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Improved Revenue Cycle Management

Improved Revenue Cycle Management Starts at the End

How simple, intuitive, patient-friendly payment options can impact your RCM

When it comes to keeping the financial systems of a healthcare organization stable and efficient, revenue cycle management (RCM) is key. RCM is a pivotal, long-term process that can track patient episodes from appointment scheduling all the way to the payment of the final balance by integrating personal and financial patient information with vital data about quality of care and treatment. This interaction between the clinical and financial sides of organizations is meant to simplify the healthcare process for both providers and patients across numerous interactions.

But with so many factors that go into RCM, simplifying is sometimes easier said than done. Making effective changes to benefit patients and providers can be hard to justify the costs or simply hard to understand. Oftentimes, hospital RCM services grow piece by piece over a number of years, costing an organization hundreds of thousands of dollars in both monetary and labor resources. One component after another is added to the existing system until complications arise, making life difficult for both patients and providers. Problems that take years to create aren’t simple to solve, and RCM processes can be so multifaceted and complex that it’s impossible to know where to start.

Begin by asking yourself, what needs simplification? What do these processes even do, and how much is each costing your organization?

A simplified payment process

Don’t be surprised if your answers lead you to the end of the RCM process. The fact is that the world of healthcare is complex, and myriad factors influence RCM and organizational cash flow. Every detail counts, and the most seemingly insignificant details that go into the final piece of the RCM process—payment of the final balance—can have massive effects on the efficacy of an organization’s RCM.

Simple-to-understand payment options benefit everyone. The more streamlined an organization’s payment processing technology is, the easier it is for patients to pay their co-pays or medical bills. This means frontline staff spend less time fielding calls or answering questions related to billing. Research also shows that when making a payment is easier for patients, providers get paid more quickly and receive higher scores on patient experience surveys. A timely, low friction payment process means less money and labor costs involved in the collections process.

Healthcare IT departments working together with external payment processing partners to simplify this process and improve the payment piece of the patient experience have seen great results and saved organizations time and money in a number of ways.

Increased cash flow

For healthcare organizations, improving payment channels means improving cash flow, and a higher cash flow is key for improving your bottom line. Cash flow will never change, however, if your RCM process makes it complicated for patients to pay bills in a timely fashion.

Work to understand patients’ wants and needs in the payment space—what are they looking for in a payment experience?—and simplify your payment process accordingly. As healthcare organizations monitor trends in patient preferences, they also should updating their payment options to match these preferences. In the long run, this will make the payment piece of the RCM process as simple as possible.

For example, more and more, patients are interested in online payment options. Helping patients access their payment history and pay bills from a computer, tablet, or even a smart-phone guarantees a more effortless payment process. A broader range of seamless options for patients to pay their bills can lead to more timely payments, increasing your organization’s cash flow.

Experts from community-orientated healthcare providers echo these sentiments. According to the Director of Revenue Cycle at Fort HealthCare John Bartell, the best way to improve RCM is to create as many avenues as possible for patients to pay any balance or bill. He recommends looking for ways the payment process can be streamlined to reduce burden on the patient and increase efficiency in business processes. Reducing steps in the RCM process means easier payments for patients, less administrative labor and an improved cash flow.

Increased days cash on hand

Not only can a simplified payment process increase your organization’s cash flow, it also can drastically improve days cash on hand (DCOH), providing increased financial stability. Simple, intuitive and patient-friendly payment options make it easier for patients to pay their co-pays or medical bills in a more timely fashion. As payments are made on-time on a more consistent basis, less money is spent on collections, allowing for a stable amount of cash on hand.

Patient payments become more and more crucial as experts see out-of-pocket and self-payment expenses increasing as changes continue happening in the healthcare sector. An increased number of unpaid bills can easily lead to a greater increase in collections-related costs if payment processing is complicated. By making payment easier on the front end, healthcare systems are able to minimize the number of charges that end up in collections.

DCOH is important to allow your organization to get money faster. Like cash flow, this financial metric demonstrates an improved bottom line and is a significant measure of hospital liquidity. By preventing expenses associated with the collections process, providers can easily increase DCOH and focus on quality of care and other metrics with more confidence about their organization’s financial stability.

Other benefits

From an accounting perspective, a simplified payment process can lead to simplified, improved reconciliation. As patient needs change, new platforms are introduced and new methods to pay are being added. The more complicated your system becomes, the more time- and resource-consuming the reconciliation process can be.
Healthcare organizations should work to streamline the reconciliation process into a single technology platform. No matter the number of payment options offered—from kiosks and online portals to recurring payment solutions—transactions are merged into a single point of reconciliation for convenient use.

A number of healthcare organizations are linking their payment processes and technology solutions to their electronic health records (EHR). By using this technology to merge patient personal and financial information, organizations are better positioned to assign and manage patient numbers and unique identifiers to keep records straight and simplify patient reporting and records. Having this data linked can lead to additional improvements in an organization’s RCM.

Industry professionals recommend forming “symbiotic relationships” between healthcare organizations and payment processing solutions. For example, Bartell noted payment processing partners help healthcare organizations stay up-to-date on the most recent advancements in payment options. Likewise, keeping the people working on your payment process current on the latest healthcare industry trends will guarantee payment processing solutions are flexible to meet an organization’s specific needs.

For most healthcare organizations, RCM is a constantly-growing line item. Expenses, both financial and labor-related, can grow slowly over years until the process is eating up five percent or more of your profits. Even worse, as previously stated, by the time RCM becomes a bother, your process can be so bogged down with added systems and procedures that it can be almost impossible to understand where the resource drain is coming from.

It may seem counterintuitive, but as you look to improve RCM in 2018, render your RCM system down to brass tacks and try starting at the end of the process. Look at the payment piece of the puzzle and find places where you can simplify and create a more frictionless experience for both your organization and your patients.

Ring In the New Year with the Right Payment Processing Solution for Your Hospital

If there’s one thing we can all agree on, it’s that 2017 was a crazy year for health care. As the industry continues to transform, how is your payment processing technology evolving to compliment those changes? Looking toward the New Year, here are a few questions to ask when deciding upon the best payment processing solution for your health system, hospital or clinic.

Does it simplify and positively impact revenue cycle management (RCM)?

The right customized, streamlined payment processing solution will reduce steps in the RCM process and make it easier for patients to pay their co-pays or medical bills. Providers will spend less time collecting reimbursements and more time on their passion: helping people through practicing medicine.

Does it increase cash flow and days-cash-on-hand?

When it comes to financial stability, every detail counts. By using payment processing technology to receive reimbursements more quickly and to minimize expenses associated with the collections process, providers can easily increase cash flow and days-cash-on-hand.

Does it improve the patient experience?

Going to the hospital can be an intimidating process for many, and figuring out how to pay the bills that follow can be even more daunting. In fact, research shows providers’ scores on patient satisfaction surveys tend to drop after patients receive their bill(s). Healthcare-specific payment processing solutions that focus on the patient payment experience are key in this consumer-driven world.

Does it implement a security-first approach?

The growing number of data breaches is another trend that has disrupted the healthcare industry. Payment processing solutions that focus on security first rather than just checking off the boxes necessary for PCI compliance are better positioned to protect patients’ financial information.

Does it include an all-star support team?

Industry professionals recommend forming “symbiotic relationships” between healthcare organizations and payment processing partners. Look for a vendor that provides around-the-clock support, dedicated relationship managers and flexible contracts with regular program reviews.

Implementing a customized, streamlined payment processing solution will create a snowball effect that benefits patients, providers and frontline staff. A payment processing solution matching your organization’s unique needs and goals will lead to happier patients, greater financial stability, and more efficient and secure payments. If you’re interested in our customized, healthcare-specific payment processing solutions, please contact me at juselman@windriverfinancial.com or 1-800-704-7253 x4238.

The top 5 issues hospitals have with their payment processors (that aren’t even known by the organization)

Payment processors play a key role in a hospital’s finances, as well as the organization’s ability to meet minimum requirements and maintain PCI compliance. But as is the case in many institutions, organizational layers, antiquated processes or simply a lack of accountability can lead to issues below the surface that greatly impact efficiency and compliance.

Here we’ll examine the top 5 issues hospitals have with their payment processors…which the hospital may not even realize exist.

So without further ado, the list:

1. Cost Benefit Confusion – A cost benefit analysis is a foundational practice for any organization or business venture, and hospitals are certainly no exception. It is important that hospitals ask, “what are we paying?” and “what are we receiving for our money?” in order to determine if there is value in the investment. If the answers to these questions are not known, there is a problem. Confusion regarding statements can lead to over payments or worse – continued payment for a service that is not being utilized.
2. Delays – Response time is crucial. Clients should not settle for “pulling a service ticket” or waiting 24 hours (or longer) to receive an answer to a question. We’ve all heard the adage, “time is money.” In few places is this sentiment more true than a hospital. The more time passes, the more billable hours practitioners may accrue, which may either be passed on as costs to the patient or essentially “eaten” by the hospital. Delays can further complicate hospital billing and eventually stall a patient’s discharge or even the initiation of care in some instances. Whether it’s a matter of dollars or negative health outcomes for the patient, the bottom line is that delays are bad for business.
3. The Changing Face of Risk – In our digital world, systems and technology are rapidly evolving. Unfortunately, so too are the threats, entities and individuals who seek to breach hospital data. New vulnerabilities and areas of risk are also coming to light as technology evolves. For example, as chip card acceptance continues to grow, so too does online fraud – a threat that is significantly expanding. If defenses are not up-to-date, payment data will be at risk and extremely susceptible to new iterations of cyber-attacks in healthcare.
4. Overpaying on Card Brand Fees – No one wants to pay more than necessary. When overpayments occur in the hospital setting, they often result in large sums of money down the drain. Overpayment can be attributed to a couple of primary factors. First, utilizing the wrong technology can result in a hospital paying more in card brand fees than necessary. The other common factor is the provider failing to proactively manage payment channels.
5. Unequipped to Assess – Lacking the ability to assess the health of the merchant services program is another significant issue that hospitals can have with their payment processors. In personal health, a multitude of factors come together to determine the well-being of a patient on a given day, as well as their level of risk for the future. The same is true of merchant services’ health. Elements must be taken individually and together. Balancing cost, security, efficiency for staff and customer payment experience are a few of the factors that converge to create a healthy program.

Learn more
Be sure to check out the other installment in our series on payment processors – “4 questions every hospital should ask its payment processor.

4 questions every hospital should ask its payment processor

Payment processors play a key role in a hospital’s finances, as well as the organization’s ability to meet minimum requirements and maintain PCI compliance.

To ensure that your medical center is ticking all the correct – and critical – boxes on the PCI compliance checklist, it’s important that your payment processor is able to answer some key questions regarding processes, systems and your organization’s ability to respond to a changing digital payment environment.

So grab a pencil and schedule a meeting with your payment processor, because here are the 4 questions you should be asking:

  1. How can we mitigate our risk exposure AND ease the process of PCI compliance? It’s important to recognize that easy PCI compliance and a secure institution are not mutually exclusive ideas. Keeping threats at bay does not have to be painful or onerous. Make “work smarter, not harder” your mantra. Streamline your processes in accordance with PCI requirements to create a sustainable system. This will ensure your hospital can protect its valuable data and sail through PCI compliance requirements at the same time.
  2. How does our growth in credit card volume impact our merchant services program? Growth is generally a good thing, it’s the growing pains that are hard. Increased credit card volume can sometimes change terms, limits and other aspects of a merchant services relationship. Areas such as minimum transaction, chargeback maximum and other elements may be impacted. Knowing the answer to this question is key to understanding how to position your organization for success and ensure the continued safety of data.
  3. What payment industry changes are going to impact us? What, if anything, can we do about it? It’s doubtful that your payment processor has a crystal ball (if they do, please contact us…we have a few predictions to confirm). But what he or she does have access to is information and trends that can help adjust practices and prepare for industry changes. For example, in October 2015 the EMV liability shift took effect, transferring counterfeit fraud liability from the credit card issuers to the party that had not enabled the chip – the merchant. Then in June 2016, both Visa and American Express extended temporary modifications to the EMV liability shift. As evidenced by this example, the industry is constantly changing. It is critical that your payment processor has a pulse on the industry and is keenly aware of developments and rule changes.
  4. Beyond having transactions passed through the system, what value should we expect from our merchant services provider and how do we quantify this value? Measuring expectations is a key component of your organization’s relationship with a merchant services provider. Asking this question will allow you to determine how the provider will be evaluated and what defines value at your hospital. It’s important to not just blindly trust that your provider is delivering. Minimum transaction, chargeback maximum, availability of EMV terminals – these are all elements of the merchant services relationship with which the payment processor should be intimately familiar. If your payment processor cannot speak to these areas or provide numbers, it’s time for him or her to get on the phone with your merchant services provider.

Need help?

Wind River Financial (WRF) can help you ask these questions and assess your systems and processes for opportunities. But it doesn’t stop there – we have the experience and know-how to turn questions into answers, opportunities into action.

Contact one of our relationship managers or sales associates today to learn more and discover what the WRF advantage can mean for your hospital.

Are your patients at risk?

Preventing card data breaches. 
Hospitals must meet numerous compliance requirements to ensure the security of patients’ financial and medical information, and for good reason – health care institutions are a major target for hackers and a frequent victim of data breaches. According to the Ponemon Institute’s Sixth Annual Benchmark Study on Privacy & Security of Healthcare Data, 89% of organizations experienced data breaches. The damage inflicted by breaches can be far-reaching and costly. Ponemon’s study found that the cost of data breaches to the United States’ healthcare industry could be as much as $7 billion per year.

As these figures indicate, PCI compliance really isn’t an option – you simply cannot afford to risk your organization’s security with the ever-present threat of hackers and other cyber threats.

Is your organization PCI compliant? If the answer is “no” or if you are unsure, both your patients and your institution may be at risk. But not to fear, we’re here to help. Read on to find out how.

WRF has you covered.
Wind River Financial (WRF) can assess your environment for point-to-point encryption (P2PE) capability to help minimize PCI scope and risk. We will help you deploy P2PE to achieve PCI compliance. Better yet, we will establish a structure for P2PE in your organization that is sustainable and ensures your continued success after our work is done. After all, PCI compliances is a marathon, not a sprint.

The experience to get the job done.
At WRF, we have successfully partnered with several health care organizations in strategically deploying P2PE solutions. From assessment to implementation, education and training – we will work with you every step of the way. When it comes to PCI compliance and defense against breaches, we’re your one stop shop.

Don’t take our word for it.
We never get tired of compliments from clients. We take pride in serving our customers and stand behind our products and services. Exceptional customer service, seamless integration and the ultimate hospital “radar” system – these are just a few of the kind words our satisfied customers have shared in describing our services.

But don’t take our word for it – check out some of our testimonials to hear from the clients themselves and learn what the WRF advantage can mean for your organization.

What are you waiting for?
Contact us today to discuss your organization’s needs and find out how WRF can help you choose a P2PE solution that will prevent credit card breaches and ensure the security of your patients’ information.