New Patient Pay Process Improves Financials and Enhances Patient Care

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HealthWare Systems Blog

New Patient Pay Process Improves Financials and Enhances Patient Care

Posted on Wed, Oct 23, 2013

Botsford Hospital implemented HealthWare Systems’ workflow management solution and saw uncompensated care costs decrease by $6.5 million a year and Point of Service (POS) collections increase by $1.6 million a year.

But that’s not the whole story.

Botsford, like many healthcare systems, realized that they were losing a lot of money by not actively addressing payment with patients right up front, whether insured or not. Their self-pay patients comprised about 15% of their accounts receivables, which means that by not actively pursuing payment, they were leaving a significant amount of revenue on the table. Botsford’s passive approach of trying to stop or avoid self-pay needed to change. The hospital needed to start actively engaging the self-pay patient.

To meet this new objective, Botsford developed a cohesive plan for its patient payment processes and technologies. They chose HealthWare Systems’ revenue cycle management software (ActiveWare), which gave them access to the insurance verification, payment estimation, and payment processing tools that are necessary for an effective point-of-service (POS) collection process.

However, just as a patient who follows only half the doctor’s orders will not fully recover, Botsford recognized that investing in technology without changing their processes would not help them improve patient payments.

In conjunction with the ActiveWare implementation, Botsford trained its staff in the new software and also implemented new policies to teach them how to have conversations about payment arrangement and payment sources.

Operating under the principle that every self-paying patient deserves to have a discussion about payment, whether it is about identifying the payment source, arranging payments or applying for financial assistance, Botsford sought to develop a payment arrangement that was agreeable to both parties.

The information available in ActiveWare facilitated Botsford’s new POS collection strategy.  For example, ActiveWare allows Botsford registration staff to launch an eligibility check as soon as they enter the patient’s insurance information. On one screen, registration staff can see:

  • What benefits are available to the patient
  • Whether the patient is eligible for coverage
  • If authorization is required for that particular treatment

This critical information allows staff to begin having a conversation with the patient about payment right away. Once eligibility is determined, ActiveWare shows a payment estimation tool, which indicates, based on the patient’s insurance and past history of what the service costs on average, what the estimated out-of-pocket expense will be for the patient. It also can turn this estimate into an easily understandable and simply formatted request for payment, which makes it easy for registration staff to a conversation like, “How would you like to pay for this today?”

These eligibility verification and the payment estimation conversations have been surprisingly well received. Botsford discovered that patients want to know their eligibility and payment options. Even better, the hospital has expanded its patient pay and discounting programs to give patients more options for payment and offer them a prompt pay discount.

But the real story of the ActiveWare solution isn’t about the system implementation. Rather, it’s about how this technology, which enables the collection of payment information and patient-pay responsibilities, helped Botsford improve their bottom line and enhance patient care and communications.

Read the full case study to find out more.

 

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Revenue Cycle Management Software Helps Hospital Improve Collections

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HealthWare Systems Blog

Revenue Cycle Management Software Helps Hospital Improve Collections

Posted on Wed, Oct 16, 2013

Like many healthcare systems, Botsford Hospital in Farmington, Michigan, is looking to provide better overall care to its patients in a cost-effective manner. As costs keep escalating, this is getting harder to do.

One financial area that is particularly difficult for hospitals to manage is self-pay collections. Botsford realized that by not actively managing its patient pay program, it was leaving a lot of money on the table. Despite the fact that patient pay accounted for about 15% of gross accounts receivable, Botsford was not addressing it as a major pay category.

That changed in 2009. Looking at its disjointed tools and programs, which were missing key elements of self-pay management, such as payment estimation, online payment collection and posting, Botsford decided to change its approach from avoiding self-pay to actively engaging the self-pay patient.

The first thing it did was look at what technology was available to simplify the self-pay process. After checking the pulse on a number of healthcare technology solutions, Botsford determined that HealthWare System’s ActiveWARE software was the right point-of-service (POS) collection solution for them.

Botsford was impressed with ActiveWARE’s ability to offer real-time insurance eligibility verification, patient payment estimations, and POS collection processing tools. In addition, because Botsford could integrate the revenue cycle management solution into its existing workflow management based in McKesson’s core system, the hospital was able to meet its goal of addressing self-pay management head on.

Currently, Botsford uses ActiveWARE for all elements of self-pay management. The tool is critical to Botsford’s point of service POS collection strategy and is used in all access areas and to date has helped the hospital decrease uncompensated care to a low of $22 million in 2011, increase POS collections from $400,000 in 2009 to $1 million in 2011, and support self-pay management process improvements, particularly in the Emergency Department.

Read the case study and find out more about how Botsford Hospital improved its self-pay management with ActiveWARE.

 

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