Catholic Health, a health system serving the Long Island region in New York, has 16,000 employees across six acute care hospitals, three nursing homes, a home health service, hospice and an extensive network of physician practices.

THE PROBLEM

The health system was preparing for a revenue cycle transformation centered on Epic Revenue Cycle as the core technology. It knew that meant there would be new opportunities to engage patients digitally and modernize the financial experience for patients.

Patient experience is at the core of Catholic Health's vision, and it understood that digitizing revenue cycle operations needed to be part of that strategic portfolio.

"As an organization, we did not collect a significant percentage of patient payments pre-service, or have access to technology that would support the operational workflow," said Jade Wanzek, assistant vice president for the patient access revenue cycle.

"We made some efforts to notify patients in advance about their cost of care, but it was administered inconsistently," he added. "We wanted to be able to collect more payments pre-service and do this while also delivering patients a clear understanding of their costs."

PROPOSAL

Catholic Health was on Epic's electronic health record and decided to implement Epic Revenue Cycle. It needed a payment vendor that could support the health system's pre-service collections objective and offer additional options for electronic payments.

"Our single billing office also needed a payment solution that would help transition from our legacy billing system to Epic," Wanzek explained. "InstaMed could integrate with Epic to enable an effective and engaging patient financial experience from pre-service to billing and payment.

"The InstaMed integration would give us the ability to take payments during the pre-service workflow, as well as save tokenized payments for future visits and the SBO activities," he continued. "The integration would also allow us to create payment plans for patients with higher balances and collect and post those payments automatically without manual effort from staff."

"We now see the pre-service experience as more than a way to collect demographic information. It's a strategic approach to our revenue cycle operations and complements our organization's vision."

Jade Wanzek, Catholic Health Services

Finally, InstaMed integration would enable a secure and easy payment experience for patients in MyChart, he added.

"The InstaMed External Payment Page Integration would allow patients to make credit card and bank account payments in MyChart while keeping sensitive data from touching our servers, which would help us minimize our PCI scope," he explained. "The MyChart integration would not only [satisfy patients], but would also help improve our patient payment collections efficiency."

MEETING THE CHALLENGE

The InstaMed technology was integrated into Catholic Health's financial clearance center operations to engage patients for pre-service collections and financial planning. As a result, pre-service collections and patient education are now core components of Catholic Health's financial clearance functions.

"We've combined our real-time eligibility solution with the Epic estimator and InstaMed for an end-to-end best practice workflow for price estimates," Wanzek noted. "When it's determined that a patient has a payment responsibility of $50 or more, our financial clearance team reviews the patient's benefit structure and notifies the patient.

"When the patient is a known 'digital user,' our team utilizes Epic's digital communication methods like email, MyChart and SMS messaging to notify the patient that a price estimate is ready for review," he continued.

"After delivering the estimate, our financial clearance staff follow up with a phone call to the patient and offer to further explain how their benefits apply and offer to collect the payment."

Staff can take payment if the patient agrees to pay at that time. The InstaMed integration allows staff to securely key the payment into Epic or use the external payment page to accept the payment.

"If a patient expresses concern about a high payment amount during the pre-service conversation, our financial clearance staff suggest a payment plan option that better fits the patient's financial situation," Wanzek said.

"During this conversation, we can clearly discuss the payment amount and plan duration with the patient and establish a payment method for automatic deductions.

"This step ensures that patients understand their financial responsibility and helps them feel more comfortable with the payment amount," he added. "Once the patient has agreed to a payment plan, we can set up a traditional installment payment plan or use Epic Auto Pay to set up automated payments."

InstaMed integration in Epic lets these payments collect and post automatically, allowing payment plans to run without manual effort from staff. Whether or not the patient pays any amount pre-service, Catholic Health creates a foundation for post-service patient payments by engaging the patient early on.

RESULTS

Before InstaMed, Catholic Health was not collecting a significant amount of patient payments pre-service. Now, staff members have been able to collect payments easily and securely during their pre-service interactions with patients, Wanzek said.

"This integrated patient financial experience led to collecting more than $1 million pre-service in just the first year of implementing the solution," he added.

Pre-service conversations with patients have allowed the staff to discuss payment plans with patients who have concerns about higher balances. The technology makes it easy for the staff to set up these patient payment plans pre-service, which has led to a 50% increase in payment plans created, Wanzek reported.

"As a result, we saw a 112% increase in installment payment volume, an increase of $1.3 million year over year," he said.

The InstaMed External Payment Page Integration with MyChart enabled Catholic Health to offer patients a secure and convenient self-service online payment option, he added.

"We saw increases in MyChart payment and transaction volume between 2020 and 2021: Total payments increased 27.5%, while transaction volume increased 28%," he said.

ADVICE FOR OTHERS

"Implementing new technology gives any organization a great opportunity to rethink traditional operating models. Technology should be a springboard to break down silos and reinvent how core business models provide value," Wanzek advised.

"For example, we now see the pre-service experience as more than a way to collect demographic information. It's a strategic approach to our revenue cycle operations and complements our organization's vision," he added. "Don't simply add on new technology without taking the opportunity to evaluate your business operations holistically."

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.