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Discover the transformative journey of Freestone Medical Center, a rural healthcare provider in Fairfield, Texas, through our latest testimonial. It’s a compelling story about hometown resilience that highlights how MEDTEAM services are helping hospitals nationwide to surmount financial challenges and elevate patient care.
It is November 2017. Like any other autumn day in Haleyville, Alabama, the residents of this small town are making holiday plans, debating the upcoming Auburn game, or anticipating fall break with their children. However, a starkly different atmosphere pervades the conference room of Lakeland Community Hospital.
The hospital’s leadership has just announced that they will be closing their doors by December 31st of that year. Some cry, others sit in stunned disbelief—a clamor slowly arises. What is being done to avert a shutdown? What are they going to do for work? What about the community—where will they go?
Megan Welborn, Director of Imaging Services, recalls how her child had required emergency treatment at the hospital recently and wonders what might have happened if that was not possible.
Feeling tears well up, she recalls asking herself, “Do I want to live in a town that doesn’t have a hospital?”
The situation was dire. As one of the town’s largest employers, the economic impact of Lakeland’s closure extended well beyond access to care. With their place of work and care shuttered, an exodus of the town’s residents was almost assured.
Ken Sunseri, the town’s mayor, knew that he needed money to keep the hospital open. With just six weeks on the clock, he decided that his office would purchase Lakeland. But that only gave the hospital another month of operations before public coffers would run dry. To make matters worse, the hospital had taken on substantial debt during its decline.
In an emergency city council meeting, a solution was conceived: by increasing sales tax and working with experienced partners, Haleyville could save its hospital.
Along with other business partners, MEDTEAM revenue cycle experts stepped in to take over Lakeland’s central business office functions, creating a process for fiscal recovery that included a payment plan for outstanding bills. Thanks to a collaborative effort, Lakeland averted closure just a few days before Christmas and remains open to serve the people of Haleyville to this day.
Read the full case study here.
Sadly, Lakeland’s story is not unique. Since 2010, 134 rural hospitals have closed, leaving millions without access to necessary medical care.
While these financial setbacks can seem insurmountable, rural hospitals do not have to accept closing the doors on their communities. At MEDTEAM, we have been serving rural and community healthcare providers for over 40 years. We have worked with hundreds of hospitals to improve financials, expand healthcare services, and keep America’s heartland healthy.
Contact us today at 1.800.383.6278 or email inquiries@medhost.com to learn more about our suite of revenue cycle services.
In this blog, we explore why you should focus on patient financial care and provide some steps that providers can take right now to elevate the patient experience and improve ROIs.
According to a survey by the Kaiser Family Foundation, 67% of adults in the United States worry about unexpected medical bills, and 45% are concerned about affording healthcare services, even with insurance coverage.
Not a bombshell piece of information. We've all had sticker shock after seeing the doctor. But as financial pressures mount and those costs continue to climb, being proactive about patient frustrations and billing concerns can help increase the likelihood that your facility is paid accurately and on time.
The world of medical billing is astoundingly chaotic. Whether it's complex billing systems, outdated technology, payor issues, communication breakdowns, or a lack of public insight into the industry—most patients are left dumbfounded about their cost of care.
A study published in JAMA Internal Medicine found that more than half of insured adults in the United States received an unexpected medical bill, and 69% reported difficulties understanding the explanation of benefits.
It's natural to want to stick with what we know and keep things in-house. But outdated billing processes, such as paper and manual transactions, are becoming costly and time-consuming in a world of digital-first expectations.
According to the 2021 Trends in Healthcare Payments Annual Report, 75% of providers still use paper and manual processes for collections, despite the fact that most patients prefer online bill payments.
Many regulatory mandates are geared toward promoting interoperability, improving transparency, and empowering patients to access their financial health information. By engaging a partner with regulatory expertise or developing a consistent process for staying up-to-date, providers can meet patient expectations and avoid fees related to compliance issues.
Maintaining compliance can help:
MEDHOST Cures 2023 Interoperability Solution facilitates smooth and secure access, exchange, and use of electronic health information while helping you maximize reimbursements and avoid penalties for non-compliance. It also alleviates the effort of addressing EHI requests and meeting information blocking requirements.
Transitioning to electronic billing and payment systems can streamline revenue cycle management and reduce costs associated with paper and manual processes. It can also improve the patient experience by offering online bill payment options, which most patients prefer.
Simplifying medical billing can improve patient understanding and trust and enhance the financial experience. When working with a partner to improve your payment options, look for solutions that:
MEDHOST online bill payment allows patients to manage their healthcare financial obligations in one integrated, responsive portal. Our Quick Pay feature allows users to make pay bills without entering a username and password, while self-service payment plans will enable them to select recurring payments or set up a customized plan within the boundaries set by their provider.
For over 35 years, MEDHOST has provided products and services to healthcare facilities of all types and sizes. Today, healthcare facilities nationwide partner with MEDHOST to enhance patient care and operational excellence with our clinical and financial solutions, including an integrated EHR solution. MEDHOST also offers a comprehensive emergency department information system with business and reporting tools. Through unparalleled support and cloud platform solutions, we make it easy for healthcare facilities to focus on what's important: their patients and business.
To learn more, contact us at inquiries@medhost.com or dial 1.800.383.6278.
In more ways than one, Nashville is a healthcare city masquerading as a mecca for country music fans. Rural themes, woven together with a penchant sound, define the songs that put Broadway on the map; but beyond the honky-tonks, some of the biggest names in medicine work day in and day out at the epicenter of a growing national health crisis: rural hospital closures.
According to a recent Becker's Healthcare Review that identified 220 rural hospitals at risk of closure, Tennessee—home to MEDHOST HQ—is at the top of the list. Despite serving as the country's nerve center for health system innovation, our state is projected to have as many as 44% of its rural hospitals shut their doors.
Representing approximately 10% of the US healthcare infrastructure, these facilities provide needed care for rural communities and serve as a bulwark for hometown economies. The ripple effect of rural hospital closures can impact every aspect of the populations they support, many of which already contend with poorer health outcomes and lower incomes than urban areas.
According to the American Hospital Association, a lack of skilled workers, staff, and nurses is among the primary factors behind rural hospital closures. Without the ability to fill critical roles, these facilities often lack the expertise or resources to provide necessary healthcare services, negotiate contracts, process claims, and optimize operations, resulting in a constant struggle to maintain patient satisfaction and an adequate flow of revenue.
While outsourcing operations may seem like an obvious answer to staffing shortages, it presents a unique host of problems for the close-knit community at rural hospitals. Many staff and clinicians at these facilities have lived in the area their entire lives. Some were born down the hall from where they now work. The value they bring, and preserving their place within that care continuum, can become complicated when a third party becomes involved.
What's worse, most traditional outsourced revenue cycle management has proven to be a disappointment for hospital leaders. From higher claim denial rates to longer patient collection cycles, many third-party vendors promising improved financial performance have left their customers underwhelmed and in the lurch.
Fortunately, not all revenue cycle governance is created equal. As unique and innovative approaches to revenue cycle management emerge to contend with this ongoing crisis, rural providers have access to new avenues of financially beneficial collaboration.
Rural providers don't need to choose between outsourcing and in-house staffing. Business partners should share in the risk and resources to ensure positive outcomes. A hybrid model, which combines outsourced expertise, and preserves in-house assets, is the key to solving rural staffing shortfalls while preserving the essential character of these providers.
Integrating people, processes, and tools in one or more areas of revenue cycle, IT, and cybersecurity, rather than replacing staff, helps protect and improve the investments of rural health providers. Through measured and managed alignment, communication, and transparency, the collaborative teams of hospitals and providers can reduce operating costs and improve short- and long-term financial outcomes.
MEDTEAM Services are part of MEDHOST and provide a wide range of services designed to improve cash flow and alleviate the burden of maintaining subject matter experts (SMEs), systems, and technology.
We specialize in claims management, focusing on claims submission, account receivables (A/R) management, and insurance reimbursement. We also offer contract management services, which include payor reimbursement variance analysis and recovery, the processing of patient statements and letters, online bill payment services, and custom reporting.
To find out how MEDTEAM is helping rural hospitals and healthcare facilities overcome workforce shortages while preserving their community of care, email us at inquiries@medhost.com or call 1.800.383.6278.
The University of North Carolina's Cecil G. Sheps Center for Health Services Research recently concluded that approximately 184 rural hospitals have closed since January 2005. Visitors to UNC's website can view these closures on an interactive map.
With the rate at which community hospitals are shutting their doors, protecting the bottom line has become critical to providing for community health needs and protecting hometown economies.
As a dedicated business services partner to rural hospitals across the United States, MEDHOST provides several ways to enhance hospital leadership's productivity and decision-making capabilities. Specifically, we can help encourage quick returns by focusing our efforts in three critical areas:
Despite breakthroughs in medical technology and a decreasing number of uninsured patients, hospitals continue to struggle with getting paid the right amount for the right services at the right time. Denials are a widespread and chronic issue, with one out of every five claims being delayed or refused. The issue is so pervasive, many smaller providers have given up on denial follow-up altogether.
Fortunately, there are leading practices that healthcare administrators can deploy when attacking denials, regardless of an organization's size. First, hospitals need the right tools to analyze revenue cycle data and uncover the root causes of denials. Next, input from subject matter experts is necessary to help create an action plan that addresses those issues.
Leveraging EHR software with analytics capabilities, as well as the support of business services experts, can help prevent denials by automating claims review to ensure data is accurate and complete before submission, flagging outstanding claims for follow-up, and providing opportunities to correct inaccurate or missing data through an expertly governed process.
Another way to reduce the likelihood of denied claims and help ensure maximum reimbursement from payers is to regularly review contracts and track whether reimbursements match expectations.
For smaller hospital A/R teams, however, contract management is often a serious challenge, especially if they're relying on disparate or manual tools. The other issues are experience and expertise. When contracts are updated without the scrutiny of a seasoned negotiator, hospitals risk forfeiting complete reimbursements due to changing codes or vague contract language that payers use to their advantage.
The longer a hospital waits to address these underpayments, the less likely it is to recover missing revenue. A robust contract management tool that works seamlessly within the hospital's EHR can streamline this process, provide oversight of contract maintenance, support underpayment tracking, and help improve cash flow.
The longer it takes for a hospital to go from care completion to reimbursement collection, the more risk there is for cash flow leaks. To prevent money from slipping through the cracks, hospitals should take a hard look at how long claims spend in accounts receivable and identify and remedy delays as much as possible.
An effective revenue cycle solutions tool can reveal the sources of delay: provider lags in delivering documentation, A/R time to file claims, lengthy waits for payer reimbursement, missing data that results in communication loops, and whatever else may be causing bottlenecks.
MEDHOST revenue cycle solutions can improve your hospital's bottom line by streamlining and automating processes, relieving strain on staff, and extending your capabilities through an ongoing partnership.
If you would like to improve your revenue cycle today, get in touch with us at inquiries@medhost.com or call 1.800.383.6278 to learn more.
Healthcare analytics is a growing field, spurred on by the need to stay ahead in tightening markets, keep pace with regulatory compliance, and harness technological innovations that demand greater and greater precision in health management.
By combining the expertise of business service professionals with robust analytical tools, like cloud-based software and smart contract management insights, hospitals can drive exceptional revenue cycle performance and improved patient outcomes.
At many rural facilities, workforce shortages and increased patient volumes often mean that process evaluation, account follow-up, and ongoing reporting are either scarce or nonexistent.
Without access to comprehensive business service analytics, it’s nearly impossible to point to current return on investment (ROI) conditions and create actionable strategies. MEDHOST YourCare Analytics™ functions as part of our expanded business services offerings, letting providers know where improvements have happened and where they still need to be made.
Hospitals spend billions on contract management every year, often using outdated processes. But without data-driven payor and contract analysis, negotiations may be leaving money on the table.
For instance, without the proper insights to guide renewals, a contract that has been performing well might become a source of denials, down-coding, or underpayments.
Critical business data that MEDHOST uses to optimize contract management includes:
Powered by the Amazon Web Services (AWS) cloud platform and its QuickSight business intelligence tools, MEDHOST YourCare Analytics gives customers valuable insights into the most critical data for their business growth and continued success.
As a part of the Amazon Partner Network (APN), MEDHOST’s innovation and development teams work closely with AWS experts to create and deploy new capabilities and enhance existing solutions.
Multi-tenant, cloud-based analytics solutions also open the door for future advancements in business analytics, including the implementation of machine learning to improve patient throughput, contract management augmented by artificial intelligence (AI), and more consumer-centric mobile applications.
To learn more about how MEDHOST can help establish actionable metrics and analytics, please reach out to us at inquiries@medhost.com or call 1.800.383.6278
For many of the hospitals we partner with, the end of the month means crunch time.
Cash posting services, a time-consuming but essential aspect of the accounts receivable process at any healthcare facility, can create ongoing backlogs in smaller or understaffed business offices.
The process begins after treatment when hospital staff receive a document from the insurance provider, known as an explanation of benefits (EOB), which describes the services provided to the patient and expenses covered by the payer. Insurance payments, contractual adjustments, and patient responsibility are then applied to the appropriate patient accounts.
It can be difficult for smaller or understaffed hospitals to complete daily payment posting. The resulting backlog can hit business offices hard. First, there’s the overtime created by that final push to get everything entered at the end of the month or fiscal year. Then there’s the effect on morale. With staff often stressed and overworked, taking time off to prevent burnout can be very difficult.
MEDHOST Revenue Cycle Services can provide a daily, custom-tailored cash reconciliation report to show where revenue goes and account for every cent. This process creates a steady stream of revenue rather than a huge influx at the end of the month, and paints a more accurate picture of your facility’s overall financial health.
Here are three ways daily cash posting can benefit your staff and your bottom line:
We pride ourselves on our same-day cash posting and reconciliation, Monday through Friday.
With reconciliation reporting happening daily, facilities are less likely to see a backlog accumulate, eliminating unnecessary overtime and improving morale. That means no more scheduling vacations around the end of the month or fiscal year-end activities.
Hospitals that employ MEDHOST Revenue Cycle Services will likely see more consistent revenue postings, giving them a better idea of how and when money is coming in.
Moreover, we provide daily transmission of PDF insurance remittance advice and insurance correspondence using a Secure File Transfer Protocol (SFTP), which allows business office staff to retrieve this information when needed and store it within their own personal network. We also take this one step further and automatically archive electronic remittances (ERA) to the patient accounts during our cash posting process.
Having a better understanding of their revenue situation means healthcare leadership can make informed financial decisions and better allocate resources to prioritize patient care.
Keeping track of ever-changing payer filing limits and rules can make submitting and appealing claims chaotic, to say the least.
MEDHOST Revenue Cycle Services simplify the filing process by providing the oversight of dedicated cash posting experts, who can help ensure filing deadlines are met, appeals are made on time, and payments are posted daily.
Our strategy when assigning roles within the business office also includes staff who work with specific insurance payers. This focused approach helps us stay on top of common payer trends and delayed payment strategies that can hinder reimbursement and disrupt the revenue flow to your organization.
To learn more about how MEDHOST daily cash posting services can reduce overtime, increase transparency, and simplify timely filing, contact us at 1.800.383.6278 or email inquiries@medhost.com.
In rural communities across the country, the business practices and processes that hospital staff once relied on are being strained by a host of emergent challenges, from workforce shortages to crumbling infrastructure, leading some to reimagine the role that automation can play in optimizing the revenue cycle.
Effective revenue cycle management is only achievable when healthcare providers can not only view their claims data but also automate the tedious 837 claim process. The new MEDHOST Automated 837 Claim Generation and Delivery solution helps you successfully meet the requirements for the generation of HIPAA compliant electronic 837 transactions and code sets and saves you time in the daily processing through automated transfers of the 837 claim files to pre-defined intermediaries. The value add is the reduction in submission errors and hence the reduction in delayed payments due to trivial human errors.
The 837 transaction sets are electronic documents critical to healthcare and must be met under HIPAA 5010 requirements. A critical part of the hospital payment process, the 837-transaction set is the electronic submission of healthcare claim information. Healthcare service providers are required to comply with HIPAA EDI standards when medical claims to payers are submitted in electronic format. However, these processes, when manual, can create multiple problems such as missing or delayed claims while putting a significant strain on your hospital staff.
The solution automates the generation of the claim files during the facility day-end in MEDHOST Enterprise. It sends the files to the respective clearinghouse or facility-specific SFTP location utilizing MEDHOST cloud-based transmission service. With the multi-tenant activity dashboard, multi-hospital organizations can verify the claim files and view reconciliation reports providing an additional benefit of validating claims across multiple facilities at the corporate level. From an administration perspective, the daily status emails can be set to send to your inbox to maintain complete visibility and access to reports.
Automated 837 Claim Generation and Delivery solution optimizes human resources and reduces manual claim submission work and works to quickly move claims out of your facility to clearinghouses accelerating your revenue cycle and working to eliminate missing claims. The built-in retry file transfer feature can save your staff time because it makes the process failsafe and completely automated.
To learn more about the Automated 837 Claim Generation and Delivery, please reach out to your Customer Success Executive or email inquiries@medhost.com.
