Though it’s a truism that the world’s become more digitized — Venmo, PayPal, and Cash App are all staples of everyday life while we bank online, order online, and stream movies — healthcare has lagged a bit.
Which is not to say the sector has not digitized to some extent: Most providers offer patients the ability to use apps or QR codes to pay online, and autopay is a mainstay of payment plans.
Dee Harding, chief product officer at Big Data Healthcare, a wholly owned subsidiary of Fifth Third Bank, said for providers, digitization can be instrumental in improving and speeding the revenue cycle, cutting the paper in the back office that flows between patients, providers and insurers. For patients, digitizing refund payments issued to them, too, helps ease the clutter of statements, checks and invoices.
But there’s plenty of paper still in the mix, which eats into the margins of the industry overall. Paper-based data typically makes its way from cubicle to cubicle and back offices spend hours gathering what’s needed to eventually get payments flowing through the healthcare ecosystem.
When considering paper in the refund process, “there’s the cost of the check that’s printed out,” said Harding, “and there’s the cost of the envelope, the cost of the stamp — and then you’ve got to rely on the fact that the patient’s going to be there, address wise.” The checks take time to clear … if they’re cashed or deposited in the first place.
“If anything goes wrong during that whole process,” she said, “you’ve set yourself up for patient complaints — and even the re-issuing of the checks.”
Healthcare companies may be a bit cautious in adopting those digital channels, but a consultative approach from firms including Fifth Third, said Harding, can help those companies become more progressive (even while keeping at least a bit of paper in the mix), as they seek to alleviate pain points.
Against that backdrop, firms like Harding’s have helped to convert explanations of benefits (EOBs) and PDFs to 835 (electronic remittance advice) to send payments from insurers to providers and patients. However, if not handled appropriately, the paper conversion with the correspondence can have significant financial impacts.
“We’re able to convert everything that’s sent to us,” said Harding, including the paper flows that have been dominant in worker’s comp and auto claims. The dead-tree-aspect of the claims and payments are converted into electronic files, handling the correspondence that comes into a provider’s organization, said Harding “over a timeframe that meets their needs. We typically turn that paper around into an electronic file within 24 hours if it’s in the lockbox,” she said.
She likened the systems to a “touchless correspondence for providers.” She offered up one example where, for a particular Big Data Healthcare client, the firm was able to process 3,000 pieces of paper, converting them to postable files quickly — with the aid of artificial intelligence (AI) and machine learning — with barely a hint of human interaction.
The same technologies can and are being leveraged for patient payments, she said, as part of Big Data Healthcare’s managed service offering that is used to send refunds to patients digitally.
Regarding manual intensive correspondence, “we’ve deployed this technology to create a workflow,” said Harding, “so that they have transparency into all of their correspondence — where it is at any time and what needs to be addressed. We’ve taken away the administrative burden.”
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