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© 06/12/2022 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. 1 Help Increase Patient Collections and Improve Patient Satisfaction Best Practices for Keeping Patients Financially Engaged

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© 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.1

Help Increase Patient Collections and Improve Patient Satisfaction

Best Practices for Keeping Patients Financially Engaged

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2 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.

Our Speakers Today

Travis Mendenhall, FHFMA, MFASr. Systems Analyst, Gwinnett Hospital System

David DykeVice President, Revenue CycleRelayHealth

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3 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.

Part 1: Market Dynamics• Patient• Market• Quality

Part 2: Case Study: Gwinnett Hospital System• About Gwinnett Hospital System• Strategies for Change• Results & Best Practices

Discussion & Questions

Agenda: Doing the Impossible

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4 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.

Part 1: Market Dynamics

• The Patient’s World View

• The Market is Shifting at an Alarming Rate

• Qulaity Madters

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Concept% of People who

THINK they understand the

concept

% of those that THINK they do, and ACTUALLY

understand

% of People (Total) who ACTUALLY

understand

Co-Pay 100% 72% 72%

Deductible 97% 81% 78%

Coinsurance 57% 59% 34%

Max Out Of Pocket 93% 59% 55%

Training: Patients

Source: Consumers Misunderstanding of Health Insurance, Journal of Health Economics & Washington Post, August 2013http://www.washingtonpost.com/blogs/wonkblog/wp/2013/08/08/do-you-understand-health-insurance-most-people-dont/

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Broad Consumer Mobile Internet Access

Trending

Americans90% Have Cell Phones

58% Have Smart Phones• 83% : Age 18-29 • 49% : Age 50-64 • 47% : In < $30k

Households• 81% : > $75k+

Activities• 82% : Pictures• 81% : Texting• 50% : Email• 49% : Location• 31% : Health• 29% : Banking

& Payments

Source: Pew Internet & American Life, January 2014

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Technology Adoption and Usage

Cell Phone

Internet

Broadband

0% 25% 50% 75% 100%

Internet & Mobile Phone Adop-tion

All Adults Adults +65

18-29 30-49 50-64 64+0%

10%20%30%40%50%60%70%80%90%

100%

Internet Use Frequency: By Age

Daily 3-5x WeekSource: Pew Internet Project, Older Adults and Technology Use Report 4/3/2014

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• Seniors with annual household income of $75,000 or more, 90% go online and 82% have broadband

• Seniors with annual household income $30,000 or less, 39% go online and 25% have broadband

• 27% of Seniors own a tablet, e-book reader or both

• 18% of Seniors own a Smart Phone

On the Topic of Seniors and Technology

Source: Pew Internet Project, Older Adults and Technology Use Report 4/3/2014

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Online account management is growing across all demographics for all markets

Online Account Management

Source: Pew Internet & American Life Project, Generations 2010, 12/2010

18-33 34-45 45-55 55-64 65-73 74+0%

10%

20%

30%

40%

50%

60%

70%

Regularly Paying Bills OnlineBy Age Group

Growing 10-14% per year

Continued steady usage

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10

1 in 5 Employer Sponsored Patients in HDHP

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

0%

4%

5%

8%

8%

13%

17%

19%

20%

29%

Conventional HMO PPOPOS HDHP

30% Growth

62% Growth

12% Growth

Source: Kaiser Francis Family Foundation, 2013 HEBS

5% Growth

ACA Impact?

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Collecting Critical Financial Information

• Helps improve efficiency• Helps reduce risk• Assists in increasing

Patient Satisfaction

See Patient Here

Take Payment Here

Take Payment Here

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Your Past, Present and Future2011 2012 2013 2014 2015 2016 2017

Standard: 5010

Operating Rules: Claims

Operating Rules: Remittance

Operating Rules: Eligibility

Operating Rules: Claim Status

Operating Rules: EFT

Op. Rule: Referral/Auth.

Standard: EFT

Standard: Claim Attachment

Standard: ICD10Standard: ICD10

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Operating Rules

•Operating rules included in the ACA

•Defines common USAGE and CONTENT for HIPAA transactions

•Most obligations on health plans provide specific data

• If ANSI 4010/5010 defined HOW to communicate

• Then operating rules define WHAT to communicate

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Operating Rules for EligibilityCMS Adopted CAQH CORE Phase 1 & 2

Rule Areas Goals

SystemUp Time

• 86% availability per week (24 hours of down time per month)• Publish scheduled maintenance• 1 week advance notice for non-routine maintenance• 1 hour notice of emergency downtime

SystemResponse Time

• Real Time - Maximum 20 second “round trip”• Batch - In by 9PM, out by 7AM• 90% adherence

Benefit Response • Support 48 Service Types• Example: Medical, Physician , Hospital, Urgent Care, Mental Health

StaticFinancial

• Co-Pay, Co-Insurance, Base Deductible for most service types• Return In & Out-of-Network when different

Variable Financials • Return “accumulators” (Year to date)• Remaining Deductible, Out-of-Pocket

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Alerts Drive Action and Quality

•Alerts•Quick Confirmation•Other coverage alerts• Real-time alerts

within the HIS

•Registration Quality•Drive process

accountability

Patient hasMedicare but it’s actually an HMO!

The HMO is “Super Duper

Health”

DO SOMETHING

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Monitoring the Team

Team – 74%Registration QA Scorecard

• Alice91% (A)• Brett77% (C)• David45% (F)• Chris82% (B)

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Coaching the Individual

DavidRegistration QA Scorecard

• Pre-Admit88%• Lab24%• ER45%• Clinic31%

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Part 2:

• About Gwinnett Hospital System

• Strategies for Change: New Processes

• Strategies for Change: New Technologies

• Results & Best Practices

• Questions & Discussion

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Process and Technology

Using process and technology to empower staff to collect payments earlier and more often while ensuring patient satisfaction

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About Gwinnett Hospital System

Lawrenceville Campus• Acute Care• 89 Bed Extended Care Center• Outpatient Centers• Neuroscience/Stroke Center• Open Heart• Trauma – Level 2• Pain Management• Clinics• FY14

Duluth Campus• Acute Care• Inpatient Rehab Center• Outpatient Centers• Bariatrics• Orthopedics• Orthopedic ASC• Concussion Institute• Clinics

553Beds

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About Gwinnett Hospital System

• Employees 4964• Affiliated Physicians 850• Discharges 28570• ER Visits 140,308• Ambulatory Surgery 25,505• OP Diagnostics 217,057• Gross Revenue $2 Billion• Net Revenue $624 Million

FY 2014

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Our Challenges

•A need to increase overall POS collections­ High deductibles are the new normal

• Lost revenue/difficulty estimating patient bills• Confusing patient statements•High call center volume•Manual posting of credit card payments•Web savvy population expects consumer-friendly

payment options

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Our Goals

• Break down barriers to payment­ Inform patients of financial responsibility upfront­ Help patients understand their bills­ Provide convenient ways to pay­ Collect at multiple points during care process

• Reduce call center volume

• Increase cash posting efficiency

• Increase patient satisfaction and loyalty

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Strategies for Change

New Technology

New Processes

Staff is empowered to

collect payments earlier and more often

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Process Strategies

Patient Loyalty Program

Pre-Visit Calls with Estimates

FC Visits for All Self-Pay Scheduled Patients

Presumptive Charity Screening

Increase Collections and Patient Satisfaction

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Patient Loyalty Program

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Process Metrics

Financial Counselor Bedside Visits: 1673

Patients who made a payment: 23%

Patients who declined to pay: 58%

Requests for a payment plan: 17%

Requests for financial assistance: 2%

January 1 – June 30, 2013 *With 2 financial counselors

23%

58%

17%

2%

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Process Metrics

• Average collection per patient at the bedside$722

• Average collection per month from these same patients after insurance pays$100k

• Financial Advocate: average payment arrangements per month$350k

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Patient Satisfaction: Measuring the Impact

Did this new process give you a better billing experience than you’ve had with us before OR with another hospital system?

• Yes86%• No11%• Not Sure3%

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Agenda

• About Gwinnett Hospital System

• Strategies for Change: New Processes

• Strategies for Change: New Technologies

• Results & Best Practices

• Questions & Discussion

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Technology Solution Strategies

Bill EstimationAutomated POS

Collections

OnlinePayment Portal

Patient Friendly Statements

IncreaseCollections and Patient Satisfaction

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Automated Insurance Verification

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Automated Bill Estimation

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Automated Bedside Collections

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Online Portal Enrollment and Pay Now

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Adding Pay Now

•Adding Pay without enrolling feature brought: ­ 15% Drop in enrollment

­ 23% Increase in patient portal payments

•Reflects growing alarm over online security•Desire to keep personal information off-line

Pay Now

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Online Patient Portal/Enrolled Patient or Guarantor

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Pay by Account/Save CC Profiles

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Payment Plan Requests

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Printable Payment Coupon

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Online Provider Portal

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Provider Portal

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Patient View

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Account Details

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Processing Payments

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Processing Payments

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Processing Payments- Swipe Card and Real-Time Alerts

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Re-enabling Account/Disable Email Notification

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Provider Portal Reports

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Provider Payment Report

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Online Portal Enrollments

22,254 Total Enrollments (May 2010-Nov

2014)

$10,334,106 Collected

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Total Portal Collections

•$39,507,735 Total

•$8.4 million in the Last 12 Months

•Average Payments Per Month: $718,322

•Average Payment Amount: $200

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Online Portal Payments ̶̶̶̶ Since Go-Live May 2010

Pay Now$7 Million$18%

EnrolledPatients$10.3 Million26%

WebPay$22.2 Million56%

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Patient Friendly Statements

Helping patients understand what they owe

Clear and easy to read

Drive patients to online account management

Targeted messages by financial class

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Thinking Ahead…

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Ramping Up Adoption

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Agenda

• About Gwinnett Hospital System

• Strategies for Change: New Processes

• Strategies for Change: New Technologies

• Results & Best Practices

• Questions & Discussion

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59 © 04/15/2023 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.

Our Top 5 Best Practices

Implement Solutions to Automate Estimation/Eligibility/Presumptive Charity

Implement a Patient Loyalty Program

Implement/Optimize Patient Payment Portal

Implement/Optimize Provider Payment Portal

Automate All Patient Payment Cash Posting

P

PPP

P

Questions and Comments

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• Reduce A/R days • Maximize claim and

remittance processing efficiency

• Reduce claim errors and denials

• Reduce Medicare rejections by more than 95%

• Reduce IT expense

• Increase revenue and reduce bad debt

• Increase patient satisfaction

• Decrease patient phone calls

• Reduce postage expense by 20-30%

• Improve patient experience

RelayAccount™ RelayAssurance™ RelayAnalytics™

• Assess operational and financial performance

• Increase financial visibility • Isolate root cause of issues • Accelerate positive

organizational change

­­

Clears the path with patient financial visibility to help:

Efficiently manage patient accounts and make payments to help:

Assure the fastest route to remittance to help:

Analyze opportunities to determine action to help:

• Determine propensity to pay

• Increase self-pay collections and reduce bad debt

• Improve work flow efficiency and staff productivity

• Identify patients eligible for Medicare, Medicaid and charity programs

Revenue Cycle Solution Leadership

RelayClearance™

Improve Registration QA and Patient flow management to help:

• Increase patient registration data accuracy

• Reduce claim denials and rework

• Monitor patient flow throughout the visit

• Report on team performance and productivity

AhiQa and Ahi Lobby

End-to-End Revenue Cycle Solutions

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Thank You for Your Time and Attention!Please contact us for further information or to request a copy of

this presentation

RelayHealth800-752-4143

[email protected]