Improve healthcare billing by ‘talking’ with your EHR

John Uselman, Wind River Financial - Print  | 

When it comes to billing patients, the healthcare industry faces an alarmingly high number of challenges.

The billing process from even a single visit to the hospital can lead to a vicious cycle of unnecessary duplication and rebilling.

After receiving multiple bills and explanations of benefits (EOBs), patients are confused about what they have paid and how much they still owe. Because of the confusion, hospitals are required to spend more time reconciling bills, and there is a large opportunity for error in back office reporting.

These issues stem from a paper-driven process and the system-driven consolidation over recent years. What was once a decentralized process that was unique to each hospital, is now a centralized process owned by one office or department for an entire health system. The methods and manual processes from each individual hospital can get carried over and inefficiencies increased because the central office can’t keep up with all of the information.

The barriers we see in healthcare billing weren’t created overnight, and there is by no means an easy button that can instantly fix the problem. However, integrating the payment process with hospitals’ electronic health record (EHR) systems is a key first step. By ‘talking’ with EHRs, payment processing technology has the power to dramatically reduce rebilling and duplication, saving health systems time and money while creating a better, less confusing experience for patients.

Here’s how.

Oftentimes, if you don’t integrate payment technology with your EHR system, staff has to manually key payment data into a merchant services portal, keep paper files, and then key the payment data again into the EHR. Manual processes like these then require a manager or other staff to check that information every day to make sure line details are correct and the payments balance out. The process noted is not only highly duplicative, but comes with huge room for human error.

One of the challenges that can cause additional billing and support is when a patient makes a payment but the money does not match with the records in the EHR. When that happens, the money is held in a suspense account. Meanwhile, patients are getting rebilled after they already paid. Their frustration builds. Not only does the back office have to spend a lot of time investigating and correcting the problem, but the front office also spends more time fielding patient calls related to billing. Compound this with an inefficient process for capturing payment data and it can cause information captured in the EHR to be incomplete, incorrect, or miss data completely. Without the proper type and amount of data to pass in the payment process, the healthcare system can experience much higher card brand fees on top of the time and effort to process the payment.

Integrating patients’ credit card or debit transactions with your EHR system allows for more automation of this process. Depending on the size of the system, integrating payment processing technology with EHRs can help health systems save tens of thousands of dollars or more on card brand fees. As the billing process improves through integration with your EHR, you will be able to reduce the number of data entry personnel needed or promote them to a role of higher value in the organization.

Just as important, patients receive less double bills and they can be further enabled to make payments more efficiently through kiosks in hospital lobbies, online portals and the option for SMS and mobile pay. Streamline the payment process allows patients to pay their bills more quickly, and ensures they will be more satisfied overall with their healthcare experience.

If you are working through similar challenges today and are looking for ways to reduce costs while improving the patient experience, here are six best practices to consider as you work to get your payment processing technology to “talk” to your EHR:

1. Review and map out your current processes and data flow. As systems grow and more departments are involved, the number of manual processes and data flows multiply. It is important to first understand where you are at to identify areas that can be improved. It often helps to have a person or partner that can help do this across functions to understand needs more clearly.

2. Where possible, consolidate systems. Many hospital systems consist of parts that were once independent and chose EHR and payment partners based on the needs at the time. As hospitals and clinical environments have been brought together, they often have different payment processors. This leads to a fractionated and inefficient system for integrating payments. A key step in this process is selecting a single solution that can meet your current and future needs.

3. Identify data handling decisions in the process that can influence the integration. Often patients do not pay a bill in its entirety with a single payment. This can be challenging when a payment is received and then needs to be matched and allocated. The more you understand the main data handling decisions around the potential allocation, splitting, and reconcilement of the payment, the easier it is to integrate and automate.

4. Leverage payment technology that simplifies the complexities. Working with solutions that can work within your process with a view towards the future is important. Understanding where the data handling decisions are made as well as understanding patient behavior will help determine the best solutions to bring both efficiencies as well as patient experience.

5. Focus efforts where it can provide the greatest savings of time and effort. Identifying the needs for payment plans and the propensity to pay are key areas where a focus can have a cascade of potential benefits. These insights will help hospitals provide patients with the best payment options and channels, while enhancing their likelihood to pay.

6. Keep security in the forefront as you work through the process. Data security continues to become a very visible issue for patients and consumers. Working with providers that understand the issues and can bring solutions to leverage a security first approach will enable ways to shrink the risk of handling payments. Beyond the payments environment, levering tools that can help quickly identify and flag potential tampering on a broader scale can help provide higher confidence while reducing costs. These type of tools can be used in the wider environment for general data security, remote access and unauthorized device monitoring to prevent hacking.

It’s clear we need to improve the healthcare billing process. As technology changes, so should the way we integrate systems to provide patients with exceptional service and care.

John Uselman is a payment processing expert at Wind River Financial. He has helped hundreds of clients reduce financial and reputational risk, streamline processes, and increase margins.

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