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  • Become an HFMA Peer Review Panelist
    presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics

    Original URL path: http://www.hfma.org/Content.aspx?id=31119 (2016-02-10)
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  • HFMA Business Profiles
    Lillibridge Using Healthcare Real Estate to Achieve Your Strategic Goals June 2014 Nuance Boosting Providers Over the EHR Tipping Point with CDI Intacct Providing Agile Performance Visibility for an Era of Change May 2014 Deloitte ICD 10 Strategies to Consider During the Delayed Timeline BACK TO PAGINATION HFMA s monthly magazine hfm and quarterly magazine Leadership periodically contain Business Profiles which highlight an advertiser s perspective about an issue in healthcare finance Below are the most recent Business Profiles January 2016 McKesson Leveraging Predictive Analytics to Rein in Operating Costs December 2015 Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health November 2015 Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Optum Enabling Transformative Change October 2015 Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value PMMC Navigating Revenue Cycle Management Challenges as Value Based Purchasing Emerges Burgess Simplify the Business of Healthcare September 2015 J P Morgan Managing Cybersecurity and Protecting Patient Data TransUnion Healthcare Smarter Revenue Cycle Solutions Deloitte Creating Value with Effective Care Management August 2015 American Express Streamlining Supplier Payments and Boosting Revenue July 2015 RevSpring Customizing a Technology Platform to Drive Patient Payment Deloitte Realizing the Potential of Your CDI Program June 2015 KPMG Readying for Health Care Today and Tomorrow May 2015 Huron Healthcare Readying Your Organization for Transformation KeyBank Helping You to Realize Your Strategic Vision in Changing Times Xtend Healthcare A Custom Approach to Optimizing Revenue Cycle Performance April 2015 Availity Connect to the Future of Healthcare Information Deloitte Leveraging IT for Value Based Care Transformation SSI Preparing the Revenue Cycle for Changing Payer Roles March 2015 Apex Cultivating Patient Payment While Elevating the Patient Experience Healthport Ensuring Compliant Exchange of Protected Health Information Community Hospital Corporation Supporting Community Hospitals February 2015 Deloitte Solutions for Healthcare Transformation GE Healthcare Delivering Sustainable Cost Reduction Cerner RevWorks Readying Your Revenue Cycle Performance for Tomorrow Aidin Better Manage Your Post Acute Provider Network and Improve Patient Outcomes January 2015 Citi s Money 2 for Health Your All in One Healthcare Payment Solution December 2014 Cerner RevWorks Readying Your Revenue Cycle Performance for Tomorrow November 2014 TriMedx Elevating Clinical Engineering Cerner Connecting Clinical and Financial Data September 2014 Parallon Revenue Cycle Services Customized Solutions for Improved Revenue Cycle Performance MedAssets Improving Revenue Performance in Times of Change August 2014 Warbird Consulting Partners CFO Expertise When You Need It July 2014 Russell Investments Optimizing Your Portfolio Strategy in Complex Times Lillibridge Using Healthcare Real Estate to Achieve Your Strategic Goals June 2014 Nuance Boosting Providers Over the EHR Tipping Point with CDI Intacct Providing Agile Performance Visibility for an Era of Change May 2014 Deloitte ICD 10 Strategies to Consider During the Delayed Timeline Please login to add your comments Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper

    Original URL path: http://www.hfma.org/Content.aspx?id=22582 (2016-02-10)
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  • Buyer's Resource Guide
    systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper

    Original URL path: http://www.hfma.org/SpecialTopic1.aspx?id=30495 (2016-02-10)
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  • HFMA Peer Review Healthcare Products and Services
    HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements

    Original URL path: http://www.hfma.org/SpecialTopic1.aspx?id=26175 (2016-02-10)
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  • Sponsorship Opportunities
    costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can

    Original URL path: http://www.hfma.org/Content.aspx?id=4474 (2016-02-10)
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  • Conifer Health Solutions: Helping Providers and Employers Build a Foundation for Better Health
    not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA BACK TO PAGINATION Advertisement In this Business Profile Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements Tell me a little bit about your organization Conifer Health Solutions focuses on strengthening healthcare organizations financial and clinical health as well as the personal well being of their patients communities and employees Serving integrated delivery networks hospitals and physician groups provider sponsored health plans and employers Conifer Health helps healthcare organizations get paid appropriately for the care provided under volume based reimbursement as well as helps provider organizations succeed under risk based models Conifer Health also works directly with consumers to guide them to the appropriate care setting and consults with them on adhering to care management programs Conifer Health s value is helping organizations address every aspect of the Institute for Healthcare Improvement s Triple Aim elevating the patient experience driving improved outcomes and achieving cost reduction The breadth of its client base across the healthcare landscape coupled with 30 plus years of experience allows Conifer Health to draw on lessons learned and offer tailored services and technology for each client We work with our clients to identify the right solutions to drive value for an organization based on its strategic goals For example an integrated delivery network might be growing via acquisition or perhaps an employer group wants to reduce its healthcare expenditures and provide care management to its employees Conifer Health s goal is to provide the foundation for these efforts and help our clients tackle the challenging clinical financial and quality initiatives they need to grow in their local markets What are some of the biggest challenges you see affecting healthcare organizations Payers and providers must control the cost of care while ensuring quality and elevating the consumer experience The changes in health care are driving the need for innovation and the development of big data capabilities For instance financial information e g claims data is the most readily available data source and can provide valuable insights across the entire continuum of patient care Data related to orders results and clinical documentation constitutes a deeper but narrower data set and can also provide important information Those organizations that have a comprehensive data strategy and can operationalize their data insights will have the ability to achieve quality outcomes and satisfied consumers both critical to succeeding under value based purchasing models Those that do not will be flying blind How does your product or service offering s help address these needs Conifer Health provides data driven performance improvement and health management solutions to healthcare organizations Harnessing the power of data to drive the design and refinement of our solutions has yielded tremendous benefits for our clients Lowering the cost of delivering services without the right focus has the potential to adversely affect patients However using analytics to pinpoint the areas of opportunity to reduce waste can not only lower cost but also improve the overall efficiency of the process Our approach to claim submission and follow up illustrates this in practice As payers constantly implement new rules for processing claims significant variations can occur on the provider side of the equation Many organizations submit claims and follow up if payment is not received within 30 days Using our data and analytics capabilities Conifer Health can segment accounts based on individual payer logic at the claim element level allowing us to pinpoint necessary changes in workflows For example a specific diagnosis to procedure combination may always get pended for utilization review by the payer adding six days to the standard payment cycle Conifer Health has the ability to recognize that logic and adjust our workflow to ensure those claims are not touched within the six day window because we know that is the new standard for that payer What are some key considerations for healthcare leaders when choosing this type of product or service A potential partner should have a proven service that is applicable to a healthcare organization s current situation and goals Moreover the company should have credible experts who can provide guidance and problem solve in areas of ambiguity Before committing to a service provider organizations should verify that the company has a lengthy history of success with similar clients Peer references should be able to corroborate the potential partner s experience In addition to having a track record vendors must be able to clearly articulate and contextualize the roadblocks an organization may face when trying to address a given problem Conifer Health for example has 30 plus years of success in health care and leverages that experience to help organizations fully appreciate the nuances of various challenges and the pros and cons of different solutions As healthcare organizations implement use of your product or service into their day to day operations what advice would you offer so they can best set themselves up for success Before a healthcare organization can solve a multifaceted business challenge it must be able to clearly articulate its goals Some questions to ask might include What issues are we trying to solve as our organization evolves Do we have a particular competency in a given service line and want to attract patients to it Or do we see a need in an underserved market and want to address it so we can cultivate and retain new business When an organization clearly defines its goals it becomes easier for a vendor partner to meet the entity s objectives selecting just the right services technology and other solutions to yield the best outcomes Are there any educational materials you would like to share to help healthcare providers in

    Original URL path: http://www.hfma.org/Content.aspx?id=43732 (2016-02-10)
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  • J.P. Morgan: Managing Cybersecurity and Protecting Patient Data
    connects to the Internet including mobile devices tablets personal computers and networks is susceptible to a cyberattack And the risk for infiltration goes up exponentially as health care becomes more technology driven with organizations using tablets at the bedside relying on mobile devices for communication and storing sensitive patient information electronically Without a strong plan for mitigating potential threats an organization can open itself up to an attack which can not only lead to HIPAA breaches but also result in substantial financial ramifications Why are cyberattackers interested in stealing medical data Hackers are interested in healthcare data because of its personal nature Cybercriminals can use the information to create a detailed picture of an individual allowing them to commit fraud more easily than they might be able to without that data For example if a hacker gains access to a patient s demographics contact data physician information and or most recent test results the perpetrator could potentially send an email to the patient and pretend to be the healthcare organization Imagine if that email were to ask the patient to click on a link for further information about testing if the patient follows the request and the link introduces malicious software to his or her personal computer the hacker could then steal additional information including credit card data or social security numbers and introduce a key logger to track all keystroke activity And the more data the hacker retrieves the more realistic future communications will seem in fact the attacker may then attempt to pose as the patient and solicit information from the healthcare organization gaining access to its sensitive financial data In addition to healthcare data s susceptibility wire transfers may also be the target of nefarious individuals or groups A hacker could pose as a hospital s CEO or someone else with authority and request a wire transfer Assuming the communication appears to be real the staff receiving the request might interpret it as legitimate And without sufficient checks and balances the organization could proceed with the transfer and ultimately be unable to recoup the money How can organizations be more diligent regarding their processes and protocols To reduce cyberattack impacts healthcare organizations should consider first identifying their points of presence meaning where when and how do their specific devices and programs connect to the Internet Next it s helpful to examine the data coming in and moving through those points in order to fully appreciate the information at risk Developing strategic guidelines and processes to ensure connectivity points are minimized from a risk perspective while functional from an efficiency perspective is the key to developing a proactive and ongoing risk analysis approach Once organizations map out what information goes where and who can see what they can put controls in place to quarantine sensitive information Controls may include employing standard preventive measures such as firewalls environmental scanning and or penetration testing Other protections may involve establishing a system of checks and balances for at risk activities For example if your organization makes wire transfers consider setting up a process in which you have four eyes on glass meaning you have an initial person who sets up the wire transfer and another individual who approves it before execution These safeguards can help to support security and prevent fraud or theft In addition to being proactive organizations can also benefit from monitoring and logging all data flow to see who is interacting with what information and for what purposes Ongoing monitoring allows a organization to spot potential threats quickly and address them before they escalate To make sure everyone is fully committed to keeping data safe it s essential for organizations to educate their staff on cybersecurity risks and how to avoid them Start by explaining why checks and balances are so important and teach staff to recognize malicious emails or other suspect situations Your employees are your first line of defense and they have to be empowered to recognize and flag suspicious communications that could lead to a breach Organizations may also want to periodically test their cybersecurity processes and procedures to make sure they work as expected It can truly be an effective strategy to engage in mock scenario testing in which the health system brings key stakeholders together to talk about what they would do in the event of an attempted or actual breach Issues to address may include identifying the authorities that need to be notified the staff that should be informed ways the organization may lock down internal and or third party systems controls to put in place and how these controls could fail and the measures the organization could take in the future to prevent similar events from occurring By walking through several possible scenarios leaders can see how the organization s policy executes in a real world situation highlighting potential flaws that could warrant addressing What role should hospital leaders play in ensuring effective cybersecurity protocol Ultimately cybersecurity should be a top priority for healthcare organizations especially as the industry continues to embrace technology and goes mobile Preserving security must be more than just a CIO issue CFOs and CIOs should continue to identify this as a key area of focus and funding with the board and c suite leadership to ensure the security of patient information financial information and any other critical healthcare data For readers to learn more about cybersecurity are there any resources you would like to recommend You can visit J P Morgan s Healthcare Insights site for more information about the best practices for healthcare organizations You can also learn more about emerging trends in cybersecurity and find out how you can protect your organization from fraud HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by J P Morgan This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Tuesday September 01 2015 BACK TO PAGINATION Advertisement In this Business Profile Brian DiPietro Managing Director Commercial Bank Technology JPMorgan Chase Co discusses the importance of evaluating your cybersecurity protocols to help prevent malicious data breaches Tell us a little about your organization J P Morgan has provided dedicated Healthcare financial solutions for more than 30 years As one of the oldest financial institutions in the United States we re a leading global financial services firm operating in more than 60 countries We provide a multitude of services including investment banking personal financial services commercial banking financial transaction processing and asset management Our company has more than 240 000 employees that serve millions of consumers and small businesses along with top hospitals and health systems as well as many of the world s most prominent corporate institutional and government clients What are some of the biggest challenges you see affecting healthcare organizations While hospitals health systems and physician practices currently face a variety of challenges one significant issue is cybersecurity the concept of keeping electronic data safe from individuals or groups who seek to exploit weaknesses in technology and steal information or disrupt systems Although every industry confronts data security threats healthcare organizations are especially vulnerable because they electronically store large amounts of diverse data about their patients which if breached can be utilized by a cybercriminal to impersonate the healthcare organization or the individual patient Any device that stores data and directly or indirectly connects to the Internet including mobile devices tablets personal computers and networks is susceptible to a cyberattack And the risk for infiltration goes up exponentially as health care becomes more technology driven with organizations using tablets at the bedside relying on mobile devices for communication and storing sensitive patient information electronically Without a strong plan for mitigating potential threats an organization can open itself up to an attack which can not only lead to HIPAA breaches but also result in substantial financial ramifications Why are cyberattackers interested in stealing medical data Hackers are interested in healthcare data because of its personal nature Cybercriminals can use the information to create a detailed picture of an individual allowing them to commit fraud more easily than they might be able to without that data For example if a hacker gains access to a patient s demographics contact data physician information and or most recent test results the perpetrator could potentially send an email to the patient and pretend to be the healthcare organization Imagine if that email were to ask the patient to click on a link for further information about testing if the patient follows the request and the link introduces malicious software to his or her personal computer the hacker could then steal additional information including credit card data or social security numbers and introduce a key logger to track all keystroke activity And the more data the hacker retrieves the more realistic future communications will seem in fact the attacker may then attempt to pose as the patient and solicit information from the healthcare organization gaining access to its sensitive financial data In addition to healthcare data s susceptibility wire transfers may also be the target of nefarious individuals or groups A hacker could pose as a hospital s CEO or someone else with authority and request a wire transfer Assuming the communication appears to be real the staff receiving the request might interpret it as legitimate And without sufficient checks and balances the organization could proceed with the transfer and ultimately be unable to recoup the money How can organizations be more diligent regarding their processes and protocols To reduce cyberattack impacts healthcare organizations should consider first identifying their points of presence meaning where when and how do their specific devices and programs connect to the Internet Next it s helpful to examine the data coming in and moving through those points in order to fully appreciate the information at risk Developing strategic guidelines and processes to ensure connectivity points are minimized from a risk perspective while functional from an efficiency perspective is the key to developing a proactive and ongoing risk analysis approach Once organizations map out what information goes where and who can see what they can put controls in place to quarantine sensitive information Controls may include employing standard preventive measures such as firewalls environmental scanning and or penetration testing Other protections may involve establishing a system of checks and balances for at risk activities For example if your organization makes wire transfers consider setting up a process in which you have four eyes on glass meaning you have an initial person who sets up the wire transfer and another individual who approves it before execution These safeguards can help to support security and prevent fraud or theft In addition to being proactive organizations can also benefit from monitoring and logging all data flow to see who is interacting with what information and for what purposes Ongoing monitoring allows a organization to spot potential threats quickly and address them before they escalate To make sure everyone is fully committed to keeping data safe it s essential for organizations to educate their staff on cybersecurity risks and how to avoid them Start by explaining why checks and balances are so important and teach staff to recognize malicious emails or other suspect situations Your employees are your first line of defense and they have to be empowered to recognize and flag suspicious communications that could lead to a breach Organizations may also want to periodically test their cybersecurity processes and procedures to make sure they work as expected It can truly be an effective strategy to engage in mock scenario testing in which the health system brings key stakeholders together to talk about what they would do in the event of an attempted or actual breach Issues to address may include identifying the authorities that need to be notified the staff that should be informed ways the organization may lock down internal and or third party systems controls to put in place and how these controls could fail and the measures the organization could take in the future to prevent similar events from occurring By walking through several possible scenarios leaders can see how the organization s policy executes in a real world situation highlighting potential flaws that could warrant addressing What role should hospital leaders play in ensuring effective cybersecurity protocol Ultimately cybersecurity should be a top priority for healthcare organizations especially as the industry continues to embrace technology and goes mobile Preserving security must be more than just a CIO issue CFOs and CIOs should continue to identify this as a key area of focus and funding with the board and c suite leadership to ensure the security of patient information financial information and any other critical healthcare data For readers to learn more about cybersecurity are there any resources you would like to recommend You can visit J P Morgan s Healthcare Insights site for more information about the best practices for healthcare organizations You can also learn more about emerging trends in cybersecurity and find out how you can protect your organization from fraud HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by J P Morgan This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Tuesday September 01 2015 Please login to add your comments Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment

    Original URL path: http://www.hfma.org/Content.aspx?id=40650 (2016-02-10)
    Open archived version from archive

  • TransUnion Healthcare: Smarter Revenue Cycle Solutions
    revenue cycle with a hard dollar return on investment our solutions help our customers recoup real cash for their businesses TransUnion Healthcare s current customer base includes more than 1 100 hospitals and 25 000 physician practices and is experiencing remarkable growth across the healthcare industry Now that the Affordable Care Act ACA is in effect is there a greater need for revenue recovery Although ACA has extended insurance coverage to millions of Americans it has actually created an underinsured population We re seeing a real shift from fee for service to a much higher percentage of self pay patients in high deductible plans who may not understand their financial obligations for healthcare Only five years ago the average deductible in such a plan was 1 500 Now it s common for it to be 5 000 for an individual or 10 000 for a family In addition insurance copayments are growing There s been a change in what is reimbursed from health plans to employers and now to patients We are now seeing that 10 20 of some services are a patient s responsibility after they meet the deductible Those two factors high deductibles and higher copayments are really affecting an underinsured population When you consider that the average family income is 52 000 per year and the average family deductible is 10 000 any type of healthcare event a surgery or emergency department visit for example can quickly put the family under water financially That s why we continue to see healthcare as the number one reason for personal bankruptcy And those bankruptcies are growing As a result of these changes hospitals and physician practices increasingly identify charity care for these patients and manage collections from insurance companies Most importantly they are shifting their business model to collect up front patients self pay money they pay out of pocket The way providers interact with patients has gone through a complete revolution How can providers address the challenge of improving collections and reducing bad debt Readily available data driven solutions can help in a number of ways First on the front end providers can collect more through automated patient access solutions that identify and verify insurance eligibility of patients who come in the door Second providers can help patients understand their out of pocket costs up front by giving them estimates specific to payers and plans associated with patients TransUnion Healthcare Revenue Cycle Management Solutions Third providers can offer patients a recommended payment plan For example TransUnion Healthcare is also a credit bureau which helps us evaluate the propensity for a patient to pay If we determine a patient cannot pay based on information they share we can automatically search for charity care We can also communicate with insurers to see that prior authorization and medical necessity are established to help with appropriate reimbursement Fourth providers can reduce bad debt on the back end In most hospitals and physician practices about 5 of uncompensated care patients have some level of insurance coverage that could have been reimbursed This problem is growing alongside enrollment in the ACA s health exchanges due to system issues that may not identify insurance due to subtle changes in subscriber names or to subscribers who don t adequately understand their insurance coverage For example to help providers reduce bad debt on the back end our coverage discovery product eScan can identify insurance for patient populations that providers can t find Armed with that information our customers can then return those dollars back to their organizations Hospitals typically run on thin margins and eScan can make a real difference to financial health In one instance a health system was able to recognize 21 million in charges They credited TransUnion with putting them back in the black In fact by December 2015 through our customers use of eScan more than 1 billion will have been returned to hospitals and physician practices Any recommendations on what to look for as organizations consider potential business partners for these types of revenue cycle solutions It turns out that if you collect one dollar at the point of service you are eight times more likely to collect the entire patient responsibility compared to waiting until the back end for collections Given that it s important to look for a business partner who understands the patient as a consumer and her or his propensity to pay TransUnion s data sets make us one of the largest eligibility clearinghouses for patient estimation tools to educate patients and drive collection of real dollars at point of service Also look for a partner with a revenue cycle management solution that focuses on the depth breadth and integrity of data They should include the features and functions we ve been discussing such as eligibility estimation charity care and coverage discovery Look for a partner with the data and analytics capabilities to provide a dashboard that shows not just cash flow but also shows ways to proactively affect patient behavior to optimize reimbursement and maximize the financial health of the organization And finally we see a common pitfall that as people increasingly move toward electronic medical records and working with larger players they default to existing partnerships without first evaluating the market It s important to take a step back to ask about core competencies of your EMR provider Do they really understand revenue cycle management patient access and the billing components that lead to coverage discovery Any additional reading you d suggest Visit our website for more information our our white papers below Capturing the lost dollar Finding solutions for uncompensated care TransUnion Survey Half of Americans will switch healthcare providers if the Supreme Court Eliminated Subsidies HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by TransUnion This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Tuesday September 01 2015 BACK TO PAGINATION Advertisement In this Business Profile Gerry McCarthy President of TransUnion Healthcare discusses industry trends contributing to higher bad debt and what to do about them Gerry is responsible for the strategic direction of the healthcare business and expanding its footprint in the healthcare market overall He has more than 20 years of experience in healthcare information technologies Tell us about TransUnion Healthcare TransUnion Healthcare is a division of TransUnion a global information solutions company that serves both businesses and consumers in 33 countries Since its inception 12 years ago TransUnion Healthcare has focused primarily on revenue cycle management and on maximizing reimbursement and cash flow in healthcare organizations We maintain that focus through three key areas 1 patient access 2 financial navigation and 3 revenue recovery In fact we positively affect all aspects of the revenue cycle with a hard dollar return on investment our solutions help our customers recoup real cash for their businesses TransUnion Healthcare s current customer base includes more than 1 100 hospitals and 25 000 physician practices and is experiencing remarkable growth across the healthcare industry Now that the Affordable Care Act ACA is in effect is there a greater need for revenue recovery Although ACA has extended insurance coverage to millions of Americans it has actually created an underinsured population We re seeing a real shift from fee for service to a much higher percentage of self pay patients in high deductible plans who may not understand their financial obligations for healthcare Only five years ago the average deductible in such a plan was 1 500 Now it s common for it to be 5 000 for an individual or 10 000 for a family In addition insurance copayments are growing There s been a change in what is reimbursed from health plans to employers and now to patients We are now seeing that 10 20 of some services are a patient s responsibility after they meet the deductible Those two factors high deductibles and higher copayments are really affecting an underinsured population When you consider that the average family income is 52 000 per year and the average family deductible is 10 000 any type of healthcare event a surgery or emergency department visit for example can quickly put the family under water financially That s why we continue to see healthcare as the number one reason for personal bankruptcy And those bankruptcies are growing As a result of these changes hospitals and physician practices increasingly identify charity care for these patients and manage collections from insurance companies Most importantly they are shifting their business model to collect up front patients self pay money they pay out of pocket The way providers interact with patients has gone through a complete revolution How can providers address the challenge of improving collections and reducing bad debt Readily available data driven solutions can help in a number of ways First on the front end providers can collect more through automated patient access solutions that identify and verify insurance eligibility of patients who come in the door Second providers can help patients understand their out of pocket costs up front by giving them estimates specific to payers and plans associated with patients TransUnion Healthcare Revenue Cycle Management Solutions Third providers can offer patients a recommended payment plan For example TransUnion Healthcare is also a credit bureau which helps us evaluate the propensity for a patient to pay If we determine a patient cannot pay based on information they share we can automatically search for charity care We can also communicate with insurers to see that prior authorization and medical necessity are established to help with appropriate reimbursement Fourth providers can reduce bad debt on the back end In most hospitals and physician practices about 5 of uncompensated care patients have some level of insurance coverage that could have been reimbursed This problem is growing alongside enrollment in the ACA s health exchanges due to system issues that may not identify insurance due to subtle changes in subscriber names or to subscribers who don t adequately understand their insurance coverage For example to help providers reduce bad debt on the back end our coverage discovery product eScan can identify insurance for patient populations that providers can t find Armed with that information our customers can then return those dollars back to their organizations Hospitals typically run on thin margins and eScan can make a real difference to financial health In one instance a health system was able to recognize 21 million in charges They credited TransUnion with putting them back in the black In fact by December 2015 through our customers use of eScan more than 1 billion will have been returned to hospitals and physician practices Any recommendations on what to look for as organizations consider potential business partners for these types of revenue cycle solutions It turns out that if you collect one dollar at the point of service you are eight times more likely to collect the entire patient responsibility compared to waiting until the back end for collections Given that it s important to look for a business partner who understands the patient as a consumer and her or his propensity to pay TransUnion s data sets make us one of the largest eligibility clearinghouses for patient estimation tools to educate patients and drive collection of real dollars at point of service Also look for a partner with a revenue cycle management solution that focuses on the depth breadth and integrity of data They should include the features and functions we ve been discussing such as eligibility estimation charity care and coverage discovery Look for a partner with the data and analytics capabilities to provide a dashboard that shows not just cash flow but also shows ways to proactively affect patient behavior to optimize reimbursement and maximize the financial health of the organization And finally we see a common pitfall that as people increasingly move toward electronic medical records and working with larger players they default to existing partnerships without first evaluating the market It s important to take a step back to ask about core competencies of your EMR provider Do they really understand revenue cycle management patient access and the billing components that lead to coverage discovery Any additional reading you d suggest Visit our website for more information our our white papers below Capturing the lost dollar Finding solutions for uncompensated care TransUnion Survey Half of Americans will switch healthcare providers if the Supreme Court Eliminated Subsidies HFMA is the nation s leading membership organization for more than 40 000 healthcare financial management professionals Business Profiles are funded through advertising with leading solution providers Learn more Content for this Business Profile is supplied by TransUnion This published piece is provided for advertisement purposes HFMA does not endorse the published material or warrant or guarantee its accuracy The statements and opinions of those profiled are those of the individual and not those of HFMA References to commercial manufacturers vendors products or services that appear do not constitute endorsement by HFMA Publication Date Tuesday September 01 2015 Please login to add your comments Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment patient satisfaction and portal adoption for meaningful use HFMA Business Profiles Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value Somnia President and CEO Marc Koch MD MBA explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes HFMA RESOURCE LIBRARY Large Health System Drives 10 UP Patient Payments and 10 DOWN Billing related Costs Faced with a rising tide of bad debt a large Southeastern healthcare system was seeing a sharp decline in net patient revenues The need to improve collections was dire By integrating critical tools and processes the health system was able to increase

    Original URL path: http://www.hfma.org/Content.aspx?id=40651 (2016-02-10)
    Open archived version from archive



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