Optimizing your Billing Process

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1 Optimizing your Billing Process Samantha Charles Greenfield Health

2 GreenField Health Fee based practice founded in 2001 Seven physicians in two locations Four integrated business units Redesigned medical practice Strategic business and technology consulting EMR hosting service (Centricity EMR and PM) Advocacy and public health work 2

3 Mission statement GreenField Health s mission is to deliver, advocate for, and promote better health and healthcare through our clinical work, consulting, and participation in community efforts. Our values Excellence Innovation Trust Joy Generativeness Humility

4 The GreenField Model TM Customized Experience Relationship Service Reliability Management Systems 4

5 Founding Pillars Move away from office visits as the only method of care Extensive use of and phone as visit alternatives Open scheduling with same day appointments and more robust (max-packed) visits Improve patient experience Improve the doctor-patient relationship 5

6 Beyond the Office Visit E visits 48% Office Visits 23% Telephone Care 29% Distribution of patient encounters at GreenField 6

7 GreenField s IT System GE Centricity EHR GE Centricity PM Rosetta Stone interface for EHR-PM Kryptiq s ConnectIQ Suite Care Manager disease registry DocuTrack scanning Secure Messaging Web portal OCR scanning e-prescribing Automated appointment reminders in beta e-statements and Online Bill Pay Hospital interface for lab, x-ray, ED / discharge documents Midmark Spirometer PC-based and integrated CCC encounter forms GreenField SharePoint intranet Health Matters monthly e-newsletter for patients Remote access to hospital IS Remote access to practice IS Networking hardware & software Network faxing (Biscom or other) Network security software, backup, antiviral, & antispam Knowledge sources: Epocrates, UpToDate, PubMed Telecommunications phone system, cell phones 7

8 GreenField Health Portal Usage Greater than 50% of our new patient registrations come via our portal Many of our patients manage demographic changes through portal versus phone or paper Numbers increasing with improved patient education 10% of our patient payments are processed through portal in 2009 Goal to grow from 10% to 25% in

9 Statement volume

10 Before Online Bill Pay Statements Workflow Printing, reviewing/batching, stuffing, postage, and mailing. Challenges Took 1.0 FTE employee 2-3 days to complete Some A/R done simultaneously with review of statements resulting in duplicate/inefficient work Results Lag time between printing statements and patient receiving meant statements were not as accurate as they could have been.

11 After Online Bill Pay Statement Workflow Doing the statement run within PM and saving the file on the server similar workflow to electronic claims submission process Challenges Internal workflow issue with our annual fee balances for patients on monthly payment plans Results Process can be completed in less than 1 hour A/R handled more efficiently Patient balances and payments are accurately reflected on statements Patients are paying much more quickly

12 ROI Reduce overall billing costs by as much as 35% Overall staff expense reduced Cost savings of 1.0 FTE reducing from 2-3 days/work to 1 hour work each month - $ Ongoing efficiencies with A/R management and patients paying bills directly via online billpay. Printing costs reduced Envelopes, return envelopes, statement paper Postage expense greatly reduced Confirmation that patients received and opened their statements

13 Practice stories The first statement run through the system there was a patient who paid off an $800 bill that was over a year old. He did not know he owed because we were using the wrong physical address. Prior to estatements: Rework happening Lag time in patients receiving statements - 5 days Patient payments received Insurance EOB s received/amounts transferred to patient balances that would not get billed out Unnecessary phone calls/follow up occurring as a result

14 Workflow Diagram No changes to our existing billing workflows within PM Send both paper and electronic statements in one statement batch Automatic upload of all statement files

15 estatement Notification Sent to all patients listed in the PM 5 days if not opened by patient, notification sent to us 5 more days if still not opened by patient, paper statement generated and sent automatically Non-delivery receipts are sent to us

16 estatement Patient can view or print Formatted for viewing on computer Make a Payment links to online bill pay for convenient payment

17 Paper Statement Patients without addresses will receive paper statements Patients who pay bills online with a paper statement are asked to sign up for estatements Offers a URL to bring patients to online bill pay Customizable to match or enhance existing statement

18 Statement Balance Displays current Patient balance Balance updated nightly Practices can set minimum payment variables Minimum payment balance Minimum percentage

19 Payment Process Allows Patients to pay by: Credit/Debit Card FSA/HSA Account echecks Patient payment details instantly verified for accurate information Patient prompted to fix any issues

20 Payment Receipt Receipt automatically ed to patient Patient payments are deposited directly into your merchant account

21 Practice Dashboard Current month statistics Manage practice & estatement settings

22 Guarantor Dashboard Payment & statement history Individual account management

23 Statistics Reporting View overall summary or specify by date range

24 Plans for the future Move to weekly statements verses monthly Link family accounts with appropriate guarantor Include online bill pay as part of our initial patient training at first visit Increase overall percent of patients making payments via online bill pay

25 Questions