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MediRevv Provides Patient Pay Functions for California-based Healthcare System

Our client, a three-facility, 714-bed public healthcare system based in Southern California, experienced a similar situation as formerly uninsured patients entered the local healthcare marketplace. This change not only contributed to growing patient volume, but also greater patient financial liability from high-deductible health plans. It prompted our client to reorganize its patient pay management and to leverage the industry-leading technologies and practices of a revenue cycle management partner.

What our clients are saying
Compared with other vendors doing the same type of work, we seem to have a better and closer relationship with MediRevv. I think part of the reason is because we gave them all of our self pay from day one, and there was an expectation they were going to represent us in a positive way. And they did. Their communication and professionalism is great.

Director

Patient Financial Services
results

SURVEY ANALYSIS RESULTS

Following the passage of the Affordable Care Act, about 16.4 million previously uninsured individuals have obtained healthcare coverage, according to survey analysis by the Office of the Assistant Secretary for Planning and Evaluation. Coverage expansions have contributed to a 35% reduction in the uninsured rate, effectively expanding patient access to care. These industry trends can also contribute to rising patient volumes at healthcare organizations, and as requests for services grow, organizations may need to modify revenue cycle processes to meet these demands and optimize their financial well-being.
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The Challenge

The Director of Patient Financial Services at the hospital recognized that the revenue cycle team did not have the technology or resources to keep pace with its patient pay workflows, which were growing due to increases in patient volumes. Our client recognized that partnering with a revenue cycle management extension service would provide an opportunity to boost patient pay collection efforts and enhance customer service offerings.

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The Solution

To optimize financial performance, the leadership at the health system began researching companies that would help improve its patient pay collection strategies while providing patients and staff with a high level of service and professionalism. We were selected based on our ability to leverage technology enhancements—such as propensity-to-pay software, call recording capabilities, patient pay segmentation, and our educated team of employees.

At the start of the project, we came onsite to familiarize our team with the hospital’s policies, procedures, and the way it historically managed its patient pay program. Since our team owned patient pay collections from day one of implementation, we discussed statement design, call center scripting, and, above all, the hospital’s organizational culture to ensure we represented the business office in accordance with its mission and values. By working closely with revenue cycle leadership onsite, we were able to replicate current processes and implement best practices to optimize collections.

We used our technology to view and work within the client's information systems. Then we took full ownership of patient pay activities, including sending patient statements, fielding patient inquiries, and following up on outstanding balances. In addition, our partnership with the health system’s long-term payment plan vendor allowed us to share responsibility for initiating and managing payment plans.

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Once we began providing these services, our client was able to redeploy its patient pay staff to other positions and leverage their experience to address other departments’ priorities. In addition, our client retained its lead patient pay program customer service representative to function as a liaison with our team.

We hold weekly status meetings to discuss project operations and service improvements. At the end of each month we also provide performance and engagement trends, such as call volumes, wait times, and abandonment rates—insights to which our client did not have access to with its prior technological limitations.

 

 

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The Results

For each of the 18 months since the new patient pay model began, we provided operational summaries based on key performance indicators to report financial performance within account workflows. Among other metrics, this data has illustrated that more than $19.4 million in patient pay collections have been secured since the project’s beginning. Moreover, our client’s net operating margin is projected to increase to 17.5% over the project’s lifespan. Our partnership has allowed the organization to keep pace with patient volumes while increasing its net operating margin.

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In addition, our data transparency has illuminated opportunities to further optimize the patient pay program, such as identifying and implementing processes to address an increase in patient inquiries. While we put our phone number on billing statements and processed most inquiries, some questions were better suited for the client to answer. This observation prompted t to develop a system for more efficiently resolving patient concerns. Successfully restructuring patient inquiry workflows was made possible by leveraging MediRevv’s collaboration software tool to communicate with one another daily.

MediRevv logged inquiries that required attention from the client. Then inquiries were divided into different work queues based on specific requests, such as itemized statements and disputes. This change enabled the client to streamline inquiry management by assigning staff to specific work queues, in turn helping the organization adapt to the shifting healthcare landscape of increased patient financial liability.

One positive element that resulted from better understanding inquiry and call volume was that we developed a logging mechanism for patient complaints. We do a better job of addressing patient concerns that I think could have been missed in our former processes.
— Director of Patient Financial Services

When we identify growth opportunities, we share them during weekly meetings and implement workflow adjustments to facilitate financial performance and customer service improvements.

It’s been a very open and good relationship. When we have hiccups, we communicate it immediately and both parties work to address it. MediRevv’s leadership team and those individuals who work directly on our weekly calls are extremely professional and easy to communicate with. Throughout the process there’s been no negative communication or editorial comments.
— Director of Patient Financial Services