Idea Transcript
Bank of America Merrill Lynch White Paper
Healthcare Revenue Cycle Roundtable: Insights on Automation
March 2016
Executive summary
Contents
Healthcare finance executives representing seven hospital and health systems from
Achieving revenue cycle success.. . . . . . . . . . . . . . . 2
across the U.S. recently met in an interactive forum with Bank of America Merrill Lynch. These executives all implemented Bank of America Merrill Lynch Revenue Cycle Solutions
Focusing on new opportunities. . . . . . . . . . . 4
powered by HealthLogic, Bank of America Merrill Lynch’s wholly owned subsidiary
Future insights. . . . . . . . . . . . . . 5
and a leading provider of revenue cycle services. These automated solutions simplify reconciliation, posting and denial processing of insurance and patient payments. The attendees’ common goal was to share challenges and achievements in optimizing their organizations’ revenue cycles. Their dialogue also helped to identify new strategies and opportunities for enhancing revenue.
HEALTHCARE REVENUE CYCLE ROUNDTABLE: INSIGHTS ON AUTOMATION | 2
Achieving revenue cycle success A 2013 merger involving a large multi-specialty academic medical center produced a cohesive work culture, but a fragmented treasury platform. Sunsetting the legacy system
“85% of our cash stream is fully electronic and we expect to raise that rate by adopting
was a major undertaking for that organization’s finance executive. It involved combining
a practice management
a centralized treasury, revenue cycle and billing system with another platform customized
system for physician billing.”
for eight different geographic regions. Bank of America Merrill Lynch Revenue Cycle Solutions consolidated the remittance flows for these regions through HealthLogic. The organization can now receive all insurance payments, as well as ancillary billings from regional organizations, including a flagship hospital that covers approximately 1.5 million patient visits per year. One of the nation’s largest nonprofit managed healthcare companies also faced varying electronic posting rates from 24 accounts-receivable systems in different regions, according to that organization’s finance officer. Because the healthcare system blended hospital and physician payments, it needed to decompose the transactions so they could reconcile at day’s end. Working with the company’s IT staff, HealthLogic created a program that classified transactions as either “hospital” or “physician” payment types, then automatically posted them to the organization’s accounts-receivable system. Another executive noted that the company’s billion-dollar payment posting is now 90% electronic. Driving efficiencies
“Since we are regionally run,
Identifying strategies to improve electronic processing was paramount for many participants.
our electronic processing
A treasury professional for an academic medical center implemented HealthLogic in tandem
varies from extremely large
with its EMR platform. The automation effort raised the medical center’s electronic-to-paper
electronic conversions to
ratio to 90%, and he hopes to achieve further gains by rolling out a single-billing statement.
regions still paper-based
At an academic medical center focused on education and research, one revenue cycle executive expects professional and hospital billing offices — from a back-end billing and systems perspective — to consolidate. That’s why he’s creating a lean cash-posting operation that can adapt to future change. The center first launched a revenue-cycle platform with three major insurers and adopted HealthLogic’s Expanded Data Capture (EDC) service to convert paper EOBs into HIPAA-compliant 835 formats. The medical center now submits more than a million primary and secondary claims to various payers, receiving from 90% to 99% of the payments electronically.
due to volume and other constraints.”
HEALTHCARE REVENUE CYCLE ROUNDTABLE: INSIGHTS ON AUTOMATION | 3
Reaping automation benefits
“As a result of automation, we
Can automation lower patient costs? That’s the objective at a community-based
have not had to increase staff
nonprofit that operates more than 20 hospitals. That organization’s revenue-cycle
even though our business has
executive recently helped launch an enterprise-wide effort to automate revenue-cycle
grown, and we consider that
activities, as well as supply chain, human resource and administrative services. The
a win.”
first phase calls for transitioning each hospital to a new EMR platform, which will be connected to HealthLogic and processed at a centralized service center.
Converting from paper to electronic 100% 90% 80%
85%
70%
90%
95%
99%
75%
60% 50%
60% Attendees' estimates
Automating revenue cycle management activities was a key objective for a rehabilitative
“We implemented HealthLogic
product and service organization with over 500 locations. According to a treasury
on our physicians’ side, where
professional at that organization, implementing a centralized practice management
about 20% of the volume
platform through Bank of America Merrill Lynch Revenue Cycle solutions helped
was paper. We’re now at
process EFTs, checks and credit card payments representing patient co-pays. Incoming
approximately 90% electronic,
checks — received locally or through its lockbox — are deposited, and the associated remittance data is then captured to create an automated posting file by HealthLogic. Reinforcing organizational values Many attendees described how automation helped reduce overhead expenses by transitioning full-time employees from manually-intensive processes to higher-value activities. A patient financial services executive with a nonprofit hospital system described how this shift helped to reinforce the system’s cultural emphasis on work-life balance. HealthLogic helped increase the organization’s posting rate from 40% to 95%, which accelerated physician payments, eliminated costly overtime and helped redeploy about a dozen full-time employees to other roles within the organization. Remaining employees could enjoy telecommuting privileges since eliminating paper also precluded the need to be on site.
and aiming higher.”
HEALTHCARE REVENUE CYCLE ROUNDTABLE: INSIGHTS ON AUTOMATION | 4
Focusing on new opportunities
“HealthLogic adjusted all the
Having reached milestones for bringing new efficiencies to their revenue cycle operations, many healthcare executives are looking ahead at tactics that will help their organizations
nuances that the insurance companies would impose on the transmission of 835s
achieve their long-term financial goals.
and allowed us to receive consistent files from payers.”
Future revenue enhancements Electronic correspondence
Streamlined 835 remittance
Single business office
Paper correspondence
“We’re on a pursuit to be
Some financial executives targeted correspondence as a critical priority. Besides having
more electronic and it
to sustain a manually intensive process, they noted that scanning and sorting letters and
means bringing 24 hospitals
other forms of paper represented zero-revenue activities. With volume increases looming,
into a centralized service
automating the handling of these documents would represent a boost to back office efficiency.
center at the end of this
Attendees are now seeking to integrate new indexing functionality from HealthLogic that will
massive consolidation.”
streamline the handling and processing of non-financial correspondence. California and the single business office California hospital systems face unique revenue-cycle challenges. Based on how the state governs physician employment, excepting teaching hospitals, most healthcare providers must segregate physician billing from other payment activities. Roundtable attendees from other states also noted challenges in managing hospital-physician convergence. They identified a potential solution: implementing a single-business office into their software platforms, aligned with HealthLogic, to electronically integrate hospital and physician payments.
HEALTHCARE REVENUE CYCLE ROUNDTABLE: INSIGHTS ON AUTOMATION | 5
Revenue enhancement
“In terms of volumes, we’re at
All roundtable participants expressed interest in working with Bank of America Merrill Lynch
about 60% EFTs, 30% checks
Revenue Cycle Solutions to find new strategies for enhancing revenue, from statement
and credit cards make up the
updates to improved patient-payment processing. Ideas included:
last 10% for the co-pays that
Non-template-based approach — Attendees noted that certain aspects of technology needed to keep up with the rapidly evolving healthcare landscape. They identified HealthLogic’s non-template-based approach to processing payer remittances as a key advantage.
we take across the counter.”
835 file enhancement — One healthcare executive noted that although they are more data-rich than ever, 835 remittance files don’t identify payments from specific EMR software platforms, which delays reconciliation. Providing additional detail could help to raise efficiency and expand the bottom line. Retail healthcare — Hospital executives exchanged ideas on improving patient-payment collections by adapting best practices from retail businesses. Discussion centered on creating a tool that tracks and consolidates patient activities, from the time the patient is scheduled and pre-registered to the moment the out-of-pocket bill arrives. Taking that notion further, one attendee described a prospective program that provides “virtual visits” between patients and doctors and using mobile payment technology to generate a revenue enhancement opportunity without writing off patient responsibility.
Future insights The Healthcare Revenue Cycle Roundtable brings together hospital finance executives from organizations of varying sizes and regions to play a hands-on role in shaping the
“When you are in the revenuecycle business, you’re still in the people business. You gain
financial tools they count on from Bank of America Merrill Lynch. This collaboration
technology and efficiency,
leads to new features, streamlined processes and a client-centric experience that
but still have teammates to
produces competitive advantages for hospitals and hospital systems.
manage and lead.”
Visit bofaml.com/healthcare for more information.
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