re: why are us healthcare providers never paid for over 50% of what is owed to them by their insured...

8/14/2019 RE: Why are US healthcare providers never paid for over 50% of what is owed to them by their insured patients and more than 80% of what is owed to them by uninsured p

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The Return On Investment Results

2009 Medical Pay Solutions

The Average Return is Approximately $50,000 - $100,000 Per Doctor Annually

Real-World Summaries from a Sampling of Custom AnalysisFull Reports from the Summaries Below are Available for yourReview.

This is a very limited view of the type of information returned in the completed spreadsheet. All

categories of the collected data will be made available for your review and consideration. These areYear One projected returns only.

What will the returns of your cost analysis show?Are youprepared to see how much you are losing weekly by notimplementing the A-Claim Revenue Recovery Solution?

For your ROI - Please contact Tracy Tytko @ 216-225-1485


2/21

Impacting Your Practice


This Big Squeeze

Over the last seven years the insurance payer payments have gonedown.

Patient billing by you has doubled and tripled in some cases.

In the Patient-Pay Sector the National Average is

49.3% Bad Debt*Literally 50 cents of every dollar is either sitting in very slow pay or non-paid

status.

Everyone is looking at how to solve this before it creates such financialpressure

you have to consider laying off people, adding more hours or

treating even more patients in a given day.


3/21

Systemic Problems


Impacting You Right Now

A doctors day usually begins long before the office opens andlong after the office

closes, making rounds at hospitals, record keeping, researchingillnesses, personal

education, medical records and consults... all in between, before

or after hours.

Staff, especially if they are provided by a Medical Staffing Servicehas apathy for the

process and does not care about what does not affect themdirectly.

Billing inefficiencies cost the practice thousands in supplies, manhours, postage

and outside billing or collection services. Doctors are forced to see more patients per day than they wouldlike to in order

to provide quality care and be able to afford new equipment andkeep the


4/21

Statistics


Industry Statistics

Deductibles, co-pays and out of pocket expenses for patients is going up andwill continue to.The amount of uninsured self-pay patients is rising and will continue.

Instant insurance verification is a focus for the industry.

Patients do not understand their policies or plan designs

2.5 trillion dollars will be spent on healthcare this year in the USA.

One trillion of this will be billed to patients.

Billions will go uncollected.

Most large groups and hospitals are trying to find a solution to thisright now.

Practices operate at about 4% profit margins.

The average cost of sending a statement to a patient is $9.00

Healthcare reform of any kind will include the patientpaying more of the bill.


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Systemic Problems


Whats Not Going On In Your Billing Departments

Many practices think they do all of this through their PMS or EMRprogram.It just is not so.What you might be thinking . . .

We already have all of this.

We have very low bad debt. We already have instant insurance verification. Our patients would not like us telling them what

they owe and asking for payment during their visit. We have been doing things this way for years and it works. We dont have the time to change or add new procedures.

Online Verification & Online Billing does not go far enough

addressing this growing problem.In each case we improved these processes and will show you how.

We can show you how easy it can be to keep up with what theindustry says is your resolve.

After you see what we offer, you will see your misperceptions are just a

condition of thinking about your practice with traditional processes that lackthe newest technology that address your current needs.


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Systemic Problems


Negotiating Payment for Your Services

Your staff negotiates with Patients for what they donot

understand about their own insurance policy, and

you oftenagree to take less than they owe, in the hopes theywill pay.

You negotiate and provide discount rates for theuninsured,

who often pay more for your services than thosewith insurance.

You negotiate with Billing Companies for the lowestrate to

collect your regular patient revenue.

After all of that, the national average of 49.3% stillwill not

pay, or will not pay efficiently with your currentsystems.

In no other business is this such a common practice so long afterservices have been provided.


7/21

Have you examined your

bottom-line lately?

Its time to add a new billing tool that canrescue up to

$100,000 Per Doctor Annually.

Take a closer look at the new technology that2009 Medical Pay Solutions


8/21

Who We Are


Authorized National Distributor

A wholly owned subsidiary ofBlueCross BlueShield of SC that

holds thepatent-pending proprietarytechnology .

The A-Claim System is the result of10s of Millions of Dollars in

development and over 3 years inbeta-testing by thelargest insurance payer in theIndustry andWorks with over 1800 Insuranceproviders,

A Full-PartnerHonoring All Major Credit Cards.


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Industry Trends


The system is inefficient, consuming15% or more (of your costs) compared to 2%for the retail payment system.

We expect real-time submission &adjudicationOf claims will gradually become more wide-spread.

MGMAsProject SwipeIT

Gains tractionfor magnetic stripe

machine-readableenrollment

ID cards.

Endorsement

are growing forthis initiative.

Since 2001 Patient Out-of-Pocket costs havetripled.

Supporters include:Humana & UnitedHealth


10/21

The McKinsey Report


Bad Debt Statistics

Providers need to create a retailrevenue cycle

36% of Patients have a Balance of 60

Daysor More Past Due Currently $60 Billion in Patient Bad Debt

(5% of Patient A/R) Expected Rise is 68%by 2015

Just a 1% increase in bad debt with a 4%

operatingmargin equals a whopping ___% Loss in

_____

Right now transactions move in batcheslong after

the patient leaves the doctors office.

Providers must become firmer at timeof treatment.


11/21

Industry Revenue Concerns


Providers could eventually givegood-faith estimates by usingvendor pricing tools.- HFMA Conference 2009

Revenue Cycle Strategies Conference

Patient-Friendly Billing providethe greatest impact to consumers,clinics and hospitals.

- HFMA 2009 National Conference Redesigning workflows that

improves financial outcomesachieves a better patient financial

experience.- HFMA November 2009

HFMA 2009


12/21

Industry Revenue Research


The patient has become the new target for the collection efforts.

- MGMA October 2009

High deductible health plans, health savings

accounts and uninsured self-pay patients arechanging the world of ProfessionalPractice Management.MGMA October 2009

The fastestgrowing areaof collectionsis your patients.

MGMA 2009


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Systemic Solutions


It is a model that works in most industries.

Physicians have to wait to send the bills until the health plan adjudicates theclaims.That process can take weeks and the likelihood of getting paid diminishes as

the clock ticks.

The McKinsey Quarterly reports that physicians only collect about 50 percentof the patients portion of the bill, adding up to about $60 billion in bad debteach year across theentire health care system.

If physicians cant determine what patients with theseplans owe

Bill For Your Services When They Are Delivered.


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Revolutionizing the System


The Quick View

With A-Claim there is no more need to:

Send Statements.

Wait for Payments.

Argue about unexpected charges foryour professional services rendered.

Pay Postage.

Pay Exorbitant Rates toBilling & Collections Agencies.

Traditional Billing Cycles The A-Claim Billing Cycle


15/21

The Suffering Is Real


You are Already Feeling The Pain. . .

Even if you think are holding your own now:

Over the last seven years the payer payments have gone down and thepatient billing by you has doubled... or tripled.

This is expected to get worse and is expected to double again within a

couple of years.

There are initiatives under way like Patient Friendly Billing & Project

Swipe

This is a Modular Add-On Component and will enhance your PMS or

EMR systemsthat you currently use.

Everyone is looking at how to solve this before it creates such financial

pressure youhave to consider laying off people, adding more hours or treating more

patientsin a given day.


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The Time To Respond Is Now


. . . And How You Operate Will Improve!

Our system is a one of a kind program and does not require you tochange how you operate.Our Patent-Pending system is developed by the largest insurance payer inthe country.

They considered the intricate details of practice needs for integration, designsimplicity andmeeting industry standards and compliances.

It will not add time to your staffs efforts and will dramatically reduce their

workload andfrustration levels so they may better serve your patients and practice

needs.

Patients love the systems real-time cost estimating and payment options

with deferredautomated billing and monthly auto-pay options. Practices grow with this

payment option.


17/21

Endorsements


Orange County Medical Association

As OCMA, one of thenations largest physiciansocieties continues toexpand thevalue-added productsand services offered to

members, A-Claim isa perfect fit in thetoolbox of medicalpractice managementsolutions,said Michael B. Hurwitz, M.D.,president of OCMA.

July 2009

I encourageMembers tocarefully evaluatetheir line of services.


18/21

Practice Management Benefits


Why Offer A-Claim as a Value Added

Service For All Your Patients or Accounts

By partnering with A-Claim your clients know you are keeping them on thecutting edge of profitability, and that you are concerned about theirprofitability and retaining them as a client.

What happens once the paperwork is completed:

All set up, training and service is provided by PHT.The parent company: Preferred Health Technology

All equipment is customized with your payers prior to shipping.New payers can be added as needed.

Equipment is shipped and ready to plug and play.

PHT will contact you to schedule a webinar to review set up and training

for all staff.

Rep will visit to insure all systems are working properly.

Ongoing training and support is offered 24/7, 365 days per year at no

charge.

The whole process is two to four weeks Results are instantaneous.


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Summary


Features & Benefits

Product Features

Real-Time Eligibility

Real-Time Claim

(Limited Areas)

Real-Time Payments

Delayed Payments Payment Plans

Auto Payment Capture Multiple Terminal Options

Excel Based Report-Tool Multi-Merchant User & Location Application

Benefits to Provider

Baseline of patients financial responsibility Saves time & increases staff productivity Estimate patient financial responsibility Speeds payment of claim Accelerates cash flow Discounted merchant fees Interchange management Speeds payment decreasing statement mailing Eliminates refunds and secures payment at POS Fosters patient satisfaction Increases cash flow and allows for forecasting Decreases/eliminates staff time for payment entry

Shrinks collection accounts Adapts to YOUR environment Multiple entry modes

Data integration & import capability

Custom reports in seconds

User based authority levels

1 solution for multi-takings with online administration

Staff training provided


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Summary


Features & Benefits

Product Features

Consolidated Reporting

HIPPA & PCI Compliant

User Friendly

Quick Implementation

Cost Effective

Benefits to Provider

Chain/Outlet level reporting

Easy electronic statements

Secure patient data

Reduce fraud risk One solution for multiple tasks

Easy online administration

Staff training provided

Fits with existing processes with minimal chan

15-30 days setup to fully operational

Minimal IT involvement or resources required

Low cost hardware

Low monthly program fee


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Isnt it time for a FiscalCheck-up?

Explore Revolutionary Procedures &Technology

Available to Rescue Your Bottom Line.

Includes Video Introductionwww.medicalpaysolutions.comwww.medicalpaydemo.com

Tracy TytkoMedical Revenue Consultant

Northeast Ohio

216.225.1485
http://www.medicalpaysolutions.com/http://www.medicalpaydemo.com/http://www.medicalpaydemo.com/http://www.medicalpaysolutions.com/

re: why are us healthcare providers never paid for over 50% of what is owed to them by their insured...

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