Sometimes, one relatively modest change can unleash a wave of efficiency that improves the entire workday.
Just ask Kimberly Velazquez, patient accounts manager at CGH Medical Center in Sterling, Illinois. Born and raised in the Sterling-Rock Falls area, Velazquez has been employed by the 100-bed community hospital for nearly 30 of its 116-year history, focusing on patient accounting for the past 22 years.
During that time, she has witnessed multiple changes in healthcare accounting. Few, she said, have benefited her revenue cycle team’s productivity as much as the switch CGH made five years ago to RemitConnect®, a healthcare receivables management solution from CommerceHealthcare® that automates payment posting and reconciliation processes.
Goal: Improve billing efficiency.
Owned by the city of Sterling, CGH has been serving the healthcare needs of residents in its corner of northern Illinois since 1909. Given its inclination to prioritize public health and accessibility over profit, CGH administrators are constantly on the lookout for ways to improve efficiency, minimize costs and maximize cash flow.
That was almost certainly on their minds back in 2019 when a group from CGH struck up a conversation with representatives of Commerce Bank at an event hosted by the American Association of Healthcare Administrative Management, according to Velazquez.
Soon, the discussion turned to the efficiency and functionality of the medical center’s receivables process, she explained.
“At that time, we were using a small local bank for lockbox services,” Velazquez recalled.
“But our options were limited, and the payment posting team was often a week behind. We were buried doing follow up on claims when the payments had been received but not yet posted. All this affected the productivity of our billing staff.”
A game-changing solution.
Over the course of the conversation, CGH leadership learned that payments made to Commerce lockboxes are posted within two days, with many posted the same day. What’s more, they discovered that CommerceHealthcare®, a division of Commerce Bank, could help them automate their payment posting and reconciliation processes.
Within months, the health center had switched its lockbox to Commerce. Shortly thereafter, it installed RemitConnect®, a healthcare receivables management solution that would allow its leaders to retain their banking relationship with their local bank, while plugging into sophisticated technology that would not only streamline the billing and payment reconciliation process but also reduce data entry errors and improve cash flow.
RemitConnect® was a game-changer, Velazquez explained. Like other hospitals, CGH regularly receives payments from insurance providers for batches of claims. An accompanying remittance breaks down the payment, showing how much was paid for each claim, any adjustments made and the reason for the adjustments. CGH uses this information to reconcile payments with the services it bills.
By converting these remittances and other medical correspondence to an electronic format, RemitConnect® made it possible to eliminate most paper from healthcare receivables.
Converting Medicaid remittances.
This electronic format was especially important to CGH for Medicaid remittances. “Reconciling payments and posting remittances from Illinois Medicaid has always been an especially cumbersome process,” explained Velazquez.
Commerce worked with CGH’s revenue cycle team to convert these paper-based remittances to an 835 format, the HIPAA-approved electronic remittance standard for payment information. “That change made a huge impact on the efficiency for both our payment posting and billing teams,” Velazquez said.
By standardizing the way payment information is shared, the 835 format makes it easier for CGH to process and reconcile payments from Medicaid and other payers.
Velazquez also likes that all the billing and receivables data is housed in one easily searchable place. “Every member of my team works with the Commerce portal,” she said. “We use it for correspondence and payments posting. Our credit balance analysts use it to research payments. When we posted batches of checks manually, we didn’t have the search functionality that we have today with Commerce.”
A solid partnership.
With the automation of Medicaid remittances, approximately 90 percent of the CGH’s remittances are now electronic, Velazquez said. “The efficiency improvement for our team has been substantial,” she said.
“Commerce is a great partner,” she added. “The implementation of RemitConnect® was seamless. Communication between our teams is great. Our account managers stay on top of every issue until it is resolved. And Commerce is always looking for ways to improve. They’ve given us back time we now use to focus on other things that matter.”