10 Most Trusted Revenue Cycle Management Solution Providers May 2021

2021 VOL. 05 ISSUE 03

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Most Trusted

REVENUE

Consuming Wisely

Social Media and Healthcare : what kind of content should we trust?

CYCLE MANAGEMENT

SOLUTION PROVIDERS

Managing the Backstage

The Role of RCM in Healthcare Organizations

Greg West | President

Healthcare Resource Group, Inc Healthcare Revenue Cycle Management Redefined

Revenue Cycle Management Solution Providers Easing the Billing Process

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he medical field has been an ever evolving one.

And when it comes to adopting the latest technologies, be it care or administrative, the medical field has been at the forefront.

One of the most complicated processes has been that of billing and maintaining the billing records of a patient.

Constant developments in technologies have thrown an array of possibilities in easing the gargantuan and monotonous tasks of healthcare establishments. One such technology is the revenue cycle management.

Even as the healthcare establishments were on a tech-driven spree, the Covid-19 pandemic only shoved them further and faster into it than one could imagine. Revenue cycle management was one of the rescuers to an already overworked medical fraternity. Those who had not yet adopted to this this technology or were in the nascent stages of adopting, also swung into action.

Management of funds, collecting payments, billing, and maintaining a foolproof record have never been easy. To make these processes smooth and simple for healthcare establishments, RCM solution providers came across as messiah for them.

Managing patient’s billing records have become easier with RCM, a medical billing software to track a patient’s data from registration process to the final payment. RCM makes it easy for a healthcare organization to store and manage the patient’s data by synchronizing personal information and the insurance provider with treatment and health care information.

The major task of RCM is to communicate with the insurance companies, check the patient’s insurance coverage during admission and if necessary, do a follow-up with the insurance company in case a patient’s insurance amount is rejected or withheld. RCM significantly reduces amount of time between providing care and treatment and receiving payment. It also has the responsibility of ensuring the safety of employees.

In fact, administrative duties like reminding patients of appointments, pending payments and the like that were handled by the staff can be automated through RCM, saving manpower and time. In this regard it is also a perfect tool for digital patient engagement.

But with rising demand for a service or technology, the market also gets overcrowded with suppliers and subsequently a cutthroat competition, making it difficult to choose the competent one. Some RCM solution providers rose above the rest and set a benchmark for others to emulate.

Our latest edition of Insights Care, 10 Most Trusted Revenue Cycle Management Solution Providers, throws light on how these solution providers paved the way for easy billing through technology to healthcare establishments by delivering quality services.

Have an interesting read!

Sumita Sarkar

Editor’s Note

20 MedEvolve Automated RCM Solutions that Empower Physician Practices

32

Vee Technologies

The Most Preferred Name in HealthTech Space

CXO 24 Expert Opinion How to Translate Data Into Revenue Growth

Articles 16

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Consuming Wisely Social Media and Healthcare: what kind of content should we trust?

Managing the Backstage The Role of RCM in Healthcare Organizations

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Revenue Cycle Management Redefined

Editor-in-Chief Senior Editor

Sumita Sarkar Anish Miller

Managing Editor

Abhishaj Sajeev

Assisting Editors

Darshan, Ashish

Visualiser Art & Design Head Co-designer Art & Picture Editor

David King Asha Bange Paul Belin Priyanka Rajage

Business Development Manager Marketing Manager

Amy Jones John Smith Sarah Wilson, John Smith, Alex Vincent

Business Development Executives Sales Executives

Kelli, Bill, Anna

Technical Head Assistant Technical Head Technical Consultants

Jacob Smile Pratiksha Patil David, Robert

Digital Marketing Manager Assistant Digital Marketing Manager SME-SMO Executives

Alina Sege Amol Wadekar Atul, Gemson

Research Analyst Circulation Manager

Eric Smith Tanaji

sales@insightscare.com

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Most Trusted

REVENUE MANAGEMENT

SOLUTION PROVIDERS

Company Name

Featuring

Description

All Right Medical Management Services allrightmedical.com

Scott Decker CEO

All Right Medical Management Services' goal is to be a partner and collaborate with healthcare organizations to provide the best possible experience for patients.

Cantata Health cantatahealth.com

Alan Tillinghast CEO

Cantata Health Solutions provides EHR & RCM software for Health & Human Services, Acute & Post-Acute Care.

ClaraPrice claraprice.com

Jory Hatton Co-founder and CEO

ClaraPrice provides RCM and Chargemaster Management solutions for hospitals and health systems with a focus on price transparency compliance and improving patient access with innovative software platforms.

Healthcare Business Brad Cording Insights VP Commercialization healthcarebusinessinsights & Product Management .com

More than one thousand hospitals and health systems nationwide are using Healthcare Business Insights (HBI) to access research and resources critical to every aspect of their business operations.

HRG hrgpros.com

Greg West President

Healthcare Resource Group’s expertly crafted revenue cycle management services provide customized solutions for associated healthcare facility’s unique needs.

MedEvolve medevolve.com

Matt Rolfes President and CEO

MedEvolve empowers physician practices to work smarter with data-driven solutions that provide unmatched transparency, automation and accountability.

Patient Billing patientbilling.co.uk

Richard Shawyer Managing Director

Patient Billing is an innovative medical billing agency developing technology that puts the patient at the center.

patientco patientco.com

Sean Joyce CTO

Patientco is a payment technology company headquartered in Atlanta, GA founded specifically to rethink the healthcare payment experience.

Chocko Valliappa Founder and CEO

Vee Technologies works as a trusted business partner to enterprises and organizations around the world, delivering production solutions for extraordinary outcomes in quality and cost.

Brian Robertson Founder and CEO

VisiQuate’s user-friendly end-to-end revenue cycle management and analytics solutions let virtually anyone in a healthcare organization explore complex data from multiple sources to quickly gain insights and create actionable workflows.

Vee Technologies veetechnologies.com

VisiQuate visiquate.com

Revenue Cycle Management Redefined

HRG is an employee-owned company, and all employee-owners share in the ownership and financial success.

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Greg West | President

10 Most Trusted Revenue Cycle Management Solution Providers

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or any business to thrive, evolving with time becomes an essential part of its growth strategy. Comprehending the avenues of progress—around the likes of adopting updated technologies, change in customer demands and preferences—plays a catalyst in the process of achieving ascension in revenue and overall growth.

Companies across the spectrum of healthcare services have witnessed firsthand the importance of acknowledging and adopting change during the initial period of the COVID-19 Pandemic. Such companies have thrived in terms of delivering quality services, in catering efficiently to the customers, and in contributing towards the safety of employees and development of the community.

Among such prominent companies, one brand that has carved its stronghold in the revenue cycle management niche is Healthcare Resource Group (HRG), Inc. Headquartered in Spokane, Washington, HRG's expertly crafted revenue cycle management services provide customized solutions for its associated healthcare clients' unique needs.

In the following interview, Greg West, the company's President briefs us about the company's journey of more than two decades and how it continues to prolong its competency in the revenue cycle management market.

Below are the highlights of interview: Please brief our audience about HRG, its values, vision, and mission.

Healthcare Resource Group (HRG) was founded in 1994 as a staffing service, aimed at hospital revenue cycle, by Colleen Hayes. From 1994 until 2003, the primary business was placing interim revenue cycle experts

onsite at hospitals. The company started in Northern California and moved to the Inland Northwest when Ms. Hayes relocated to Sandpoint, Idaho .

In 2003, HRG decided to open their Outpartnering™ Center and focus on the outsourcing of hospital billing and collections. Since that time HRG has become a premier revenue cycle service company with best in industry

processes, state of the art technology, and our people and culture. HRG is an employee-owned company, and all employee-owners share in the ownership and financial success.

The employee-owners and leaders who have made Healthcare Resource Group successful have done so with a spirit of passion for the work they do. We are about working hard and providing unprecedented client delight. This

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Growth will continue in this same spirit ensuring the work we do remains meaningful and makes a difference for our clients. HRG has been named a top place to work both regionally and nationally.

HRG has several important missions that drive us: Ÿ To bring financial stability to our healthcare clients so they can provide the best possible care to the patients' communities they serve. Ÿ To assist rural hospitals so the underserved communities can continue to get healthcare close to home. Ÿ To assist our Tribal Heath facilities with their revenue cycle needs so they can grow and continue to serve their tribal members and communities.

HRG provides the following services to achieve these missions: Ÿ Complete Business Office Ÿ Extended Business Office Ÿ Early Out Self-Pay Ÿ Medical Coding and Coding Auditing Ÿ Denial Management Ÿ Consulting and Interim Ÿ Management of Revenue cycle What aspects make your company standout in the healthcare sector?

Tell us more about how your services add value to associated companies and the healthcare industry.

Helix AI™ is our technology platform that was developed and built with the vision and leadership of Steve McCoy, HRGCEO. HRG has made a substantial investment in building our own proprietary software, Helix AI™ which uses artificial intelligence and data analytics to streamline workflow

and minimize labor.

Healthcare revenue cycle management involves a myriad of steps to submit insurance claims to the government and commercial payers. Obtaining prompt reimbursement from the payers requires checking and rechecking the stages that a claim passes through in order to be paid. Much of that verification process has been automated.

Each evening, Helix AI™ activates a multitude of BOTs that perform tens of thousands of queries that validate insurance eligibility, authorizations, and claim status.

Artificial intelligence then evaluates the result of the query and determines if human interaction is necessary given the situation. If human interaction is required, Helix AI™ determines the

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passion is what makes us successful and helps us build our signature HRG culture.

HRG has been named a top place to work both regionally and nationally.

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Helix AI™ is HRG's technology platform that uses artificial intelligence and data analytics to streamline workflow and minimize labor.

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best person to take action, queues the account in workflow, and recommends the action to be taken.

Our software captures a mountain of information as each claim progresses through the process of being reimbursed. This data is analyzed to determine how workflow can be streamlined and if the timeframe to resolution can be shortened.

In essence, this platform identifies root causes of problems and highlighting potential solutions, thereby allowing HRG to do a better job, quicker and less expensive than our competition.

Behind our technology is our people,

our training, and our TQA model that makes HRG's performance outstanding. No matter how much technology grows, healthcare will always be a people business and continues to need the type of caring, dedicated employee-owners that HRG is comprised of.

The entire team is engaged and invested in the success of our clients and projects. Winning many awards for best places to work and top performing revenue cycle vendor is a by-product of this engagement and growth.

HRG has grown by providing innovative and flexible solutions that are tailored to each client and their

individual needs. Our business development team is not the typical sales team. Instead, they are comprised of seasoned and experienced revenue cycle experts, who help develop the perfect solutions for each client.

In summary, HRG is the perfect blend of technology, people, and flexibility so that every client gets maximum value and achieves their goals.

Being a leader in the healthcare sector, share with us your opinion on how the adaptation of modern technology in the healthcare discipline has transformed the industry and what more could be expected in the near future?

Healthcare is finally catching up with other industries in adapting technology that automates the repetitive and low value tasks.

Taking into consideration, the current pandemic, and its impact on global economies, how are you driving HRG to sustain operations and ensuring safety of your employees at the same time?

Prior to the pandemic, we had 90% of our workforce working from our corporate headquarters in Spokane, WA. In March 2020, we moved this entire team to a remote workforce in three days' time. Our IT and support staff were amazing in this transition and we did it without interrupting our service to our clients and their patients.We now have become very good at working and performing in this environment.

This is allowing us to recruit and hire talent from all over the country which has strengthened our ability to scale and adapt to our clients' needs faster.

We have a small team of employeeowners who still work out of the office and we have assured their safety with a screening and distancing program that keep everyone at a safe distance, wearing masks, and screens out anyone with COVID symptoms or any recent contact.

As we head out of the pandemic we have decided to continue with the

remote workforce when it's a good fit.

Security of data and productivity of our staff will be the key factors when deciding if a future employee will work from our office or remotely.

Our sales and marketing team started doing quick ½ hour webinars on revenue cycle topics and we started a podcast, interviewing revenue cycle experts from all over the country. The webinars were so well attended and received by the community. The sales team also made a large effort to provide PPE to hospitals all over the country. These efforts allowed us to keep assisting hospitals even in our downtime when we were not allowed to fly and visit clients and prospects.

What advice would you give to those aspiring to venture into the RCM space?

I would give the following advice: Ÿ Focus your service on a very specific solution and client type at first and then grow from that skill set. Ÿ Invest heavily in two areas: Technology and Marketing. Ÿ Always remember this is a patient care industry and don't let your team ever forget that. Every interaction we do still impacts the patients and their perception of our clients' services to them. That fact is so important on how we do our business.

How do you plan to scale HRG and/or its operations in 2021?

We are adding to our technical capabilities in all of our services with more AI being built into our Helix AI™ system so that we can help our clients manage their pay or relationships, adapt to the new payment methodologies, and provide their patients the best financial care available.

We have grown our Business Development team into parts of the country where traditionally we have had less of a footprint.That will allow us to reach more potential partners with our solutions and build on the great reputation we have in our more developed territories.

As the Pandemic slows, we plan on attending conferences and visiting clients and prospects at a pace that gets us back to telling our success stories.

About the leader Greg West, President of HRG, started in healthcare in 1988 in the insurance payer business. His first healthcare job was working for a Blue Cross plan in the Northwest as a Manager of Customer Service for the program that provides benefits to retired military and

military family members (CHAMPUS).

“That was a great place to start my career in caring for others in the finance area of healthcare. Assisting military personnel with their healthcare needs was an honor and privilege,”says Greg.

Greg then moved to the provider side of healthcare in 1991 when he became the Business Office Manager for a large multi-specialty physician clinic and rural critical access hospital. This introduction to the provider side and rural healthcare was where his passion for helping rural facilities started. Greg rejoined the payer side as a Director of Provider Contracting and Network Development in 1998 and then spearheaded building a provider network in rural eastern Washington.

In 2000, Greg joined HRG first as Revenue Cycle Consultant and then became the Director of Interim Staff, matching clients' needs with the best people. He worked in that position and in business development until 2005.

“Due to personal reasons, I needed to travel less so I rejoined the provider side of healthcare as a Vice President of Revenue Cycle at a large healthcare system in the Northwest,” Greg added.

During that time, he was using HRG as a vendor to support the team and he kept a close relationship with the HRG leadership. In 2008, HRG asked Greg to return as Vice President of Operations running the Outpartnering™ Center and he agreed.

“Since rejoining HRG I have moved from Vice President to Chief Operating Officer, and in 2011 was named President. I am active with several healthcare associations and am privileged to do a lot of public speaking on revenue cycle and leadership topics,” Greg expresses.

Exhibiting Excellence “At UCSD Health, some of our ongoing challenges include filling unique positions, identifying and implementing process improvements, and continuous education of our team. HRG has been with us through it all. They have been a partner of ours for over three years, assisting with projects across the revenue cycle. HRG's flexibility and ability to deal with diverse projects and challenges truly sets them apart from other vendors we have used in the past. With healthcare, you never know what's around the corner but knowing we have a partner we can count on gives me peace of mind.”

– Laura Handy-Dineen, Executive Director of System Revenue Cycle | UCSD Health, San Diego, CA “The HRG team has exhibited excellent leadership and exceptional organizational skills. They are, without exception, motivated and dedicated to managing our accounts efficiently and effectively.

As a result, our patient accounts receivable balance and average time-to-collect has been reduced by 30%. We are very impressed.”

– Ed Engesser, CFO | Barlow Respiratory Hospital, Los Angeles, CA “HRG has exceeded our expectations, and with their expertise, we continue to rank as a top hospital in revenue cycle metrics within Washington State.”

– Larry Cohen, CEO | Ocean Beach Hospital, Ilwaco, WA

Social Media and

Healthcare:

what kind of content

should we trust?

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nything new is taken to be innocent and a source of authenticity in its initial days. This includes the social media, the youngest source of communication, and these days a source of information that’s not always known to be authentic, original or even verified. Yet people believe in it with disastrous consequences sometimes.

An offshoot of the entire digital communication conundrum, social media these days is taken to be the ‘de-facto’ standard when it comes to authenticity of any information, health-related or otherwise. That said, Governments the world over have put in place reasonable means such that articles that can cause damages of any kind are put to the test of authenticity and those purveying wrong ideas, notions and so-called news are dealt with strictly and sternly.

But given the speed at which things circulate the world over on social media sites, the best of governments’ steps to stem

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Consuming Wisely

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the tide can sometimes be stymied and at times even circumvented persistent purveyors of falsehood, sometimes abject falsehood.

That said, social media has its advantage when it comes to speed and sheer approachability. Given its ‘Chinese whisper’ quality, it does come in handy to spread the right words at the right time. In sum, a double-edged sword, social media, and more so in the context of healthcare ought to be trusted while taking the following steps: 1. As a general rule, if it’s too good to be true, it MUST be a fraud! Responsible governments the world over have been breaking their heads trying to get the Covid-19 virus back into the bottle from where it leaked and wreaked havoc. But it just refuses to be contained, and besides these days is finding newer and more virulent strains that can strain the best of healthcare systems.

And in all this, if someone comes up with bizarre idea that promise a near- instant and permanent cure, it ought to be taken with a big pinch of salt, which unfortunately most don’t. A case in point is the death few days back in the state of Andhra Pradesh in India of a man who claimed 'miracle' drug cured him of Covid-19!

Even without waiting to authenticate his claims, people in droves descended upon the village. Where it all went out of the window was when the news and details of a ‘miraculous & instant’ cure hit social media sites prompting people to just pick themselves up and land up at his door!

2. Rely ONLY on the words of reputed health-care professionals! Despite everything the world says of doctors, the profession requires constant reading and updating, and this is more evident in those who head bodies of eminence and repute. Their words in most cases can be taken as truth or their words in the context of any social media posts can be considered authentic and worth depending upon.

purveying or even brining about facts that aren’t backed by the right kind of information that comes invariably from research.

Owning to this, any information that’s available from timely bulletins of government agencies and departmentsunless it’s absolutely and patently false, can be taken to be true. That said, it should also be crossed-checked with details given by bodies like WHO, newspaper organization like the Washington Post, New York times and the likes.

4. Worldwide bodies including the World Health Organization, Consortium of Universities for Global Health (CUGH), The Global Health Network, International Society for Infectious Diseases (ISID), Planetary Health Alliance and The Earth Institute.

These bodies’ continuing research for decades means they have details on every known disease anywhere on earth in all its details. Anything that they say (or do) is always backed by research, data and facts, and can be used to cross-check anything that is being said on social media on the subject of health.

5. Reputed News Agencies like Associated Press News, BBC, The Bureau of Investigative Journalism, The Economist, Reuters, Washington Post, New York Times to name some. In a world clogged with fake news and news meant to incite hatred, the stated news organizations are known for their impartiality in imparting quality news including health-related ones. Anything they say on matters of healthcare can be taken to be true to a very large extent without the fear of purveying fake news.

In the end, social media is as social as one takes it to be.

And for that, and in the content of something as pertinent as health and healthcare, the best strategy when it comes to believing content, is to be safe with the right information from the right sources.

Thankfully, most known and admired healthcare professionals have their own social media presence (Twitter handles, #hashtags, social media pages and the likes) which if not hacked into – a real threat these days, can be expected to display authentic information worth depending upon.

3. Governments worldwide have their own Health Departments! Governments can be held to task for

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- M. Purushoutham

10 Most Trusted Revenue Cycle Management Solution Providers

Automated RCM Solutions that Empower Physician Practices

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evenue management is essential for every business including healthcare. Hospitals and physician practices find it difficult to collect revenue due to higher regulations and legal ramifications. Moreover, some traditional or outdated billing processes make revenue collection further difficult for healthcare institutes.

Thus, hospitals and physician practices these days have opted for revenue cycle management services from a plethora of enterprises. Among these service providers is MedEvolve which, under the leadership of President and CEO Matt Rolfes, has set itself apart by empowering physician practices via provision of data-driven solutions with unmatched transparency, accountability, and automation. It is these solutions that have helped its clients reduce the cost to collect, streamline processes, and drive transparency, which further helped physician practices to stay independent and profitable.

Making a mark with excellence.

MedEvolve, since its inception, has been constantly innovating its products and offerings to meet the market demands. And this has been possible with the team's expertise in building solutions that drive profitability for medical practices.

“Our solutions are built to optimize the revenue cycle process and allow for faster payment of insurance claims and better patient experiences,” says Matt “we are constantly changing and innovating with the healthcare industry to ensure providers are collecting every dollar owed at the minimum cost for them.”

Over the years, the company has focused on building automation, data transparency, and patient payment solutions to empower its clients with more control and insight over the entire process with less work and fewer resources.

“We realized years ago that our core strength was in the business side of the practice; therefore, we integrate our PM software with any EHR so we can concentrate our efforts on the business side of healthcare. We learned to focus on the areas where we excel,” explains Matt.

Leading with expertise Matt brings to MedEvolve over 17 years of expertise in accounting and finance, as well as corporate development and operations experience in both public and private companies. He began his career with Grant Thornton, LLP in Audit and Assurance Services while working with several private and publicly traded companies in the technology, service, banking, and consumer industrial products sectors.

During his 17 years of career span, Matt served as the Controller of Streamline Health, a publicly traded, healthcare IT provider. While at Streamline Health Solutions, Matt led the company's accounting and reporting function through a time of significant growth, including the planning, integration, and reporting on two strategic acquisitions.

He joined MedEvolve as Chief Financial Officer in August 2013 and was promoted to President and CEO in 2017.

Since becoming CEO, Matt has led the company through a transformation by expanding MedEvolve's solutions beyond practice management software and revenue cycle management services to advanced healthcare revenue cycle technology.

Under Matt's leadership, the company has developed AIpowered workflow automation, data transparency, and convenient patient payment solutions to drastically improve margins for the company as well as help its physician practice clients to reap the benefits.

Sustaining the pandemic with automated solutions The company, under Matt's leadership, had designed the revenue cycle workflow automation solutions before the pandemic. This ended up being the perfect solution to enable MedEvolve's RCM services business to go virtual immediately after the lockdown was imposed.

The solution auto-generates worklists for the company's billing team members, which has helped the team members analyze and prioritize the work. “We can prioritize at-risk claims or those claims that have the highest returns for the practice. In addition, it enables our management team to

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I believe success or failure of RCM business hinges on having the right technology in place and alignment of your team to the technology.

Matt Rolfes President, and CEO

always monitor staff productivity and effectiveness with transparency into what our staff is producing every day.

This ensures all claims are being worked at the right times and nothing slips through the cracks,” explains Matt.

The closing of ORs delayed surgeries and in turn deductibles later in the year. January 2021 brought the signs of the COVID situation calming down driving up patient balances precipitously.

Along with the technology to streamline business operations the company leadership has always believed in the power of transparency. “During the height of the pandemic from April through August and as things calmed thereafter, we remained extremely transparent with our employees, and let them know the challenges we may face,” Matt shared, “we did our best to make sure all our employees were well taken care of both for their physical health as well as their financial health.”

Due to the sudden surge in patient care and balance collection, physician groups who did not have an effective patient AR engagement strategy are struggling with collecting those patient balances effectively. Realizing the changing trends and client needs, in 2021, MedEvolve is set to expand Patient Call Center Services to include Patient Financial Counseling Services and Mobile Engagement Services.

Most of the company's operations are currently remotely handled by the respective teams and MedEvolve aims to provide remote working as an option moving forward. The company is also working on safely reopening the office in the coming weeks.

Future-ready with counseling and care COVID's wake, when it comes to the business side of a physician's practice, has certainly affected in-patient care.

MedEvolve has expanded its Little Rock-based call center to provide patients with explanations of benefits and medical bills, as well as providing convenient payment options. The team attends inbound calls with clients' billing office and provide mobile outreach to increase patient payments. “We look at this as a crucial service to improve the overall patient experience and will apply the great customer service to the patients as we have for our clients for the last 23 years,” says Matt.

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In addition to the call center, MedEvolve provides outbound past-due balance payment services to help facilitate patient payments through phone calls, text messages, and mobile chat. MedEvolve now will accept a variety of convenient payment options to help clients decrease outstanding patient balances, including payments via text, web, mobile, over the phone. The company is further setting up payment plans in case immediate payment is not an option.

Matt shares how these approaches will benefit the company's clientele. “MedEvolve's Patient Services have achieved a 97.1% patient satisfaction rating since its inception. We are confident these new services will help decrease our clients' patient A/R and improve patient engagement for their practices.”

Words from the wise “Even though RCM is a people-based business, I believe success or failure of RCM business hinges on having the right technology in place and alignment of your team to the technology,” says Matt when addressing those entrepreneurs aspiring to enter the RCM space. The CEO further explains that a good technology aligned with the team benefits in a more predictable and managed work environment, as well as better analytics to reward people for good performance.

Apart from aligning with the right technology, staffing is another big challenge in the RCM services business.

Finding and retaining quality billers and collectors is a struggle due to the high-turnover nature of the role. Matt explains, “Our tools provide a very structured work environment and relevant performance analytics to our people. New employees coming to MedEvolve cannot believe how much more simplified their day is because the system plans it for them. It takes the guesswork out of your day, and you can just get to work.”

“Our relationship with MedEvolve has always been a strong partnership characterized by open communication. We appreciate that they have listened to our needs over the years and consistently prioritize product innovation to improve processes and workflows.”

Exhibiting Excellence

“MedEvolve has revolutionized our revenue cycle processes. Besides seeing how many accounts the teams are touching, we have transparency into the effectiveness of those efforts. At the end of the day, you know the effectiveness of a revenue cycle engine by what you bring in the door and how much it's costing you to do it.”

Kevin Don Executive Director of Global Business Services with Falck US.

“I think what makes these solutions so successful, especially for a practice like Key-Whitman, is that MedEvolve has deep experience providing both revenue cycle services and innovative technologies. They know what independent practices need and how to lay the best foundation for improving operations and overall financial health.”

Matthew Chapman MHA, COE, OCS, Director of Revenue Cycle, Key-Whitman Eye Center

“[MedEvolve RCM Workflow Automation] is like a GPS: representatives sit down, log in to MedEvolve RCM Workflow, and hit go, and the system leads them. We've already seen a 15% reduction in A/R and we anticipate additional long-term improvements as the machine learning algorithms continue to identify new opportunities.”

Jonathan Parisi

Theresa Hammack Office Manager, South County Urological

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Director of Business Operations and Strategy Neurosurgeons of New Jersey

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ost health system executives will agree there's no shortage of data in the healthcare industry.

The problem is knowing what to do with it. In just three years from 2016 to 2019, healthcare organizations saw the volume of health data increase by 878%. Despite the abundance of data, bridging information silos and extracting useful insights that improve patient workflows remains a challenge.

Advanced data analytics and greater connectivity present opportunities for health systems to automate processes, minimize revenue leakage and create a better patient financial experience.

In the wake of COVID-19, the health systems that act on these opportunities will gain a head start on their financial recovery from the pandemic, so this begs the question: what's holding the revenue cycle back from translating data into meaningful insights for better decision making?

What are the hurdles?

Healthcare organizations spend multi-millions of dollars on clinical and financial IT systems each year. Yet, those systems often create a disjointed experience for patients and revenue cycle teams because they aren't truly integrated and therefore, the data remains in silos.

Today, it's common for large health systems to have multiple electronic health record (EHR) systems, along with separate systems for scheduling patients, generating price estimates, checking a patient's insurance eligibility, offering affordable payment plans and more. Essentially, every touchpoint is often powered by a different software product with its own data silo.

Also, many healthcare IT companies have merged and therefore "bolted together" solutions via acquisitions to create their product offerings. For example, conventional patient payment companies typically "bolt together" portals and billing statements that only minimally connect to the underlying payment technologies.

As a result, there's rarely a single source of truth for patient financial activity. This can lead to discrepancies in what the patient sees on their bank statement and what the revenue cycle team sees. As a result, it's difficult for revenue cycle teams to work with patients and address their financial needs while ensuring the health system gets paid for the services provided. Even worse, the breakdown in information does irreparable harm to the trust between the patient and the health system.

What needs to change?

To make data more reliable and actionable, revenue cycle teams need an integrated payment platform that connects data from various sources and creates a truly patient-centric experience.

An integrated payments platform acts as an information hub between different IT systems, including the EHR, estimator tools, insurance information, and more. Think about it this way – before smartphones, you left your house with your wallet and keys, plus you had a map, GPS (miss you, Garmin), notebook with a list, or written directions to your destination.

Today, you just carry your smartphone, which provides directions, contact information, lists, and even your credit card information for contactless payments. An integrated payments solution consolidates information the same way

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Expert Opinion

your smartphone consolidates your personal items. Patients can view their up-to-date bill balance, review a price estimate or their payment history, sign up for payment options that match their personal financial needs, message their provider and more – all from one place.

By leveraging an integrated payment platform that consolidates data from multiple enterprise systems, healthcare organizations make it easier for their patients to understand, manage and pay for healthcare expenses. This data creates the foundation for a personalized and adaptive experience that empowers patients to confidently navigate the financial responsibilities associated with their care while improving revenue cycle outcomes for health systems.

Why act now?

Healthcare billing and payment experiences continue to be leading sources of frustration for patients.

According to Patientco’s 2020 State of the Patient Financial Experience survey, when paying healthcare bills, four out of five patients have felt confused or frustrated. Patients have felt confused and frustrated for various reasons, from the lack of upfront pricing before treatment to receiving multiple bills after one visit. Meanwhile, over one-third of patients have been frustrated because it was difficult to understand what their insurer covered.

Patients are also concerned about the cost of their care. In fact,

About the Author Sean Joyce is Patientco's chief technology officer (CTO) and is responsible for the ongoing product, engineering, and innovation initiatives for Patientco's patient financial engagement platform.

For over 15 years, Sean has focused his career on enhancing the consumer healthcare journey across all stages of engagement with a health system.

Prior to Patientco, Sean launched the first advisory software for small businesses navigating the Affordable Care Act as a product leader within ADP's TotalSource business. Earlier in his career, Sean built software at startups that pursued his passion for detangling the complexities of healthcare through technology.

Sean received his B.S. in Computer Science from Eastern Michigan University and his MBA from Emory University.

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patients often defer necessary medical care over financial concerns – 45% have delayed medical care or skipped it altogether over concerns about their out-of-pocket costs.

While such concerns about healthcare expenses are not new, the COVID-19 pandemic and the economic recession that followed has amplified them.

added burden on the health system's team members.

Many of the frustrations felt by patients are actually the result of point solutions that health systems rely upon for various revenue cycle processes such as scheduling, cost estimates, and eligibility. With so many siloed systems, patients don't know which source of information to trust.

Patients get overwhelmed trying to figure out the nuances of why they owe what they owe and make sense of their financial obligations. Ultimately, they become disconnected from the health system and patient loyalty is compromised.

With a payment platform that consolidates data across different systems, healthcare organizations can personalize each patient's financial care in a scalable way. At the same time, this makes data actionable and enables revenue cycle team members to better assist patients navigate their financial options.

Meanwhile, for busy RCM teams, responding to confused patients who have questions about their financial responsibilities can seem daunting, manual, and timeconsuming. Health systems employ hundreds of team members to handle high volumes of manual tasks, such as answering patient phone calls, responding to email and patient portal messages, accepting, and posting payments and more.

As a result, when patient visit volumes grow, so does the workload for these team members. There is an opportunity for technology to streamline these tasks, so team members can focus on other efforts and enable the health system to care for more patients without significantly increasing operational costs. Realizing this opportunity is key, especially following the COVID-19 pandemic as many health systems will have a backlog of elective procedures to reschedule.

Technologies, such as chatbots with natural language processing and personalized self-service payment options can empower health systems and their team members to focus more on patient care and less on administrative tasks.

For instance, if a patient is anxious about the cost of their care and has a question about their price estimate, the patient can easily be guided by the chatbot to a personalized view of the cost information they need including easy instructions on enrolling in an affordable payment plan and links to self-service scheduling. This all takes place with no

However, these technologies require an integrated payments platform and advanced data analytics.

What Does Success Look Like?

Health systems can leverage data including a patient's preferred communication, such as email or text, along with other data, like bill balance amount and prior payment history to tailor outreach and payment options to each patient. For example, health systems can encourage a patient who has a large bill balance to sign up for a payment plan with messaging on their bill and influence a patient with a smaller balance to pay in full with a prompt payment discount.

Data that's consolidated and actionable allows health systems to predict the best ways to drive patient engagement, proactively meet patients' preferences and give patients an easy way to manage their current and future expenses with tailored, self-service affordable payment options. This also empowers team members to offer better support when patients need assistance most.

Collectively, by doing this for all patients in a health system, health systems use what traditionally was transactional data to outline a better, more tailored financial experience that delivers meaningful financial results for their organization.

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THE ROLE

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OF

IN

HEALTHCARE ORGANIZATIONS 28| May 2021|www.insightscare.com

Managing the Backstage

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anaging healthcare organizations, be they hospitals of any kinds, clinics or tertiary outlets call for dedicated resources that help sustain and grow. Such resources have implications on the financial efficacy of the organization as also the kind of care they provide.

Grants and handouts besides, what helps is to make every step in the process of healthcare as monetarily efficient as possible. Revenue Cycle Management, RCM in short is the one system most hospitals worldwide look up to when it’s about deriving maximum efficiency, revenues and the best possible care from existing systems.

The role of an RCM starts right the time a patient (or a visitor) arrives at the doorstep of a medical facility. At every step thereafter, a combination of patient’s information be it identification-related or related to the medical issue at hand, mode of payment (if it’s through insurance, the predominant case, details of the insurer and details of the policy or policies. If it’s through cash, then details of the

bank or funding body), and codes assigned by the industry are put to use to generate invoices.

To streamline healthcare provisioning besides reducing likely gaps, data collection is done centrally within the organization to ensure efficient and speedy reimbursements for the treatment and proper care of the patients.

Essential steps in the process include: Detailing charges: Be it standardized costs or costs that differ according to treatment, these are recorded basis the Medial Practitioner's detailing of work. Beside capturing the element of costs, this step also helps document the treatments a patient might have undergone with the system’s API into EHR. In a way this step creates a link between costs and medical procedures undergone.

Creating and using universally recognized codes: Every element of the costs incurred, and the treatment undergone are recorded in universally accepted charge codes for easy

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referencing by everyone including the insurance companies, and the medical field itself for future medical interventions.

Submitting claims & related communication: RCM essentially boils down to this step where the healthcare organization sends it bills (in the acceptable formats) to the insurance companies that represents the patient.

Given the system’s accuracy and the clarity it provides, claim settlement has seen a marked upswing in recent times. Besides helping make claim settlement smoother and efficient, the RCM helps both the healthcare organization and insurers communicate better with each other on healthrelated information and levels of cover available to a patient.

Reviewing service levels: In the end, a system that has truckloads of data is also the best place to gauge points where the system can be made more efficient both in terms of money, and in product offering. In this the RCM plays a stellar role given the kind of information it generates and stores.

With AI and Big Data, treatments and customized communication can be made far sharper and quicker than ever before and do so with either existing or even lesser manpower.

That said, the process does have its share of challenges.

Among others, this is a complex cycle of a system where the usual culprits include: • Wrong EHR entries. Being an API-based system that picks up information from other sources, wrong entries at sources including EHR can have repercussions in the RCM, and more so when it starts to affect receipts from insurance companies.

medical costs and focus more on outcomes. These may affect a healthcare provider's existing financial systems including RCMs, despite their being the best. In the US, the ascent is increasingly towards end-results that matter. To this end, reimbursements are now based in demonstrated care and not simply the presentation of bills.

Challenges apart, the RCM present a plethora of positives that include.

• For Healthcare providers, the RCM provides the right means of clarity and efficiency in billing, and ensures the right information goes to insurance companies and patient themselves. It helps automate parts of billing cycles and thus reduces dependence on employees and has better and faster outcomes.

• For patients, the RCM provides better, faster, and errorfree claim settlement. Being integrated to patient’s insurance records, it also provides both the hospital and insurance company the exact status of insurance available to patients, and helps process claims faster.

• For an insurance company, and to an extent healthcare companies, an RCM system gives instant information about types of diseases being treated, when and where.

That besides, it helps with detailed information on patients and their profiles. All this helps the medical industry in particular focus on areas that need high priority.

- M. Purushoutham

• Wrong entries by healthcare staff. Codes for payments, processes and procedures are central to the efficient working of any RCM. Series of wrong entries can change scenarios besides delaying receipts from insurance companies. It doesn’t stop here. Payments can also be stopped by insurance companies.

• Changes in legislations and regulations. Health being a sensitive national issue, governments across the world are constantly working towards policies that lower

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Vee Technologies The Most Preferred Name in HealthTech Space

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trong foundations, unmatched competence, and a ceaseless drive for achieving excellence are the aspects that exemplify Vee Technologies as a leading name in the global business process management space.

Headquartered in New York, USA, with a powerful blend of people, processes and groundbreaking technology enabled solutions, Vee Technologies works to streamline operations, increase cash flow, reduce costs, and maximize compliance while giving associate organizations a leading edge over the competition.

Pertaining to our edition titled, 10 Most Trusted Revenue Cycle Management Solution Providers, we at Insights Care had the opportunity to interview Mr. Chocko Valliappa, the Founder and CEO of Vee Technologies.

In the following interview, Mr. Valliappa briefs us on the company’s journey to becoming an industry leader; the challenges he and his team had to overcome during the pandemic to sustain operations and market competency; his vision for the company’s future, and more.

Below are the highlights of the interview: Please brief our audience about Vee Technologies, its values, vision, and mission.

Vee Technologies delivers technologyenabled health information management and revenue cycle management outsourcing services to prominent organizations throughout the United States. Recognition of our excellence comes in many forms – competitive and sustainable business and industry-wide acclaim.

Most recently, the International Association of Outsourcing Professionals recognized Vee Technologies as a ‘leader’ in its list of the Best 100 Global Outsourcing Companies. This follows four consecutive years of being given this award. Additionally, Inc. Magazine recognized Vee Technologies as one of the fastest-growing American companies for the fifth year in a row.

Our client base includes prestigious healthcare organizations in the U.S. and is comprised of large integrated delivery networks (IDNs), academic medical centers, health systems, independent hospitals, ambulatory facilities, physician groups, software companies, and other medical facilities and healthcare provider organizations.

Vee Technologies’ experience outside the healthcare vertical brings a unique perspective to improving business processes in healthcare. The result has been tremendous growth year after year. As an example, one large academic medical center client has grown from a single service to over 40 statements of work across the revenue

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cycle management spectrum in just six years.

Vee Technologies has offered coding services with significant experience in coding for acute care and ambulatory settings since 2010. We have coders who are experts in inpatient, emergency, observations, infusions, rehabilitation, home health, ambulatory, same-day surgery, medical oncology infusions, radiology, interventional radiology, labs, recurring outpatient, outpatient clinics, and other ancillary chart types. Vee Technologies also performs prospective, concurrent, and retrospective risk adjustment coding reviews.

Charge capture is a regular part of our coding process. A full suite of clinical documentation improvement (CDI) services utilizing both offshore and onshore staff is available. The overwhelming majority of our staff hold Bachelor of Science degrees in Health Sciences or Life Sciences with certifications from AAPC or AHIMA. Credentials vary, based on the type of work and the client requirements.

What aspects make your company standout in the healthcare sector?

Tell us more about how your services add value to associated companies and the healthcare industry.

Vee Technologies differentiates itself from the competition by being laserfocused on delivering exceptionally high levels of quality and customer service to our clients. With an

10 Most Trusted Revenue Cycle Management Solution Providers

undergraduate and graduate degrees in management, health sciences, and engineering. Vee Technologies administers a coding school at the university where we recruit the best students and provide additional training prior to being assigned to a client project.

Competency Vee Technologies employees are career-driven and highly motivated.

Our turnover rates are some of the lowest in the industry due to the support we provide. Because of this, our clients benefit from this stability as employees continually apply their institutional knowledge and experience developed over time servicing the same client leading to even higher levels of quality.

Chocko Valliappa Founder & CEO

Knowledge Sharing Knowledge by Vee Technologies is an e-Learning platform built with gaming techniques that reinforces classroom concepts with visual aids to enhance learning. Online assignments are completed daily to monitor everyone’s level of understanding of assigned topics.

“

Deep domain expertise in population health, value-based care, and coding is what sets Vee Technologies apart from our competitors.

emphasis on accuracy, competency, and teamwork, we are well aligned to deliver extraordinary outcomes. This is a conscious and thoughtful decision by Vee Technologies’ leadership to serve our clients in this way.

University-Enabled Growth Achieving high levels of accuracy and productivity starts by recruiting and hiring highly skilled individuals who work well in a team environment. Vee Technologies owns a private university, Sona College, with more than 10,000 enrolled students. The university offers

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Candidates advance to the next level of training once they complete assigned modules. The Knowledge platform is also used on an ongoing basis to communicate client changes to guidelines and industry updates, ensuring that all employees are utilizing the most current guidelines for coding.

Accuracy Distinguished in the industry, Vee Technologies uses a two-layer quality assurance process with 12% of all work performed undergoing this review. Trending analysis is performed at the coder level, hospital level, and provider level.

world-class patient care and healthy financial outcomes. In this new environment, more is expected of suppliers such as Vee Technologies, particularly a smarter service model with smarter solutions.

Vee Technologies is at the forefront of value-based care and population health initiatives and offers solutions to many of the prominent health systems in America. There are few, if any, companies that process more coding transactions than Vee Technologies.

Deviation from the norm or failure to meet a 95% level of accuracy triggers a root cause analysis. Once identified, coder retraining is completed, and a 100% quality review is conducted until a coder demonstrates the level of competency required. We consistently experience levels of quality that exceed the client’s requirements.

Through our services on patient access, we contribute to improved patient experience and ensure that the claims are billed timely to the correct insurance(s). Our strong coding and billing experience helps us ensure accuracy in our delivery, thereby reducing the time and money spent on reworks.

Value Proposition Vee Technologies’ leadership team has created a culture to deliver extraordinary outcomes to our clients.

Our focus on accuracy, competency, and teamwork creates an environment with very high expectations, bringing together extremely intelligent people who consistently exceed our clients’ expectations.

Being a leader in the healthcare sector, share with us your opinion on how the adaptation of modern technology in the healthcare discipline has transformed the industry and what more could be expected in the near future?

Vee Technologies’ technology solutions increase output, improve quality, and offer our clients tremendous year-over-year return on investment.

Increased financial pressures on the hospitals and provider groups have elevated the importance of managing the working capital. Through our revenue cycle services, Vee Technologies directly helps alleviate these pressures by ensuring a consistent cash inflow. We cover every aspect of the revenue cycle, from scheduling a patient to making an account zero.

The result: lower costs, better risk management, and more resources available for improving healthcare services.

There is no doubt that the entire healthcare landscape is shifting, and health systems must find new ways to reduce overhead costs while delivering

Since 2012, Vee Technologies has been a recognized leader in the coding arena and continues to be an industry-leading force. This is in large part to the company’s ability to process large numbers of coding transactions quickly with impressive levels of accuracy (minimum 95%).

Deep domain expertise in population health, value-based care, and coding is what sets Vee Technologies apart from our competitors. Our proven processes, which have been tightly honed over the course of a decade, are the wellspring of our company’s development and use of technology. We perfected the processes first, and then we determined where automation can add value.

Our competitors’ solutions address efficacy depending only on their technology. With these proposals, clients will still have to identify separate solutions or resources to complete the work that is unable to be fully processed by the technology.

In contrast, the Vee Technologies solutions comprise the very best technology and staffing to bring in the efficacy clients look for. Vee Technologies utilizes certified clinical reviewers and coders to address cases and processes that cannot be handled through technology alone. Our

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Stable Power and Connectivity: Vee Technologies facilitated UPS for employees at home and also provided broadband/high-speed internet for stable connectivity.

combined solution of technology and highly skilled resources allows us to bend the production curve and affords economies of scale.

Our clients gain more than just cost savings from the relationship. Vee Technologies helps clients become more efficient and use better, more accurate information. This means that caregivers can focus staff resources on what they do best: care for patients.

Internal LMS Tool: Even while virtual, our employees have continued learning and training. Our internal LMS is loaded with self-paced training and assessments to help the team remain up to date.

Businesses turn to Vee Technologies for our complete understanding of the parameters that control payer reimbursements and for our help in creating processes that produce an accurate payment from insurers while facilitating better patient care through coding, documentation, and accompanying provider education.

Time Management: We use the time tracking tool “Teramind” to help monitor the time spent at work by each CSR.

From the perspective of the revenue cycle, modern technology has directly helped on two significant aspects: improving patient experience and reducing the cost to collect for the hospitals and the provider groups.

Virtual RNR programs: To keep our employees motivated, we offer regular rewards and recognition.

Internal Communication: In a workfrom-home environment, communication is key. MS Teams has allowed for seamless communication.

Taking into consideration, the current pandemic, and its impact on global economies, how are you driving your organization to sustain operations and ensuring safety of your employees at the same time?

The Coronavirus changed everything overnight as a lockdown was enforced and social distancing became thae new norm. With the lockdown in place, we moved around 3000+ employees to work from home overnight and set up systems for connectivity. We accomplished this with minimum impact on our client deliverables while ensuring security and compliance.

Compliance and Security: Internal policies reworked to ensure the maximum level of security for our clients’ data.

What advice would you give to those aspiring to venture into the RCM space?

The RCM market is fast changing.

New entrants to this market must be agile and ready to adapt to changes.

The market is shifting to a more technology-based solution, so the days of the labor arbitrage are gone.

continuing to grow together and independently.

In this new environment, more is expected of suppliers such as Vee Technologies, particularly a smarter service model with smarter solutions.

A sustainable partnership model in the pursuit of excellence must be built on a solid foundation of like-minded, interdependent individuals working towards the same outcomes. Just as important, each organization must have a core value that lends credibility and strength to the other, reflected in a unified delivery of excellence.

Vee Technologies is planning to add nearly 1,000 people to our team. We also plan to have ten centers in smaller towns. After the pandemic ends, people need to be closer to their hometowns.

We plan to also move people closer to where they work. Another major change will be our move to the Philippines this year, with operations commencing in Manila at the end of April.

How do you plan to scale your company’s operations in 2021?

In times of change, the next step is not always easy.

The entire healthcare landscape is shifting, and health systems must find new ways to reduce overhead costs while delivering world-class patient care and healthy financial outcomes.

This evolution leads to the natural progression of strategic partnerships that will consistently deliver excellence in the short and long-term future while

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