Online Billing Can Speed Up Payments & Increase Patient Satisfaction

Cut healthcare costs through existing infrastructure
For over a decade now providers have been told about the benefits of online billing and payment in healthcare. Its adoption offers a wonderful opportunity to improve the business of healthcare for both providers and patients at the same time. Despite its benefits, why have some in the healthcare industry resisted online billing and payment?

Challenges in Healthcare Online Billing and Payment
More and more Americans have taken their key financial transactions online. A 2008 Fiserv study found that 67.9 million households—or 80 percent of the estimated 85.1 million U.S. online households—use online banking services, up from 63.4 million in 2007 (Coping During the Crisis, Fiserv, Oct. 2008).

However, some areas of the healthcare industry still show tepid interest in adopting similar practices. Healthcare has occupied a unique position in the American marketplace: Unlike a consumer’s electric bill or banking relationship, much of healthcare is a non-reoccurring financial proposition. In the past it has made sense for consumers to establish accounts, passwords, and user names for a monthly bill. But for many patients, healthcare payments are unpredictable in frequency and span over multiple physicians, labs, and hospitals, eliminating the need to establish an online billing and payment account through their providers.

There are also strict government regulations unique to healthcare, such as HIPAA, that create concerns about patient information. Furthermore, there is a perception in healthcare that online billing and payment systems are expensive to implement and time consuming to manage.

Simple and Secure Online Billing and Payment

The healthcare industry is overcoming these concerns with solutions that simplify billing and payment for both providers and patients. Today’s best solutions can work in conjunction with paper billing and payment processes to streamline collections and increase efficiencies. Moving these processes to an electronic format reduces errors and delays to make workflows simpler for the provider and increase satisfaction for the patient. Online billing and payment solutions are easier to use than ever before and it’s a practice that some patients are coming to expect since they already have the ability to pay most of their other bills online. Also, with security being a top priority in healthcare, most online patient billing and payment applications are compliant with HIPAA and adhere to strict security regulations allowing patient data to be housed.

In addition, the cost of implementing online billing and payment is not as expensive as the healthcare industry perceives. The application service provider technology to enable these capabilities is available with modest IT and capital investments. Initially, healthcare providers must make some necessary workflow changes to facilitate online patient billing and payment; however, these workflow changes may be as simple as creating a method to capture and store necessary patient communication data, such as e-mail addresses. There are long-term workflow changes that are necessary to give consumers visibility into primary insurance payments, contractual discounts, and coordination of benefits on a timely basis.

Value Is More Important Than Ever
The growing influence of consumer-directed health plans require patients to make more decisions regarding where they go for care, which has made the need for efficiency and customer service more important for providers than ever before.

Online billing and payment processes save time and money for the provider while providing patients with billing options that fit their web-centric lifestyles. Giving patients convenient and comfortable billing and payment options may be the best solution for some providers to help them become more patient friendly. Online billing and payment solutions also give providers the ability to connect the registration and billing processes. This allows key information to be shared that can help establish viable payment plans and increase collections later on in the healthcare process.

Are You Ready for Online Billing and Payment?
Even though most online billing and payment solutions are HIPAA compliant, providers must ensure that any solution being considered encompasses both healthcare billing compliance requirements and standards to protect patient information. Because the typical provider has limited IT resources, the ideal online billing and payment solution should minimize these resource requirements for implementation and maintenance.

When providers are evaluating an online billing and payment system, they should note that these solutions can be integrated with their patient statement printing and mailing process. This prevents a second system implementation, minimizes ongoing maintenance costs, and eliminates synchronization issues that would confuse patients. An integrated solution enables visibility of all payment activity across multiple facilities and should eliminate the need for manual keying of payment information through automated payment posting.

Another important factor that providers should consider when selecting an online billing and payment solution is the ability to accept a wide variety of payment types, such as credit cards, check cards, and eCheck/automated clearing house (ACH) payments. The more flexible the payment options are, the more likely a patient will pay.

The movement toward offering online billing and payment solutions is gaining momentum in the healthcare industry. With most of the U.S. population already paying bills online, providers can be confident that patients will utilize their online billing and payment solution. By bringing billing and payment online, providers are offering patients the convenience and account self service they expect.

Emdeon is the leading provider of integrated patient billing and payment solutions that simplify consumer billing and payment processes for hospitals, physicians, and healthcare providers. Through our innovative suite of print and e-commerce solutions, we facilitate provider-patient communications for optimized revenue collection and enhanced patient satisfaction. Contact us today at 877.EMDEON.6 (877.363.3666) or visit us at to find out more.


"See"EO: Chief Executive Officer, George Lazenby, Sees All in Emdeon's Infrastructure

A look inside the organization Take a peek behind the technology that makes innovative system monitoring possible

From his office in Nashville, Tennessee, Emdeon CEO, George Lazenby, always has a clear view. This fact has nothing to do with what he can see outside his window. Instead it refers to what he can see inside his organization. With an innovative in-office infrastructure monitoring system, Lazenby can watch all aspects of Emdeon business and service performance—in real-time, at any time. He has unobstructed visibility of every level of the company’s infrastructure, and he watches intently with the goal to better serve customers.

Even the smallest details are within view with this real-time infrastructure monitoring system. Lazenby can see how long it takes for every customer service call to be answered. He’s able to keep a watchful eye on Emdeon’s two data centers and all activities, from billing and reporting to product functions and service. If it takes more than 30 seconds for a customer service call to be answered or there’s even a slight glitch at any point in the process, he’s able to know it—and address it—immediately. And, if he’s not in front of his in-office infrastructure monitoring system, email alerts are sent directly to him should anything merit immediate attention. The monitoring is so thorough that Lazenby can drill down to any point in the vast corporate infrastructure to identify who on his team is responsible for anything he observes. And because monitoring is only valuable if the company is able to respond to issues as they are revealed, Emdeon’s infrastructure is built to provide inherent tactical responsiveness. The company can not only identify problems, but track patterns and take fast action to implement solutions.

According to Lazenby, this level of monitoring and response is the fruit of a continued concentrated focus on improving service levels across the board. The company’s IT division has successfully consolidated operations so that communications are tight, technological functions run efficiently and reliability is consistent. Of course, with the CEO constantly a click away from “seeing all,” accountability comes from the C-suite out—positively affecting performance company-wide. “Urgency is increased when the good people who work here realize addressing service and performance issues are so important that I have a monitor in my office that tracks everything up to the second,” Lazenby explains. “A proactive process emerges from this level of visibility.”

Additionally, this comprehensive monitoring has enabled Emdeon to identify and improve many things that were previously under the radar. Correlations are identified between various aspects of operations and service and can be addressed effectively. By drilling down to find issues that affect interdependent functions, Emdeon is able to eliminate causes of down time and improve reliability. “What we do is critical to what our customers do,” states Lazenby. “That’s why we invest in things like this.”

Lazenby’s in-office infrastructure monitoring system is a quick, comprehensive reference tool created expressly for the CEO. However, the goal is to one day provide customers access to similar information. That’s how confident and committed Lazenby and the team at Emdeon are regarding the integrity and transparency of service. Though sharing the infrastructure monitoring system with customers is likely a few years out, the high quality, real-time data, stats and reporting are already in place and in use—to the customers’ benefit.

As a matter of fact, Emdeon’s extensive monitoring system is the manifestation of the company’s ongoing efforts to improve its core infrastructure. Highly complex and multi-layered, Emdeon’s technology is constantly being honed to ensure near-flawless performance between divisions and disciplines. Ironically, this complexity ultimately provides transparency and simplicity for customers who enjoy such reliable service that they rarely need to think about what’s going on behind the curtain.

A peek behind the curtain reveals the vast complexities of all that goes into Lazenby’s seemingly simple, clear view. Emdeon is ceaselessly engaged in improving its technologies and service. In an infrastructure that runs deep and wide, every aspect of operations is interdependent on the other and it takes a skilled and committed team to navigate the challenges and opportunities that technology brings. “Of course, customers have no need to worry about all that,” Lazenby summarizes, “with this, they know we’re on the case...providing integrity of service.”

With that kind of viewpoint, it’s quite clear. Emdeon is committed to simplifying the business of healthcare no matter how complicated that process may be.

A look inside the organization
Overall Technology Strategy: Emdeon has long been committed to quality management in IT with the goal of 100% reliable performance and efficiency of operations. Already, the company has achieved near Six Sigma levels of sustained performance/service while containing costs. This strategy is a core differentiator for Emdeon with its customers.

Data Center Consolidation: Emdeon now operates two world-class data centers (rather than several locations), geographically distant from one another and equipped with the highest levels of security and functionality possible with today’s technology. These facilities are fortified to sustain operations even in the most extreme scenarios (i.e. - natural disasters).

Solutions Availability Reporting: With an unwavering goal of 100% uptime, Emdeon tracks and reports uptime for the company’s core infrastructure. This valuable information is used company-wide to influence strategies and tactics focused on reliability.

Business Activity Monitoring through Technology: As previously described, Emdeon has advanced its monitoring capabilities to not only watch and respond to issues by division; the company now monitors company-wide interdependencies, in total view and in real-time. In addition to constant assessment of IT infrastructure, Emdeon has added Call Center monitoring to ensure impeccable frontline service.

Use of Ticketing: To achieve uninterrupted uptime, it is essential to do more than trouble shoot. Emdeon utilizes a ticketing system to denote and resolve issues while creating a reference for historical resolution. This approach helps to identify patterns and root causes and institute long term solutions.

IT Service Management (ITSM): Emdeon has implemented ITSM to proactively lead the company to new heights in technological service. With a goal to earn ISO certification and implementation of a comprehensive information security framework by end of year 2010, Emdeon’s ISTM team is focused on integrating procedures that intrinsically improve IT operations, maximizes internal resources and ultimately provides the best service for customers.


Red Flags Rule Delayed, but Brought to the Forefront in Healthcare

Cut healthcare costs through existing infrastructure
New FTC regulations enforcing identity theft prevention include providers

In an important announcement affecting hospitals and physicians, The Federal Trade Commission (FTC) has extended the deadline for creditors to implement Red Flags Rule to August 1, 2009. Under this directive, which is aimed at preventing consumer identity theft, creditors are required to create a written and actionable program to detect warning signs, or “red flags”, which alert institutions to take extra steps to confirm an applicant's identity. The official directive is defined loosely so that it can be applied to numerous industries.

Providers as creditors
Why is this important news for hospitals and physicians? If healthcare providers allow patients to defer payments or set up an outside line of credit to help them pay for care, that is considered acting as a creditor under the federal regulation and will require providers to create a reasonable set of rules to identify red flags to prevent identity theft. In addition, each institution's board of directors will be obligated to monitor the new system. This board will also be accountable for making sure the system is reviewed and updated regularly to deal with the changing marketplace and tactics of identity thieves.

Seek expert guidance
Creating these new procedures can create unique and complex situations for providers due to privacy concerns, regulations and even legislation (such as HIPAA) specific to the handling of patient records, securing of financial information and refusal of care. Therefore, consulting with the appropriate legal, financial and technical professionals to ensure compliance should be considered. There are also commercially available tools designed to guide providers through this process. These advisors and programs can help create an efficient and effective system that fits the way a facility currently operates. Because every facility is different, and there is a wide range of options for assistance, it is important to closely examine potential partners to make sure you find someone who understands the unique needs of a healthcare business.

No criminal penalties
There are no criminal penalties for non-compliance with the FTC Red Flags Rule. However, failure to comply could potentially lead to civil monetary penalties that would be costly for any healthcare business. The primary reason creditors, businesses and the healthcare industry should participate is simple: it’s what customers and patients expect.

What to look for
The FTC lists the examples below as events that should set off red flags and trigger a more in-depth review under the new guidelines:

• Alerts, notifications, or warnings from a consumer reporting agency
• Suspicious documents, such as an incorrect or invalid driver’s license or social security card
• Suspicious personal information on applications; such as a suspicious address
• Unusual use of, or suspicious activity relating to, a covered account
• Notices from insurance companies, victims of identity theft, law enforcement authorities, or other businesses about possible identity theft in connection with covered accounts
The FTC describes these as starting points, and not the end result every Red Flags system should follow.

What to do with a flag
Once a suspicious event has been brought to your attention, there are a large number of things that can be done to help protect the integrity of a healthcare business and a patient’s privacy. Here are a few suggestions from the FTC:
• Do not open a new account if there are suspicions of the validity of that person’s true identity
• Continue monitoring the covered account for evidence of identity theft
• Contact the customer to confirm correct identity
• Change passwords, security codes, or other methods of account access
• If unauthorized access is expected, close an existing account and reopen the account with a new account number
• Do not try to collect on an account or sell an account to a debt collector if you have reasonable and strong suspicions that identity theft has occurred with a covered account
• Notify law enforcement for further investigation
Prevention is the key
If the new Red Flags system is effective, it should not only help prevent fraudulent patients from receiving potentially dangerous medical treatments, but it will also help providers realize more revenue due to the reduction in unpaid bills left by fraudulent actions. The responsibility for reducing identity theft and fraudulent activity within the healthcare industry lies with each healthcare provider. The more proactive providers are to address the Red Flags Rule the more prepared they will be on August 1, 2009.

Learn more by visiting the Federal Trade Commission’s website and be sure to consult documented FTC literature: Fighting Fraud with the Red Flags Rule: A How-To Guide for Business.


White Paper Exposes Healthcare Administrative Waste

Cut healthcare costs through existing infrastructure
Practical steps for cutting healthcare costs through existing infrastructure & collaboration

The U.S. economy transmits over 18 billion electronic payments each year, yet approximately half of all healthcare financial transactions are still paper-based. Costs of paper, printing, postage and labor for manual processes in healthcare are estimated to add up to nearly $30 billion a year in waste. As healthcare reforms are considered in Washington and in all 50 states, administrative savings represent a bright spot—low-hanging fruit—that could help pay for longer-term reforms.

To help inform this dialogue, Emdeon, in cooperation with the Center for Health Transformation, unveiled an important white paper at the HIMSS 2009 Annual Conference in April. The white paper, Taking the Paper Out of Paperwork: How Electronic Administration Can Save The U.S. Health System Billions, looks at the gaps in the industry that keep it dependent on manual processing—and offers practical steps for breaking this costly and inefficient cycle. "In these trying economic times, combined with the specter of unsustainable spending, Medicare insolvency and runaway growth in Medicaid, we must find those IT solutions that can not only save lives but can also lower costs," said Former House Speaker Newt Gingrich, founder of the Center for Health Transformation.

"It's not about infrastructure," says George Lazenby, chief executive officer of Emdeon. "The infrastructure is there, and the technology exists. All the constituents are looking for ways to optimize their business processes." Among the barriers cited are lack of integration, lack of complete standards, competing priorities between stakeholders and a perceived lack of value to healthcare providers. "We see higher adoption of electronic healthcare transactions when they meet the needs of both providers and payers," said Lazenby. "It's about making the information available at the point where decisions need to be made."

The white paper provides a step-by-step roadmap for both payers and providers and highlights best practices that are delivering tangible results today. This pragmatic approach leverages technology and infrastructure that already exist—and provides a vision for a new kind of industry collaboration. Recommendations outlined in the white paper include:

For Providers:

• Keep abreast of federal funding opportunities for health information technology

• Include process re-engineering for an electronic end-to-end eligibility, claims and payment process in electronic medical record (EMR) implementation strategies

• Work with medical societies and specialty groups to advance national standardization goals

For Payers:

• Develop and pilot reimbursement programs that reward quality healthcare practice and results, including electronic information exchange

• Ensure all future information technology development is done according to industry standards

• Collaborate around multi-payer functionality, understanding that providers want a single resource for interacting with health plans

Download the whitepaper.


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