1. SELF – PAY
R
BILLING MANAGEMENT AND
PATIENT FINANCING
PROPOSAL
Presented to:
2. Mr. John Smith
Accounts Receivable
Via Health
Thank you for the opportunity to introduce our early out self-pay
billing management services and our exclusive patient financing
program with non recourse funding. I believe you will find that our
services can revolutionize the way accounts receivables are managed
at your facility.
Since the cost of our services is contingency based giving Via
Health a try is risk-free to you! Bottom line is that if we don’t collect –
we don’t get paid.
Our early out self-pay billing management services will increase
your cash flow and improve your A/R days. We can relieve the self-pay
headache by working your accounts as early as day one and up to day
sixty. The earlier you send your accounts to us, the less you have to
worry about. Let Via Health cure your headache.
We also provide a unique financing solution not offered by any
other vendor. Our patient financing option now available with non
recourse funding is increasing cash flow for hospitals nationwide. This
solution benefits both the patient and the hospital - the patient is
allowed more time to pay, and the hospital is not waiting years to
receive their money. Everyone wins!
We hope that you find the enclosed information educational and
helpful in assisting with your visions for new, more productive accounts
receivable management procedures. If you have any questions about
our services, please do not hesitate to call me personally.
3. Sincerely,
Ron Thomas
President
www.viahealth.com
(719) 473-5444
Fax (719) 633-6384
415 North Tejon St. #200 Colorado Springs, CO
80903
Dear Mr. Smith,
Thank you for allowing Via Health to provide you with the
enclosed Self-Pay Billing Management and Patient Financing Proposal.
Via Health will provide Via Health with a service that we believe is the
most effective and “community sensitive” self-pay billing program
nationally available. In addition, we are also able to provide your
community with a creative financing alternative.
We work diligently at avoiding the antagonistic relationship that
often occurs when a patient’s healthcare account is outsourced to a
third-party. We also offer the option to do business as a third party
which can increase resolved accounts by a higher percentage; (this is
dependent upon your community and your hospital’s culture). By
maintaining a seamless relationship with your patients we greatly
increase the percentage of accounts resolved satisfactorily. Achieving
a high collection success rate on your accounts is in keeping with Via
4. Health’s ultimate goal: to provide outstanding service to our clients
and their patients.
If we can provide further information in order to meet the needs
of your organization in selecting a self-pay billing management and/or
finance company we will be happy to do so. We thank you for your
interest in Via Health and hope that we are able to work with Via Health
in the near future. Please don’t hesitate to contact me should you
have any questions.
Sincerely,
Bob Lewis
Chief Operating Officer
www.viahealth.com
(719) 473-5444
Fax (719) 633-6384
415 North Tejon St. #200 Colorado Springs, CO
80903
5. HISTORY
MCRS, Managed Care Reimbursement Services, is the parent
company of Via Health, which was founded by Ron Thomas and Bob
Lewis in the year 2000 in Colorado Springs, Colorado. The company
was founded on the vision to bring ever increasing value to our clients
by providing them with services designed to maximize their profitability
and the
effectiveness of
their business
office while
maintaining an
acute awareness
of the
patient/provider
relationship. Via
Health has
customized its
operations in order to provide the best services possible for hospitals
and their communities nationwide. We strive to provide the best care
possible through financial health. The financial health of the hospital
and its patients is our primary focus. We understand that there is an
ever increasing need to convert every receivable into cash. It is also
important to maintain or even improve the hospital’s relationship with the
community and especially with its patients. To address this need Via
Health designed its Self-Pay Management program and our Patient
Financing options. The Self-Pay Management program was designed to
enhance business office operations by lowering costs, improving
efficiency, and increasing bottom line profits. Via Health will provide Via
Health with an effective process that will increase cash flow from self-pay
receivables by providing a financing alternative to all of your patients.
Ron Thomas is President/Chief Executive Officer of the company. He
graduated from Colorado State University with a Bachelor of Science
6. degree in Business. Ron’s background includes over thirty years of
business experience, including over fifteen years in the healthcare
industry. Ron has received several awards for creative and innovative
marketing campaigns, both nationally and internationally. Ron has
specialized experience in healthcare finance, marketing, and business
development.
Bob Lewis is Vice President/Secretary and Treasurer of the company.
He graduated from the University of Colorado with a Bachelor of Science
degree in Business. Bob’s background includes twenty years of
experience including ownership of manufacturing, consulting and service
companies. Bob has extensive experience in information systems
development, project management and business systems analysis in a
variety of industries.
REFERENCES
MR. Hank Rem – Director of Patient
Financial Services
303-544-5750
311 Mapleton Avenue
Boulder, CO 80308
Ms. Maria Simmone-Director of
Revenue Cycle
860-585-3179
Brewster Rd.
Bristol, CT 06011
7. Holly Parkinson-Director of Patient
Financial Services
208-239-2107
651 Memorial Dr.
Pocatello, ID 83201
Ms. Jane Cain – Manager, Patient
Business Services
7 34-324-3516
2333 Biddle Ave
Wyandotte, MI 48192
OUR ETHICS
Via Health offers a variety of
different programs that can be easily
customized to fit the needs of the
hospital and its community. Our goal is
to tailor our services, so that we may
provide the hospital’s community with
the best financial resolution possible.
At Via Health we are sensitive to
the fact that individual communities possess different needs. We
understand that in smaller communities it is possible that an employee
from the hospital may associate with patients on a personal level as
well as professionally. Take the following example: Brenda works in
the billing office at the local community hospital. Fred came to the
emergency room with his son who broke his arm playing baseball with
8. his friends. A few months ago Fred lost his job after being with the
company for fifteen years, and thus he lost his medical benefits. Fred
has since found new employment, but is still uninsured. Fred’s son is
treated, and now they have a large balance medical bill they are
responsible for without the help of an insurance company. Brenda and
Fred are good friends and neighbors. Brenda’s job requires that she
obtain payment from Fred, and she knows that he is going through a
financial hardship at this time due to his change in employment. It is
important that the hospital obtain payment for the services rendered to
Fred’s son, but it is also important to retain the positive relationship
between Brenda, Fred, the community, and the hospital. Via Health
cares about these issues, and is sensitive to helping maintain those
relationships. Customer service is our focus. We want patients to feel
as though we are right there in their community and as though we
would give them the same attention, care, and concern as Brenda
would give to Fred.
We also know
that there are larger
communities in
urban areas that are
more financially
driven. In those
communities it may
be unusual that a
patient and a billing
office employee would associate with one another. The bottom line is
that in both scenarios patients need to be taken care of and the
hospital needs to get paid. Via Health knows that it is critical to the
success of the hospital to receive payment for services rendered. The
hospital can not act as a bank and can not afford to ignore the millions
of dollars in revenue that patients are responsible for.
9. SELF-PAY
MANAGEMENT
Via Health’s management of the self-pay patient billing function
eliminates the problems often associated with patient resistance to third
party billing management. Working with the hospital’s self-pay billing
representative, Via Health can act as an extension of Via Health’s
business office by calling and corresponding with patients using the
hospital’s name and logo on all interactions with the patient. By working
in this manner the patient never perceives that the billing function has
been outsourced to a third party. Via Health also has the capability of
acting as a third party, either way our professional staff always presents a
patient-friendly attitude that will result in improved patient satisfaction.
Via Health will provide Via Health with services designed to lower
self-pay receivables while sensitively working with your patients. Some of
the service options included in our Self-pay Management program
include:
• Seamless Identity (We will use the hospital’s name and logo on all
patient interactions.)
Establishment of a local post office delivery location for
all payments and correspondence or we can utilize your
designated payment lockbox location if it is desired that
payments and patient correspondence be managed by
your personnel.
Establishment of a telephone number in your local
exchange to be used during all patient interactions.
10. • Third Party Operation (We will do business as HPA, Hospital
Patient Affairs, and act as a third party pre-collect company.)
• Payment Options
We adhere to the credit policies that the hospital wishes
to implement.
Full payment (We accept credit and debit cards, and
check-by-phone. They may also mail in a check, money
order, or cashier’s check. They may also utilize our
auto-pay program.)
Patient financing option with non recourse funding for
patient payment plans. In addition, we will manage
payment plans that were established under the
hospital’s current credit policy, both interest free and
interest bearing accounts are supported.
THE PROCESS
Operations:
• Extended call center hours of operation from 6:00 am to 7:00 pm
(Mountain Time Zone).
• Bilingual telephone introduction to patients to our multilingual
customer service personnel or utilization of over-the-phone
translating for 140 additional languages.
• All telephone interactions are recorded and all call history for any
account can be replayed instantly from our proprietary
Customer Service application.
11. • Multiple call attempts are made on each account for a quick
resolution.
• Patient location services and automatic NCOA verification is performed on
all mailing addresses and on all returned mail.
• Screening; Insurance verification (follow up and billing/rebilling as
necessary), Charity, Medicaid, Indigent.
• Flexible weekly reporting. Invoices including payments, adjustments
and returned accounts can be delivered in hardcopy (paper)
format, emailed in PDF format, or downloaded electronically in
a format your I.T. department designs to allow for automated
importing into your accounting system.
Process:
Using Via Health will provide Via Health with a consistent effort
targeted at improving collection rates while also providing a community
and patient friendly solution.
At Via Health our philosophy is that great customer service
combined with direct telephone contact is the most important ingredient
in maintaining good relations with your patient base and results in
achieving quick payment. Via Health attempts to talk with every patient
having a balance of $50.00 or more during the time we maintain the
account. If the patient cannot be reached a message is left asking them
to return our call. In addition to calling, Via Health sends a series of very
effective billing statement letters to the patient. Each letter solicits the
patient to mail payment or to call one of our professional staff to arrange
a payment plan. Our goal is to work with the patient to achieve payment
while also maintaining the hospital’s relationship with both the patient
and community. On the following pages you will find examples of the
statements received by patients.
15. CONTACT
WITH PATIENTS
As an extension of the hospital’s business office, we believe
that your patients are our personal customers. Our patient friendly,
personalized approach to talking and working with each patient
means active accounts are recovered quickly and easily with fewer
accounts requiring collection agency efforts. Proactive follow-up
processes and increased recovery of troubled accounts lead to a
reduction of Days Revenue Outstanding (DRO) and a healthier cash
flow for the hospital.
Below is an example of the process map Via Health follows in our
attempts to contact and resolve patient accounts. This cycle will be in effect
for either 120 days or 90 days dependent upon the age of the account at the
time of receipt from your facility. This is an airtight process that is designed to
touch every patient.
Day 0 - 6 Day 3 - 28 Day 29 - 54 Day 55 - 80 Day 81 - 104 Day 120
Day 0:
Day 120:
Import Day 3: Print Day 28: Print Day 80: Print
Day 54: Print Cancel
New Statement 1st Request Transfer
Final Notice & Return
Accounts Letter For Payment Notice
Accounts
Bad
Address?
High
Yes
Balance
Report
Update
Bad
Address
Day 1-14: Day 31: Day 56: Day 70:
Call all Call all Follow-up Call Follow-up Call
Accounts Accounts Non-responsive Non-responsive
> $1,500 > $50 Accounts Accounts
Wait 1 day
Contact No Contact No Contact No
Contact
Made? Made? Made?
Made? No
Yes Yes Yes
Yes
Record Record Record
Day 2 – 4: Print Payment Payment Payment
Statement Or Or Or
Letter or Pay Plan Pay Plan Pay Plan
Update Ins.
16. PATIENT FINANCING
WITH NON RECOURSE FUNDING
ALL PATIENTS QUALIFY – NO CREDIT SCORING IS
REQUIRED !
Our patient financing option with non recourse funding has been
specifically designed to target the cash flow problems hospitals often
have with carrying ever increasing patient responsible costs. Via
Health’s financing option allows you the opportunity to remove
payment plans from your books – no more high “reserves” to offset
questionable self-pay debt, or writing off payment plans to bad debt
and then adjusting for recoveries.
Via Health’s patient financing option is a unique program that
provides every patient with a finance option – not just those with a
credit score high enough to qualify. There is no application, income
verification, or credit scoring required – every patient qualifies.
THE SYSTEM IS SIMPLE…
For the patient:
The patient may be contacted by Via Health, if we are the
early out vendor for the hospital, to set up a payment plan; or the
patient may contact Via Health wanting to make payment
arrangements. The patient will need to provide Via Health with the
following information: contact information, name of facility where
treated, account number with facility or social security number, and the
balance on the account(s) they are wanting to finance. The patient will
then receive a financing package in the mail containing a welcome
letter, two promissory notes (one for them to sign and return, and a
copy for themselves), payment coupons, and mailing labels. An
example of the financing package can be found on the following pages.
Once Via Health receives the Agreement and Promissory Note signed
by the guarantor their finance plan has begun. Monthly payments are
set at a minimum of 4% of the balance. The length of the payment plan
17. is to be determined by the patient’s balance. Payments are mailed to
Via Health in Colorado.
For the hospital:
Via Health will provide the hospital with literature to educate
patients on the financing program. Patients set up a finance plan with
Via Health – not with the hospital. Via Health does not sell these
accounts, nor does a bank manage the payment plan; Via Health
handles all matters regarding the account internally. Via Health will
charge patients interest if the hospital determines to do so. There is a
sliding scale which directly relates the amount of interest (not to
exceed 12%) charged to a patient and the percentage at which the
account is purchased at from the hospital. Via Health will finance all
patient balances and will purchase those accounts which have a
balance of $7500 or less. Via Health does not charge a fee for
managing those accounts with a balance over $7500. Via Health will
purchase the patient’s account(s) after four payments have been
received from the patient. All payments received on the payment
arrangement prior to the purchase date will be forwarded to the
hospital less the finance charge. Minimum payments are calculated to
have a specific amount going to principal and interest for each
payment.
18. NON RECOURSE
FINANCING FACTS
Q How will utilizing this financing program affect our current hospital
credit policy?
A Typically, Via Health recommends utilizing the
implementation of this financing program as an opportunity
to tighten the current credit policy to 90 days same as cash
or make financial arrangements with Via Health, if such a
policy is not already in place.
Q What if the patient does not return the Agreement and Promissory
Note, but is making monthly payments?
A The patient is considered to be in default. Via Health must
have a signed promissory note in order to purchase the
account from the hospital. Via Health will send a statement
to the patient informing them that they are required to sign
and return the promissory note.
Q What if the patient is making on time payments, but they are less
than the agreed 4% of the balance?
A The patient is considered to be in default and will be
contacted to bring the account to a current positive status.
Q What if the patient makes a late payment or skips a payment after
the account has been purchased by Via Health?
19. A The account remains with Via Health. Via Health will attempt
to contact the patient to resolve their account and bring
them back to good standing. The account(s) do not get
returned to the hospital. The account will be purchased
from the hospital after 4 payments have been received from
the patient.
Q What if the patient wishes to pay off their account early is there a
prepayment penalty?
A No. There are no penalties for paying off the account before
the agreed upon time.
WELCOME LETTERS
22. CUSTOMER SERVICE
Self-Pay is Our Focus – Our Business – Our Profession
Experienced Personnel:
Some of the qualifications our
customer service
Personnel possess include:
• Call center environment (our
representatives are all
experienced in working in this
type of environment).
• Bilingual representation
(Multiple members of our
team are Spanish-
speaking, and all
representatives have the
capability of utilizing our over-
the-phone translating service for 140 additional languages).
23. Quality customer service is crucial to the results we provide
hospitals.
• Training
• Your hospital’s culture, processes, and even how to read
your account notes
• How to ask for payment
• Problem account handling
•Incentive plans targeted at results & quality
Patients have a positive response to our customer service associates.
We work hard to ensure that every patient receives a
quality customer service experience and personalized attention to
their account.
BENEFITS
So why do we believe that we can collect more on your
accounts than what you are currently collecting?
• Investments in technology such as proprietary software and
state of the art telephone systems that not only allow us to
record every call, but also allow us to access those calls
directly from the patient account.
• Consistent billing effort.
• Airtight processes that are designed to touch every patient.
• Payment alternatives that provide everyone an opportunity to
pay.
• Multiple payment options.
• Experienced Personnel – no personnel requirements for the
hospital.
24. What profitability can we offer your facility?
• Improved self-pay A/R days
• Improved Patient Relations
• Faster insurance resolution
• Long-term solution to billing process
How do we stack up in comparison to other
vendors?
• Our fees typically match or beat our
competitors; these fees are for
early out self-pay billing management services only.
Day One= 6 % of dollars collected
Day Thirty = 7 % of dollars collected
Day Sixty = 8 % of dollars collected
• We are open extended business hours from 6am to 7pm
• We offer immediate service; when a patient calls they typically
wait less than one minute before their call is answered by a live
representative. The only time a patient will receive our
answering service is before and after our office hours.
• We attempt to touch every patient multiple times, by mail and
telephone.
• We offer customized weekly reporting.
• We provide consistent communication with your facility
including:
• Daily and weekly communication with a designated Via
Health account representative.
• Quarterly visits from either an operations representative,
management, or the President of Via Health.
BOTTOM LINE
PROFITS
25. The following chart represents the estimated profits
provided to Via Health through using Via Health’s self-pay billing
management services only, (profitability from the patient
financing program will be dependent upon your hospital’s
demographics). Based on receiving an estimated $ million
annually in self-pay accounts from Via Health we believe we can
dramatically improve profitability. On average, Via Health
resolves from 55% to 60% of the patient accounts it receives
within the first 15 days of self-pay classification. This illustration
demonstrates how using Via Health as your self-pay partner can
impact your bottom line if your current resolution rate is a
minimum of 50%.
Current Via Health
Annual Self Pay A/R: 89,000,000 89,000,000
- Estimated Resolution Rate (Day 1) 40% 50%
Estimated A/R Receipts: 35,600,000 44,500,000
Subtotal (A/R Sent to Collections) 53,400,000 44,500,000
- Collection Agency Resolution Rate: 14.00% 14.00%
Collection Agency Receipts: 7,476,000 6,230,000
Net A/R Receipts: 43,076,000 50,730,000
Cost of Managing A/R during Early Out
period (105 days)
Assumes:
$200 Average Account Balance
15 FTE @ $21.75/hr Loaded
Mailing Expense @ $0.50 per letter (4 letters) (885,500) (3,115,000)
Net 105 Day Costs: (885,500) (3,115,000)
Collection Agency Costs: 20% (1,495,200) (1,246,000)
Total Cost of Collections: (2,380,700) (4,361,000)
Raw Cost Savings or (Expense) $ (1,980,300)
Net Additional Receipts: $ 7,654,000
Estimated Profit Improvement using Via Health: $ 5,673,700
26. Internal Via Health
Annual Self Pay A/R: 150,000,000 150,000,000
- Estimated Resolution Rate (Day 15) 40% 42%
Estimated A/R Receipts: 60,000,000 63,000,000
Subtotal (A/R Sent to Collections) 90,000,000 87,000,000
- Collection Agency Resolution Rate: 14.00% 14.00%
Collection Agency Receipts: 12,600,000 12,180,000
Net A/R Receipts: 72,600,000 75,180,000
Cost of Managing A/R during Early Out
period (105 days)
Assumes:
$200 Average Account Balance
25 FTE @ $21.75/hr Loaded
Mailing Expense @ $0.50 per letter (4 letters) (1,692,656) (3,780,000)
Net Day Costs: (1,692,656) (3,780,000)
Collection Agency Costs: 20% (2,520,000) (2,436,000)
Total Cost of Collections: (4,212,656) (6,216,000)
Raw Cost Savings or (Expense) $ (2,003,344)
Net Additional Receipts: $ 2,580,000
Net Profit to Hospital $ 576,656
27. SERVICE
IMPLEMENTATION
1) Implementation Planning Meeting. Little or no impact to the ongoing
hospital business office operation is assured by our low impact
implementation plan. Implementation starts with an initial site visit.
It is recommended that the following people and/or departments
are represented at the initial site visit / implementation meeting:
• Chief Financial Officer and/or
Controller
• Director, Business Office or
Patient Financial Services
• Manager, Patient Accounts
and/or Collections
• I.T. Representative
• Self-Pay Collection
Representative
• Cash Control Representative
• Customer Service
Representative and/or Financial Counselor (optional)
The implementation planning meeting is the time when we meet
with your representatives to discuss options to the services we
offer and the process of how these services will operate after
implementation.
2) Communication. Regular and ongoing communication regarding
patient calls, payments, and collection issues will be necessary in
order to provide “best practice” and consistency between the
hospitals’s billing group and Via Health. These communications
will be handled on a daily basis using e-mail, fax, telephone, and
one-on-one meetings. In addition, a Via Health representative will
be onsite approximately
every four to six weeks
to answer questions and
resolve concerns on a
consistent basis.
28. 3) Identity. At Via Health we are capable of providing your hospital
with either a transparent identity or we may do business as a third
party. If we are providing your hospital with a financing program
unaccompanied by our early out self-pay program then we will
operate solely as Via Health.
1) Transparent and Local Identity. In order to provide a seamless and
transparent experience, hospital patients will be able to call
Via Health using a local telephone number to reach our
professional staff. During implementation, Via Health will
work with the hospital to develop letterhead and billing
statement documents
that closely mirror those
currently being used by
the hospital. The only
differences between the
documents used by Via
Health and the hospital
will be the telephone
number assigned by the
hospital (or local
exchange if necessary),
and the mailing address
information used on the documents. Other requirements
necessary to achieve a seamless identity with the hospital will
be the implementation of online access to the hospital’s
internal billing system. Payments can be directed to a post
office box which we establish in your community (including
your designated lockbox).
2) Third Party Identity. In this version of services provided to the
hospital and its patients Via Health will act as a third party.
Billing statements will be received by patients with the logo of
HPA (Hospital Patient Affairs), and they will be directed to use
our toll-free telephone number to reach our customer service
department. Payments can still be mailed to a local address
or to our post office box in Colorado; this decision is left to
the hospital’s discretion. Payments we receive are posted in
our system on the day they are received. Patient inquiries
regarding the services performed will be directed to the
appropriate hospital department.
3) Via Health Identity. This identity is used during direct
communication between our business office and the
hospital’s billing group. It is also used when a patient elects
29. to participate in our financing option. Their communication
then becomes separate from that which they may have
communicated with prior to financing their medical bill
balance.
4) Patient Financing Options. At Via Health we focus on tailoring
payment plans that meet both the needs of the hospital and the
patient. Based on your current hospital credit policy, payment
options may include discounted quick payment and no interest, or
low interest payment plans. Via Health will adhere to the credit
policies and payment plans the hospital wishes to make available
to their patients. Additional payment options such as our non
recourse financing option may be advantageous in achieving the
highest possible collection rate and will be implemented should the
hospital elect to provide its patients with this payment alternative.
Should the hospital choose to provide patients with this opportunity
then materials will be provided to the hospital and staff to educate
patients on how the program works.
5) Patient Billing. Your existing billing process is reviewed with eye
toward where implementation of Via Health’s services will be
most effective. Discussed during the initial implementation
planning meeting are operational details such as the timing of
when billing letters are generated and mailed; when discounts and
payments plans are to be used; what the letter series will look like;
the process for returning accounts; and other communication and
transfer details. Based on the results of our implementation
meeting, transition letters are generated and billing statements
mailed. Bulk mailings occur each week, while other types of
documents are generated daily.
6) Information Technology. During the implementation planning
meeting is the time when we meet with your I.T. department
representative to discuss download options, file formats and timing
issues. Since our system has been developed specifically for
outsource billing we are able to build an import module tailored to
accept your data in almost any format. There are three specific
types of information that we require:
• New accounts to be billed.
30. • Payments received by the hospital.
• Adjustments made by the hospital.
Also discussed during this meeting are opportunities for obtaining
the ad hock notes contained in your billing system. If available we
try to import these to improve our ability to answer patient
questions immediately.
1) System Development and Testing. After determining with your I.T.
department which billing data elements will be downloaded to
Via Health, our I.T. staff will design an import module tailored
to accept your data. A test download will be scheduled and
error checked, test billing letters will be generated and any
transition letters will be created using your electronic logo
information.
2) Receiving Data. Downloads are scheduled with your I.T.
department and can be delivered via our secure FTP site or
dialup using P.C. anywhere. Data transfer to Via Health can
occur anytime after the final bill to the patient drops (this is
the bill sent to the patient after insurance has paid or denied
their portion of the charges).
7) Invoicing. Each week Via Health generates an invoice report that
details the results of the previous week’s activity. Included in our
invoice report are period to date and year to date reimbursement
results as well as total payment plans currently active. Return
account reporting includes address and telephone number validity,
bankruptcy, and deceased patient information. All of the reports
we generate are simple to read and make posting payments and
adjustments into your system extremely efficient. If your system
can import payments electronically then this information can be
provided in a format to meet your requirements. Additional reports
can be customized to meet your specific needs. Illustrated on the
following pages are samples of what our standardized invoice
reports look like.