Winning in the healthcare ecosystem is all about delivering moments that matter. Consumers, clinicians and administrators alike connect to these moments and remember them long after the experience is over. Healthcare providers and communities are often bombarded by countless software products and solutions that guarantee superior productivity and service delivery. But the last thing any healthcare provider and/or patient needs is another solution that rains down a torrent of instructions, procedures and complexity. From the healthcare provider’s standpoint, the snowballing uncompensated care and unreimbursed costs remains a pressing challenge. The growth in uncompensated care can be attributed to rising unemployment and the lack of insurance coverage for millions of Americans, despite the availability of the Affordable Care Act. Amid the ongoing, global pandemic, the pressure is mounting as providers are experiencing dwindling efficiencies in determining patient eligibility.
Firstsource, is fueled by the vision of experts in Revenue Cycle Management, serving over 700 hospitals in the U.S. with its differentiated financial process management and patient engagement technology-based platforms MFocussm and MGagementsm. Firstsource’s commitment to the ‘Digital First, Digital Now’ approach, accentuates human capabilities by leveraging rapid advancements in cloud, Software as a Service (SaaS) and automation technologies, to solve specific business problems. “The approach helps our clients build digital-first ecosystems that redefine performance, optimize human interaction and harmonize the human-machine relationship to produce the greatest impact,” says Vipul Khanna MD & Chief Executive Officer, Firstsource. “Firstsource is committed to empowering healthcare providers and health plans, helping them achieve stronger financial foundations while also assisting patients with their financial journey.”
Built on digital technologies, Firstsource’s solutions span the healthcare community and service value chain, and go beyond addressing the challenge of predicting patient eligibility. Focused revenue cycle solutions across eligibility, enrollment, business office management and collections, help hospitals and health systems maximize reimbursement, increase cash flow and reduce bad debt. “We work with our clients to simplify the financial experience for uncompensated care patients, giving them peace of mind while reducing uncompensated care costs for our clients. Our digital solutions help providers engage with patients at the point of clinical encounter and secure self-pay funding options for the uninsured,” adds Khanna. “We deliver these benefits through our flagship patient eligibility solution, MFocussm”.
Taking a patient-centered approach to fostering financial responsibility
Imagine if both hospitals and patients could skip the indefinite wait involved in verifying insurance, patient registration, financial determination and so on. MFocussm allows real-time, automated insurance verification, cascading insurance detection, Medicaid screening and financial assistance application automation, all while the patient is being registered or before-hand in pre-service efforts. Whether the patient has state-specific Medicaid, financial assistance or coverage through the federal or state insurance exchange, MFocussm determines the patient’s obligations and coverage alternatives in real time.
In scenarios where a patient doesn’t have insurance, MFocussm captures any potential missed/unknown insurance and leverages an in-built screening tool to determine the most appropriate funding source. “It does all of this at the point of registration – before patients leave the hospital,” beams Khanna. “MFocus’ fast and efficient front-end determination enables clients to increase reimbursement probability by ensuring that patients understand their financial responsibility before leaving the facility.”
Creating retail-like experiences that stick
Modern healthcare consumers are accustomed to customer-centric experiences on popular e-commerce and tech platforms. Demand for similar customer-first experiences, speed and functionality, is taking root in the healthcare industry. “Enterprise technology is racing to meet these changing expectations. At the same time, there has been a shift in payment responsibility from health plans to patients, making it more challenging for providers to recover net revenue,” elaborates Khanna. “Firstsource is playing a crucial role in evolving the healthcare technology experience so healthcare providers can stay abreast with the technology curve. The mission is to match capabilities with the likes of millennial tech companies and deliver a seamless, online customer/user experience in a traditionally complex clinical and financial environment.”
The compounding issues of lower payment realization for healthcare providers and an increased number of unpaid bills are grim realities today. The effectiveness of collections follow-up via phone calls and letters has declined dramatically. The caller-ID feature on phones makes it easier for customers/users to screen calls and decide which calls to answer. While outbound marketing calls (robocalls) have increased, patients often decline calls from unknown numbers – often a part of collections follow-up campaigns.
“In fact, almost 70 percent of providers indicate that it takes more than a month to collect from patients using traditional letter and call methods. Nearly one-quarter of working-age adults have past-due medical debt. Furthermore, collections efforts are an expensive and time consuming process that involves more than merely collecting from health plans,” expresses Khanna. “It forces providers to hire large billing teams and to augment their efforts to educate consumers about healthcare finances.”
To keep pace with the changing consumer expectations and challenges, healthcare providers need to optimize their collections and patient billing practices. Firstsource’s MGagement, a user-friendly, digital engagement solution integrated into the provider’s financial service process ensures an efficient, modern collection process through improved communication and patient engagement. MGagement also enables the provider to improve their cash flow and revenue performance. Additionally, providers are able to deliver a full-service financial experience for patients, improve patient-liability recoveries, reduce bad debt expense, and lower collections expense. “By creating a retail-like financial experience that is seamless and easy-to-use, hospitals achieve greater contact and payment rates that exceed industry average recovery best practices significantly. Also, providers achieve greater patient satisfaction scores with our digital collection process,” adds Khanna.
MGagement’s acts as a seamless one-stop portal with user-friendly navigation fundamental to customer-centric websites. These features are custom-branded for each hospital and compatible with all EHR systems. With an intuitive-experience, patients can conduct healthcare financial interactions from their personal devices, wherever and whenever they want. In every aspect, the solution is built to provide a superior customer experience.
Accelerating an automation-first mindset
Healthcare providers need Intelligent Automation to cost-effectively drive digitalization, attain scalability and deliver flexibility that meets crucial hospital administrative reporting requirements. “Revenue enhancement and cost transformation opportunities exist throughout the healthcare industry,” explains Khanna. Intelligent Automation helps modernize and integrate these systems and processes, alleviating the time, effort and financial constraints facing providers in the new normal.
Intelligent Automation fuses Robotic Process Automation (RPA) with Machine Learning and Artificial Intelligence (AI) to elevate RPA capabilities, enabling customers to make more complex decisions using not only structured but also unstructured data. Automating unstructured content involving text and images allows the human workforce to focus on high value patient-centric activities such as improving case management, handling exceptions and improving the patient care experience. Hospitals need these superlative outcomes to thrive during the pandemic and beyond.
Simplify the financial experience: A story that resonates deeply
Powered by Firstsource’s foundational ‘Digital First. Digital Now’ approach, Firstsource’s impressive track record of helping healthcare organizations reinvent operations and business models resonates with growing expectations around simplified financial experiences. The Firstsource story is truly embedded in the anecdotes of hospital teams and their patients. “Everything that goes into the non-clinical part of the patient experience is a complicated maze of financial challenges for both patients and hospitals,” says Khanna. “Hospital leaders rely on us to simplify the financial experience for both their patients and the team members in their organization. With our solutions, hospitals achieve a stronger financial foundation, while patients experience clarity and peace of mind about how to pay for their care,” he concludes.