financial side is becoming just as important as delivering value on the clinical side.