Tag: Best Use of Technology

Patient Satisfaction and the Collections Conundrum

Emergency Strikes

The year was 2001—seems like a distant memory. Expecting our first child, my wife and I were living in Modesto, California, thinking about cradles and nurseries. We were so excited—the little one we’d been expecting was on his way! Excitement quickly changed to deep concern as we learned there were some major complications with the pregnancy and our baby was in serious jeopardy. Life’s pause button was pushed as everything else in the world came to a screeching halt.

An ambulance transport and emergency delivery later, we found ourselves in our new home—the neonatal intensive care unit. For the next four months, we worked with medical teams around the clock to slowly usher our new 1-pound, 4-ounce son, Noah (now 15 years old), into the world.

Financial Domino Effects

This was an incredibly stressful time in our lives. Of all the things that burdened us, one of the most memorable was the nearly $5,000 invoice we received for a specific service. With no clue how we would pay this, I finally worked up the courage to pick up the phone and call the number on the invoice. The provider was demanding immediate payment before sending the bill to collections.

Me? Collections? But I’m the good guy, right? People should be reaching out to care for me. What just happened? After days of multiple information exchanges between me, the billing office and my insurance carrier, we finally figured it out—all charges were to be covered by insurance.

While our care through this time was generally very good, this unexpected charge put a cloud over the provider who lacked the proper information—despite a 120-day inpatient stay. Why did the provider send our bill to collections without contacting us? Where was the disconnect? Does this still happen today?

Fast Forward 15 Years to Smarter Billing and Collections

Sadly, this is not an isolated incident. Everyone knows a person with a similar story. But what if this patient billing story could be different? What if instead of multiple collection agency invoices demanding payment, I had been contacted early in the process? Or better yet, what if everything had occurred behind the scenes between provider and payor?

Technology advancements have narrowed the data gap that created these and other tensions for patients, providers and insurance carriers. Health care providers today can better serve their patients and communities through technology. The systems required to instantly supply insurance information and ensure patient-friendly billing are now available. It’s a matter of awareness and investment. Two key technology strategies are rapidly emerging to make collection letters and calls a thing of the past.

Real-Time Insurance Discovery

Insurance discovery solutions help providers find hidden insurance coverage for patients up front versus after the fact. Especially in emergency or self-pay situations, patients may have coverage the provider doesn’t know about. Finding coverage provides a tremendous boost to patient satisfaction and financial engagement.

For providers, finding and securing coverage early in the encounter helps billing teams circumvent months of patient statement and collection efforts. Operational costs are reduced and payor reimbursement is hastened. Best practices are rapidly emerging on how to incorporate real-time insurance discovery within patient registration and billing workflows.

Payment Likelihood Determinations

Where insurance coverage can’t be found or high deductibles result in exorbitant patient financial responsibilities, checking “payability” becomes crucial. Patients with minimal cash reserves or low propensity to pay can be moved to charity care, Medicaid, or account write-off. Families likely to qualify for financial assistance are also quickly identified by using payment likelihood applications.

Billers and collectors are more efficient and effective without damaging patient relations or community reputation. It is often a smarter long-term decision to write off patient balances in those cases where personal bankruptcy is only one medical bill away.

Proactive financial engagement, insurance discovery and smart collections are in the early stages in healthcare. However, provider organizations that embrace more patient-friendly billing strategies can significantly promote patient satisfaction and long-term community benefits.

Ted Williams has been a featured presenter at regional and national EMS conferences, including the state medical associations, ambulance networks, and technology user group conferences. Williams is a founder of Payor Logic, a national provider of healthcare revenue cycle solutions.

2016 AMBY Best Use of Technology: Trinity EMS & Firstwatch, Opioid Epidemic Project

Congratulations to the 2016 AMBY Award Winners

Each year, the American Ambulance Association honors best practices, ingenuity, and innovation from EMS providers across the country with our AMBY Awards. 

Trinity EMS & FirstWatch Opioid Epidemic Project Awarded a 2016 AMBY for Best Use of Technology

Trinity EMS & FirstWatch | Massachusetts

amby-congrats-trinity-ems-with-firstwatchMassachusetts has seen a massive increase in opiate overdoses and deaths. In 2013 there were 918 opiate related deaths in Massachusetts. Massachusetts had 1531 deaths in the first six months of 2016. Many of the communities Trinity EMS serves are on the front lines of this issue. Their EMT’s and paramedics are helping to revive patients every day from an opiate overdose. Understanding the scope of an issue is a critical first step to solving an issue. They started using their PCR data to help frame the issue for their communities. They began tracking the demographics such as age and gender of the patients, time of day and day of the week, and location within the communities. They also monitor the volume to identify spikes in volume in individual communities and system wide. Trinity reported data monthly, one month behind to the health department, public safety partners, methadone clinics, hospitals and city governments. This data was well received. Other services contacted them for help in developing their tracking and reporting. They added FirstWatch to their program to speed up the notifications. Monthly reporting is still valuable. Instant reporting is even better. FirstWatch allows their communities to be notified within an hour of an opiate overdose. Public health and public safety now have this intelligence right away.

The goal was to gather and present data in a cross discipline format for aid with better understanding on the situation. First responders, law enforcement, public health, EMS, and district attorneys, and the press have received and used their data. Trinity wanted to show:

  • The profile of the patients we are seeing
  • The frequency of the patients
  • The location and time of the overdoses
  • The severity of the patients. (Our volume of overdoses have leveled off, the acuity of the patents is still increasing)
  • Our monthly report is a key performance indicator as to the opiate issue at the street level in our communities
  • Our needle pick up data indicated where outdoor intravenous drug use is happening
  • Many of the overdose calls to the 911 centers are not communicated as being overdoses; “fall”, “respiratory”, “unconscious” are common chief complaints at dispatch. This data would not have been collected and reported using chief complaint as a filter

When it became clear the opiate issue was becoming a wide spread crisis Trinity started working the issue. They knew their best area to provide data from was PCRs. They came up with a set of data points they thought would help. They attended many meetings and public events. During those forums dozens of additional questions and theories came forward. Trinity took and implemented all that they had data for. (Example. There was question about social benefits and opiate use. They are able to show on an ongoing basis that there is no correlation between opiate overdoses and the 1st and 15th of the month.)

Before 2015, Trinity reported opiate overdoses usually annually only when requested. Starting in 2015 they reported monthly. They wanted to provide data even quicker. Trinity had seen FirstWatch a few years before. They felt the speed and automation FirstWatch could provide was a critical improvement. The intelligence gathered with knowing in live time of opiate overdoses can’t be overstated. The automation allows that intelligence to be gathered no matter the day or time.

Trinity started working with FirstWatch in December 2015. In May 2016, Trinity put FirstWatch directly into the hands of public health, public safety and public schools. Each discipline has a HIPAA compliant login with access to data specific to their mission. They worked very closely with FirstWatch so they could understand the capabilities within the system. They brought the idea and FirstWatch brought the execution and focus. The FirstWatch platform is amazingly powerful for Trinity, to provide live access is amazing. In June 2016, Trinity participated in a Middlesex County District Attorney opiate task force meeting. Trinity had earlier in the meeting done a 20 minute presentation on the opiate crisis in our city. This provided the 70 people in attendance a fresh look at the data. Towards the end of the meeting conference to alert families and friends of addicts to watch their loved ones, and scheduled “emergency” Narcan administration training for the community. During DA Ryan’s presentation, Trinity received a FirstWatch alert for a 39 year old female opiate overdose from 30 minutes before. Three minutes later they received another alert for a 41 year old female that suffered a fatal opiate overdose. They were able to share that with the group and drive home the DA’s message.

The City Governments, Public Health, Police and Fire Departments in Trinity’s communities were eager to learn about the data they were able to collect, and their data began to become focal points at press conferences and city council meetings. News agencies began contacting Trinity to help paint the picture of the epidemic in feature stories. In sharing the mapping aspect of Firstwatch they hope that these agencies can further understand the epidemic and develop plans to combat it. Trinity has become the de facto subject matter experts of the opiate crisis.

Congratulations to Trinity EMS and FirstWatch for their selection as 2016 AMBY Winners.