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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.
It's high time healthcare caught up with the digital revolution.
While most industries have embraced paperless billing, healthcare seems to be nostalgically clinging to snail mail. According to the 2021 Trends in Healthcare Payments Annual Report, a whopping 75% of providers are still stuck in the dark ages of paper and manual processes, even though patients clearly prefer the convenience of online bill payment.
Holding onto outdated billing methods is more than just old-fashioned; it's costing healthcare facilities a fortune. Manual transactions like printing bills and buying stamps are draining nearly $20 billion annually from healthcare budgets. That's 48% of what they spend!
Additionally, paper bills are slow to collect, often taking more than 30 days, and require more manpower for follow-ups and dispute resolutions. This not only hampers revenue collection but also racks up labor costs.
In this post, we'll explore how an online bill pay feature can revamp your revenue cycle, bring transparency to your operations, and enhance the customer experience.
Understanding and catering to the financial needs and preferences of healthcare consumers is vital. MEDTEAM Services achieves this by offering financial communications tailored to individual patients. Our behavioral analytics and targeted messaging ensure patients have payment options that suit their preferences—like the ability to bill online or set up a payment plan.
With paperless billing, you get real-time insights into patient experiences. MEDTEAM's online bill pay platform offers clear reports to track adoption rates, communication strategies, and payment details. Plus, eStatements provide patients with an easy snapshot of their accounts, accessible from anywhere.
To support the adoption of eStatements, it's crucial to keep patients informed. MEDTEAM's text notifications alert patients when their eStatements are ready each month.
An online billing history feature allows patients to easily access their financial records anytime, anywhere. MEDTEAM's platform provides archived statements and payment histories without the need for creating an account or remembering login details.
Online payments directly integrate with your patient accounting system for clearer financial insights. This convenience speeds up revenue flow back into the hospital.
MEDTEAM's online bill payment system offers a seamless, integrated portal for managing healthcare finances. Features like Quick Pay (allowing users to pay bills without entering a username and password) and self-service plans add to the convenience, letting patients handle their bills in a way that works for their budget.
To discover more about MEDTEAM's Digital Patient Experience solutions, email inquiries@medhost.com.
Electronic health record systems (EHR) are often the primary reason for physician burnout. That’s because using an inadequate EHR system can be like participating in a marathon with shoes that don't quite fit.
Physicians are tired of fitting the foot to the shoe when it comes to healthcare software solutions in general; they want an EHR designed in collaboration with real, live practitioners. People who understand the touchpoints and the frustrations. They want easy access to information, seamless communication between care providers, and drill-down analytics with data they can use to make informed care decisions, created by those who understand healthcare numbers aren’t always black and white.
In this blog, we’ll go through the criteria you should use when evaluating potential vendors or contemplating ways to optimize your existing EHR.
Since physicians and nurses devote a significant portion of their day documenting patient interactions and inputting data, enhancing documentation efficiency can reduce time spent on administrative tasks and allow more meaningful patient interaction.
For an EHR to provide streamlined documentation, it should include templates, task automation, and tools for simplifying documentation and order entry processes.
A hosted EHR solution can alleviate the burden on internal IT teams, offer additional cybersecurity safeguards, and minimize downtime for EHR users, including physicians, nurses, and hospital staff.
EHRs designed to enhance patient care and safety while delivering an exceptional experience should align with clinicians' natural processes. Effective clinical workflows promote operational and financial efficiencies, as well as compliance with healthcare regulations.
A hospital's primary goal is to deliver excellent care, but this can only be achieved if the organization's financial and revenue cycle performance is strong.
A comprehensive revenue cycle system enhances cash flow, financial performance, claims processing, and communication with patients, employers, and payers. Improving processes and gaining visibility into accounts receivable can significantly enhance financial performance.
Coordinating care for patients can be challenging, but a user-friendly scheduling platform streamlines the process for both patients and healthcare professionals. Providers can efficiently schedule follow-up appointments and hospital procedures, while also sharing clinical information across platforms.
EHR patient portals should provide secure online access to personal health records and tools for patients and caregivers to interact with each other.
Advanced EHR technology should prioritize patient safety via embedded clinical decision support throughout the continuum of care. Preventing diagnostic errors, such as missed or delayed diagnoses, is crucial.
The right EHRs can help organizations address systemic causes of diagnostic errors, including communication gaps, inefficient workflows, safety culture deficiencies, and limited performance data.
Physician burnout can lead to medical errors, care quality issues, and physician attrition. EHRs with customizable systems, time-saving documentation features, and software optimization can help combat fatigue and reduce administrative burdens for physicians.
Irrespective of your healthcare organization's size or specialization, one thing remains certain: EHRs should actively contribute to improving your overall flexibility and efficiency. If you believe there's room for improvement, it may be time to upgrade your EHR, leaving behind those ill-fitting running shoes.
To discover how your EHR can be a problem-solving asset for your healthcare institution, please contact us at inquiries@medhost.com or call 1.800.383.6278 to connect with one of our specialists.
Nearly 50 percent of rural hospitals in our country are operating in the red, with over 450 at risk of closure. As hospitals face regulatory and market pressures, they are focusing on areas that can have an immediate positive impact on cash flow, such as revenue cycle management (RCM).
In this blog, we explore some of the pain points in RCM related to contract management, and how to resolve them.
Hospital contract management is the process of overseeing and optimizing agreements between a healthcare organization and various stakeholders. It often involves negotiations with insurance payors, labor representatives, vendors, Group Purchasing Organizations (GPOs), and contractors.
The process of contract management includes negotiations, creation, implementation, monitoring, and maintenance of these contracts to ensure financial viability, efficiency, and compliance.
Managing this process can be complex and time-consuming. When organizations are experiencing staffing shortages, or operate with a smaller team, it can be easy to let contracts re-up without review, put maintenance on the back burner, and neglect other important aspects of the contract management process.
Effective contract management is essential for healthcare organizations to establish financially beneficial relationships with their stakeholders. Well-maintained and expertly negotiated agreements help ensure that organizations receive appropriate reimbursement for services, helps maintains good relationships with partner organizations, prevents unnecessary legal risks, and supports overall financial stability. Unfortunately, providers spend approximately $157 billion annually on less-than-optimal contract management.
Maximizing reimbursement should be a well-governed, ongoing pursuit. Established steps, including workflow automation, a centralized document repository with audit tracking, linking to regulatory and policy documents, and proper representation in the development team can help to cut down on these costs while simultaneously ensuring more revenue is flowing back into the facility.
Conventional wisdom states that “a contract will perform as well as you let it.”
A hospital may believe they have negotiated a fine contract, but without an effective means of payor and contract monitoring, it can be a challenge to know if that’s really the case. A contract may be performing particularly well for a period and then start realizing occurrences of specific types of denials, down-coding, or underpayments. At an average cost of $118 per appeal, this can be a significant drain on resources.
Effective analytics and performance monitoring can provide critical insight to prevent denials, including:
A transparent approach should also allow you to see underpayment variance trends, understand insurance payor agreements, and anticipate where issues may arise in the future.
MEDTEAM supports healthcare organizations in negotiating, building, updating, and maintaining contracts that include favorable rates and terms. Moreover, they provide payment variance analysis and recovery services, meticulously identifying reimbursement variations and collaborating with clients to pinpoint underlying causes. This strategic approach ensures that no revenue opportunities are left untapped.
To learn more about how MEDTEAM supports effective contract management, please reach out to us at inquiries@medhost.com or call 1.800.383.6278.
When talking about denials, it’s important to understand that it’s a broad subject.
There are variations in denial rules across different healthcare facilities, and factors like contracts, payor mix, case mix, local coverage determinations, and staffing influence the types of denials affecting each facility. Instead of getting lost in the weeds, we’ll take a broader approach by examining best practices that can apply to most settings.
Our examination focuses on practical and beneficial methodologies most facilities can adopt right now. Specifically, improving appeals processing performance. Since studies indicate that 24 percent of denials can’t be recovered, implementing an effective appeals process for the other 76 percent is critical.
Here's how:
Defining a clear set of business rules is a key first step in creating a process to resolve denials. Here’s some questions to ask to determine if you’re on the right track:
Ironing out gray areas and establishing well-defined rules that categorize appeals appropriately will help your team manage them more effectively.
Every week that an account sits in receivables, unresolved, your bottom line takes a hit. While aging denials may be necessary to settle some remit activity, once this aging process is complete and you decide to pursue an appeal, filing it within one week, at maximum, should be the goal. In addition, knowing when to discontinue a costly appeal can prevent downstream financial strain.
Do a cost analysis. Gather the data you need to understand the costs associated with certain appeals, enabling informed decisions regarding the types that are worth pursuing.
Even small back offices should undergo routine performance monitoring. While implementing oversight often carries negative connotations, knowing where your strengths lie can benefit even a lean team. For instance, an evaluation might identify which appeals coordinator is most effective with certain appeals, helping you determine where workloads can be shifted to increase efficiency.
In addition to regularly assessing staff performance, analyzing denials and appeals data should drive ongoing maintenance of business rules.
Evaluating success rates and associated administrative burdens will illuminate opportunities for rule adjustments or modifications to optimize your business model. Regularly benchmark against competitors to establish a baseline and determine the effectiveness of your model.
Ready to revamp your business services?
MEDHOST can assist you with the enterprise-wide revenue cycle management, including denials. Get in touch with us at inquiries@medhost.com or call 1.800.383.6278 to learn more.
In this post, we’ll take a deep dive into a critical aspect of revenue cycle management: the billing flow, particularly pre-payment billing.
Billing flow refers to the entire process of generating and submitting medical bills. Security concerns, complex stakeholder agreements, and ever-changing regulations make this a byzantine process that often leaves patients and providers frustrated, short-changed, and stuck in the dark.
This process includes everything from patient registration to coding and billing. It starts before a patient enters the facility and ends long after they’ve received treatment. Because of the number of steps involved, one error in this process can compound down the line, leading to outsized revenue problems that are difficult to identify and root out.
An estimated 80 percent of medical bills contain errors. What’s worse, these billing errors not only impact the speed of reimbursement but also incur additional costs involved in appealing denials. High-dollar claims pose an even greater concern as they often require a more resource-intensive corrective process.
To effectively reduce billing errors, every step of the pre-billing process must be treated as crucial, demanding best practices and attention to detail.
Coordination of Benefits (COB) denials, for example, can be easily avoided by accurately gathering, verifying, and recording patient insurance information. Although seemingly straightforward, these processes become more challenging due to regulatory and economic factors as patients experience changes in insurance coverage. Therefore, maintaining vigilance and precision in COB and other pre-billing procedures is paramount.
Another essential yet often overlooked performance metric is the discharged-not-final-billed (DNFB) ratio, which represents the number of accounts waiting to be billed. Insufficient documentation and coding during care can significantly hinder the completion of patient charts, coding, and abstraction. Therefore, accurately recording the patient's status and place of service is crucial to generating accurate bills and making sure your facility receives every dollar owed.
A great deal of importance is put on achieving high clean claim rates (CCR), with RCM consultants often aiming for rates above 90 percent and clearinghouses promoting percentages exceeding 95 percent. However, it's important to note that while a high CCR indicates claims accepted by payors, it doesn't directly correlate to low denial and underpaid claim rates.
A better metric to focus on is the first pass yield, which represents the percentage of claims that are paid in full upon their initial submission.
Reducing claim denials and maximizing timely and complete reimbursements necessitates pre-billing processes incorporating comprehensive performance monitoring and insights at each stage.
By prioritizing operational efficiency, analytics, and performance monitoring, MEDHOST can assist you in enhancing your revenue cycle management. Contact us at inquiries@medhost.com or call 1.800.383.6278 to learn more.
For over 35 years, we’ve had the privilege of witnessing the unparalleled compassion, commitment, and self-sacrifice of the healthcare workers who staff this nation’s rural hospitals.
Along with an impressive collection of reviews for diners, photos with roadside attractions, and souvenirs from small-town claims to fame, we’ve also managed to garner a number of insights from providers and organizations invested in improving the health of their communities. We’ve used those insights to craft affordable, customizable solutions that meet these facilities where they are and tackle their unique needs.
In this blog, we’ll unpack how our latest solution—MEDHOST Rural Emergency Hospitals (REH) Package—is addressing the issue of financial viability and healthcare access for rural populations.
The partnerships we’ve made among rural providers have given us a front-row seat to the decline of rural healthcare access. Clinics and hospitals in these areas have long been struggling with a host of financial stressors, but the pandemic dramatically worsened this situation. While providers shut the doors, people have begun to ask what will become of these communities and their economies.
To tackle the issue, congress recently passed legislation allowing certain hospitals to bring in more revenue, or reopen, as Rural Emergency Hospitals (REH), providing critical care and services to these remote patient populations.
When we saw this coming down the pipeline, we didn’t waste any time crafting a solution that could help our partners take full advantage of its benefits. We’ve already helped hospitals to adopt this designation, and we want others who may be struggling financially to know that a lifeline is available.
The Rural Emergency Hospital (REH) was established under the Consolidated Appropriations Act of 2021 to address the healthcare disparities and accessibility issues faced by rural communities. This new Medicare provider type aims to provide an opportunity for community hospitals that are struggling to bring in enough revenue, especially those competing for financially desirable patients with larger short-term acute care facilities.
Hospitals that convert will receive a 5 percent increase in Medicare payments for outpatient services and an average annual facility fee payment of about $3 million. This additional payment will also increase each year by the same percentage as the hospital market basket increase.
Considering that 66 percent of Medicare payments to small and rural hospitals are coming from outpatient and emergency services, this is a potential game changer for struggling facilities.
Providers who meet all three of the following criteria may be eligible:
Backed by over 35 years of serving rural and community healthcare providers, our REH conversion solution includes practical strategies and tools to strengthen America’s rural healthcare providers and ensure long-term success.
Here’s what you get:
Don't let financial challenges jeopardize the health of your community. Contact us today at 1.800.383.6278 or email inquiries@medhost.com to learn more about our Rural Emergency Hospital Package.
