University Physicians’ Association manages the medical billing services for more than 475 physicians in Knoxville, Tennessee, and serves as an advisor to medical practices across the eastern part of the state.
As a growing business, it needed to take a look at optimizing the efficiency of its central billing office and how patients paid their bills. Not only is UPA growing, but patients continue to absorb a higher percentage of the cost of their medical care.
“Collecting from patients is quite different than collecting from insurance companies and Medicare/Medicaid,” said Christy Bailey, vice president of client strategy and revenue operations at UPA. “We needed the ability to get notification of debt to the consumer quickly. When competing with other sources, we wanted to ensure we were doing all we could to collect first. We were behind industry standards and wanted to take the lead, not fall behind.”
Many of the patients UPA serves see multiple physicians that use UPA, creating multiple accounts per patient. The process for applying patient payments across more than one balance required staff to open each patient account separately and manually post a portion of the payment to each balance.
It was not only time-consuming and tedious for staff, but placed a burden on UPA as a third-party billing vendor to determine in what order patient payments were applied across multiple balances.
“Finding a solution that could manage the structure of a third-party billing company was not an easy task,” Bailey explained. “We needed the ability to manage hundreds of clients with separate financial institutions and debits from one management platform.
“UPA wanted to find a vendor that could help us automate these processes so patients could have expanded access and the ability to pay their bills easily 24/7, and so the distribution of patient payments was quick and empowered patients to manage their balances when they owed on more than one account,” she said.
"The time saved and increased accuracy from the integration auto-posting payments within our system is priceless."
Christy Bailey, University Physicians’ Association
Financial IT vendor Relatient proposed a custom CBO system and mobile payments for patients. Their proposed system would give patients the ability to make payments from a mobile device, without requiring them to log in to an account or download anything to their phones.
When patients would make a payment, they could determine how they wanted a payment split across multiple balances, if that was their situation. When a patient made a payment, it would automatically post to the appropriate accounts and balances, without requiring intervention from UPA’s CBO staff.
“For UPA, this would mean that our staff would have better ability to spend time on complicated patient accounts, better response time on the phone and happier patients overall,” Bailey said.
MEETING THE CHALLENGE
Relatient’s MDpay revenue cycle management system provided the functionality UPA was seeking. The implementation was one of the smoothest Bailey has experienced.
“Everything is more streamlined, and our patients have adapted to the technology because they’re now making payments digitally 60% of the time,” she noted. “For patients that call into our service department, the process of taking their payments is faster and easier. Our CBO staff are the main users of the MDpay system and patient balance messaging. The platform gives us the ability to control the frequency and timing of our messaging, and is easy to use for both our staff and patients.”
UPA also started implementing the vendor’s appointment reminders system across its physicians’ practices, something that’s mainly used by physician practice managers and clinic staff. The RCM system and appointment reminders are integrated with UPA’s practice management system from Greenway Health.
“The integration allows for real-time balances versus the traditional statement-generation process that drives a longer revenue cycle,” Bailey explained. “The time saved and increased accuracy from the integration auto-posting payments within our system is priceless. It also means patient responses to appointment reminders update in our scheduling system automatically, making the data easy to access and powering proactive patient communication when needed.”
Further, Relatient makes benchmarking data available to UPA, allowing UPA to make modifications where needed to continuously improve its use of the system to get better results, she added.
UPA saw patient payments increase 43% upon implementing MDpay and patient balance messaging.
“We believe this is because patients are more responsive on their mobile devices, and it’s so much easier to pay,” Bailey said. “It’s helping us collect debt faster, too. The payment lag for self-pay patients is down 20 days. That’s huge.”
UPA also has patients who grant permission to keep a credit card on file and charge smaller balances automatically, so they don’t have to keep track of them. They get email receipts, so they have a record of all the charges. It all works together to bring these patient payments in more quickly and to increase what’s collected. UPA has seen a 10.5% reduction in accounts receivable days.
“The 43% increase in patient payments is driving an overall increase in monthly physician revenue of 7%,” she added. “That may not seem like a big number, but that increase is significant – it equals a lot of revenue for our physicians.”
ADVICE FOR OTHERS
“Get a crystal clear understanding of what you’re trying to solve and why,” Bailey advised. “We’re a third-party vendor, so we were making decisions based on how we could expand the value we offer our customers and do it in a way that would benefit patients, too.”
But UPA also knew that it was going to need an IT vendor that would listen to its specific requirements, as it serves many varying specialties and the business is complex.
“A vendor that was going to try to force us into a cookie-cutter solution that didn’t really meet our needs wasn’t going to work,” she said. “If you know what you’re trying to solve and what your non-negotiables are, you can be confident in what you’re asking a vendor for. A real partner will be ready and willing to sit down and look at those things with you and help you come up with something that meets your needs.”
This type of technology is becoming more widely available, and that’s important because patients are expecting this kind of access and financial experience – physicians and companies that cannot offer it will be hurting, she said.
“So take a look at where you’re holding on to time-intensive, traditional processes that could be better handled by automation and technology,” said Bailey.
The Business of Health
This special collection of stories, which will be updated throughout the month, explores how hospitals, health systems and physicians are attempting to not only financially survive, but thrive, under the new normal.