The state of hospital billing has stayed the same over the last number of years with no provider able to maximise the advances of technology. The reason for this is that the claims process in Ireland is complex with many stakeholders required to do their part for successful billing. This has led to greater levels of unbilled, which leads to cash flow challenges. More people are involved than ever before in managing the spinning plates and trying to keep the revenue cycle management a well-oiled machine.
Our approach to the challenges
I appreciate this is difficult for providers. I started the business three years ago and only in the last few months have we all the components to make this a viable option. Our approach to the challenges hinges on a model we used from the six sigma input-output model which “inputs represent the flow of data and materials into the process from the outside. The processing step includes all tasks required to effect a transformation of the inputs.”
Hospital billing input
The inputs are a critical part of the juncture in claims processing. The forms from the insurers require information from the patient themselves, the hospital, and the various doctors who administered the care. Relying on so many stakeholders inevitably leads to errors in the claim form. Simple things like a missing patient signature can set hospital billing back by 30 days – precious cash flow tied up by a simple mistake.
In MedoSync, we see the input’s aspect of claims as everyone’s responsibility. However, if you are going to ask the patient, hospital, and consultant to play their role, there should be a focus on technology to make this as simple as possible. Currently, these three stakeholders use different methods from each other, and these differences require a person pulling them altogether which causes errors. MedoSync gives everyone access to the same platform and the data arrives at the same place. This simplifies the work of processing and time spent processing.
One way this can be realised is at the patient access level. In a private setting, the vast majority of patients are arriving for a planned procedure and in many cases are arriving to fill in a form before their treatment. Instead of having the inevitable busy period, patients can arrive with their “paperwork” complete. Patient access teams can send the form the night before, verify their details and check the all-important signature.
MedoSync was able to reduce common claim form errors related to patient information by 50% using this method, thereby speeding up the payment and getting the hospital paid.
Hospitals are losing 6-9% of their revenue due to leakages in the billing process. MedoSync stops these leakages by creating the invoice in real-time and ensures hospitals get paid in full.
I am taking more time for reflection and writing up posts related to MedoSync’s areas of expertise: medical billing, healthcare, technology, and being a start-up in that ecosystem.
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