When customers buy their morning cup of coffee, the shop gets paid right then and there. Motorists pay for their gasoline at the pump. And if you want something from the grocery or department store, you must pay before you leave.
Healthcare practices don’t work quite the same way. While patients generally make a copayment when they visit their doctor, their provider must wait for reimbursement from an insurance payer. And once insurance payments, deductibles, and annual limits are factored in, many patients remain responsible for a portion of the bill.
Collecting those patient payments is where things can get complicated.
According to a 2019 article in Medical Economics, “For a provider, the true value of a dollar received for services depends on the timing of its collection.”
Priority one: Fix the collections process
That financial reality was no surprise to James Carr at Richmond Eye Surgeons, a growing practice with 45 providers that serves between 110,000 and 115,000 unique patients and is on pace for 200,000 patient encounters annually.
Carr joined Richmond Eye Surgeons after working at a 12-hospital system that was doing many similar things. His first move when he arrived at the smaller organization was to ask the front-office and back-office staff what their financial priorities would be.
“One of the most important ones from them was we’ve got to fix the collections process. You’ve got to get patient payments more streamlined,” Carr said. “We had a third-party vendor reconciliation that was, you know, just brutal. There was a delay, and it was affecting patient performance.”
Facing common industry challenges
The challenges were not unique to Richmond Eye Surgeons. The Medical Economics article made clear that some very fundamental and important financial challenges are found across practices of every type, size, and location.
As the article noted:
- Administrative costs, according to one source, mean providers may receive as little as 18 to 34 cents per dollar of care billed for patients with high-deductible health plans.
- When the patient is responsible for paying a balance, practices send out, on average, 3 statements before receiving payment.
- Printing, mailing, and staff labor costs can also represent a significant financial burden for many practices seeking to collect payments.
“I came from a large health system, actually a 12-hospital system running a lot of the similar things that I’m doing with Richmond Eye,” Carr said. “I looked and said, ‘Well, why aren’t we leveraging some of the technology that we have?'”
In fact, as Carr quickly pointed out to his colleagues, the practice already had a set of financial tools within reach, including healow Payment Services.
“I think from the moment that we had our first discussion on that we had it implemented within three months,” he said.
A few meetings and a smooth implementation
Carr had been through several system implementations previously, so he knew that a bit of planning would make this one much easier. He organized weekly meetings, held them for about a month, and then moved into the implementation itself.
“This was probably one of the smoothest ones I’ve ever seen with the healow Pay,” he said. “The thing was, we had folks on the front end that were worried — ‘How am I going to collect the cash now? I’m not going up to this third-party site.’ You know, we had ‘How are we going to get the patients the information they need, because right now we were having to print out from a third-party system and staple it to their discharge papers.’ Well, change is scary for a lot of folks until you show them just how easy it is.”
Among the steps Richmond Eye took:
- Across the practice’s eight locations, more than two dozen personnel working on billing received training using a “train the leads” approach that was simple and empowered key personnel to work with others.
- Staff focused on showing patients that their payments were reconciled with their statements, everything updating in real time, helping give staff and patients confidence that the new system works well.
- Two training sessions involving all front-end staff were held the week before going live with healow Payment Services.
An eClinicalWorks representative was on-site, but Carr said everything went so smoothly that the practice was able to handle the Go-Live without any further assistance.
Achieving greater efficiency, eyeing next steps
Carr said one of the best features with healow Payment Services is the auto-posting.
“We don’t spend time chasing a lost payment like we did with a third-party vendor,” he said. “That’s the back-end piece. We would spend hours over the course of a week just chasing down this missing payment or payment that didn’t get posted correctly.”
In addition, he noted that Richmond Eye Surgeons recently went through Revenue Cycle Optimization with eClinicalWorks. That process worked so well that the practice is now looking forward expanding its healow Pay campaigns and implementing healow Statements to unify their billing process.
Having one financial ecosystem, Carr said, is easier for the practice and makes it easier for patients to pay their balances and interact more frequently with their care providers.
“You increase your collections, you decrease your cost to collect having it all in one place,” he said. “Yes, that’s what we’re working toward. I would be fine with zero paper! If we can get everyone in healow and every electronic statement, that is the end goal. That is what everyone should have.”