Becker's Hospital Review

19 Executive Briefing Zotec Partners is an industry leader in revenue cycle and practice management services for physicians and health systems, managing in excess of 70 million medical encounters annually. The company is committed to the continual pursuit of excellence, delivering effective solutions through its proprietary technology, personalized service and measurable client results. Currently, Zotec Partners serves more than 8,000 physicians in all 50 states. How technology can reduce friction If providers successfully employ technology to determine an estimated amount of friction, they can then fine-tune the best next steps to boost a patient's likelihood of paying. Zotec caters its technological solutions to each patient to ensure they use the platform that best suits their needs and preferences. "We personalize patients' profiles based on what they are most likely to appreciate in terms of collection methods," Mr. Law says. "If a patient is a millennial, they may want a text telling them to pay online. If a patient is 70, they may want to receive a text because their grandkids are texting, but they may still want to hand-write a check and mail that in." Through its individualized platforms, the payment process is eas- ier for patients and will likely translate to a higher propensity for patients to follow through on bills. As the industry continues to trend toward the consumer, providers cannot forgo the impor- tance of minimizing friction, particularly because value-based outcomes and patient satisfaction scores dictate payments. Employing a third-party revenue cycle management partner can empower healthcare organizations to reduce the friction with patients and help providers bolster their bottom line by increasing collections. A 2017 Navicure survey found 51 percent of providers say it takes an average patient more than three months to pay their full balance. However, only 18 percent of patients claim it took them longer than three months to pay their last balance, indi- cating a lack of consensus between the two parties on this topic. Whether a lapse in communication or varying perspectives on payment dates, many providers and patients are not on the same page regarding payments and their timeliness. Using a third party vendor is becoming more commonplace in the industry, especially as healthcare executives are increasingly adopting more responsibilities, such as improving infection control protocols or meeting CMS' reporting requirements. Letting the patient billing experience fall to the wayside may cost a provider significant amounts of money, which is where a revenue cycle management partner comes into play. Black Book projected the market for outsourced revenue cycle management services is likely to increase at a compound an- nual growth rate of 26.5 percent in the next two years, reach- ing $9.7 billion by 2018. On a micro-level, hospital executives understand the benefits a revenue cycle management partner can offer. The survey found almost 50 percent of hospital CFOs acknowledged outsourcing has become a more viable alterna- tive to in-house management in 2017. Zotec works with providers around the United States to improve the payment process so practices and hospitals can focus on other areas, such as clinical delivery. Mr. Law says Zotec brings patients into the mix much earlier in the process, which helps eliminate some of the missteps that can occur along the way with payments. The company will file a claim to the insurance company on be- half of a practice. Once completed, Zotec will send the patient a text message informing them that Zotec filed the claim and the patient should be aware they will likely owe a certain amount of money. In the text, Zotec tells patients they will be notified once the insurance company adjudicates that claim. "The big problem with consumers is the surprise," Mr. Law says. "They get a bill for $5,000 and they didn't even know. They are getting billed for an entire deductible maybe in the first en- counter they have [with a provider]. That's a big surprise for $5,000 that they don't have and for [care] they don't think they need. Who is going to make that choice?" Being transparent with consumers is increasingly important, and having an open dialogue about the estimated cost of care will often translate to reduced friction. Healthcare payments do not work the same way as other industries. If an individual fails to make a credit card payment repeatedly, this will affect their Fed- eral Insurance Contributions Act (FICA) score. If a patient does not make a payment for a healthcare service they received, this will not impact their FICA score, making it exceedingly difficult for providers to exercise disincentives when collecting payments. "I don't have a hammer to affect people's credit ratings," Mr. Law says. "[Instead], we introduce things earlier in the process by edu- cating patients on their deductible and why they owe this money. We do it through technology, versus the old days, where you'd send two or three payments and hope patients paid them." Zotec offers a portal that allows patients to stay updated on their insurance information and set up payment plans through a text or integrated voice response system. Texting is a preferred method of communication for a large portion of patients, and using a platform that bodes well with patients will fare well for providers in receiving payments. "Text messaging is by far the [most popular] thing when you get into the consumer space," Mr. Law says. "We have to meet consumers in spaces they understand in order for them to ap- preciate the exchange." Technology can also minimize the likelihood of a denial due to inaccurate or incomplete information. Equipped with editing engines, Zotec has solutions that compare a claim to a patient's policy information to ensure there aren't any discrepancies that would prohibit a provider from receiving payment in full. Ad- ditionally, Zotec does eligibility checks and verifies statements prior to sending those to patients. "We wouldn't send a bill for a high-dollar amount without that [the verification]. Those are the ones that cause the most friction," Mr. Law notes. With technology, providers can avoid friction that impedes a successful payment process. Zotec was aware of the consumer- ism shift within healthcare nearly five to seven years ago and has been creating solutions to address this trend. Providers that fail to prioritize the consumer will fall behind their competitors, both in terms of reputation and finances, as patient satisfaction is a core component of the value-based healthcare era. With the rise of high-deductible health plans, patient-focused care is here to stay and providers should prepare to thrive in this landscape. n

• Cover