945 dyke and mendenhall
TRANSCRIPT
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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
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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
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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
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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
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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/
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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
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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
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• 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
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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
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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?
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Collecting Critical Financial Information
• Helps improve efficiency• Helps reduce risk• Assists in increasing
Patient Satisfaction
See Patient Here
Take Payment Here
Take Payment Here
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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
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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
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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
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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
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Monitoring the Team
Team – 74%Registration QA Scorecard
• Alice91% (A)• Brett77% (C)• David45% (F)• Chris82% (B)
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Coaching the Individual
DavidRegistration QA Scorecard
• Pre-Admit88%• Lab24%• ER45%• Clinic31%
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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
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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
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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
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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
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22 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
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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
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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
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Strategies for Change
New Technology
New Processes
Staff is empowered to
collect payments earlier and more often
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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
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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%
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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
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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%
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Agenda
• About Gwinnett Hospital System
• Strategies for Change: New Processes
• Strategies for Change: New Technologies
• Results & Best Practices
• Questions & Discussion
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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
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Automated Insurance Verification
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Automated Bill Estimation
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Automated Bedside Collections
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Online Portal Enrollment and Pay Now
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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
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Online Patient Portal/Enrolled Patient or Guarantor
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Pay by Account/Save CC Profiles
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Payment Plan Requests
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Printable Payment Coupon
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Online Provider Portal
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Provider Portal
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Patient View
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Account Details
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Processing Payments
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Processing Payments
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Processing Payments- Swipe Card and Real-Time Alerts
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Re-enabling Account/Disable Email Notification
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Provider Portal Reports
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Provider Payment Report
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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%
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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
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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
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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
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• 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
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Thank You for Your Time and Attention!Please contact us for further information or to request a copy of
this presentation
RelayHealth800-752-4143