HMonline Boosts Cash Flow for Healthcare Providers in Workers' Compensation.

Business Editors/Health/Medical Writers

SOUTHINGTON, Conn.--(BUSINESS WIRE)--May 9, 2003

HMonline (HM) released details of a new service that speeds the payment process for healthcare providers and dramatically reduces amounts and days in accounts receivable.

This service, a major boost to enhanced cash flow, has been in operation for over a year now. It requires no investment in new systems or software, instead, it simply leverages current office and billing systems to high effectiveness by clever use of technology.

Bill Chesley, HM's President and CEO, in releasing details, said, "Because workers' compensation billing has been paper-based providers have been forced to rely on paper, postal services and manual processing - all of which extend reimbursement times. The only tool they had to check on bills submitted was the phone. While managed care benefited from electronic data interchange (EDI) and clearing houses that simplified and sped up reimbursement; workers' compensation missed the efficiencies of the computer revolution. Until now!"

Workers' compensation bills are more complex than managed care bills. They must have supporting clinical documentation and the whole process is regulated by the states. Because of the need for clinical notes, the whole package of information, bills and notes have been too complex technically to send electronically. To complicate matters, bills must, by law, be reimbursed within a regulated time - usually 30 days. But herein lays the problem. The 30 days for the provider starts at the date they bill for the care they render whereas for the payer the 30 days start when they have a 'clean' bill and supporting medial notes.

The concept of a 'clean bill' is important because about 30% of workers' compensation bills are rejected by payers when they are submitted. Because these rejects are then mailed back to the provider for repair and re-submission, this automatically puts them overdue. This means that at least 30% of workers' compensation bills will automatically become overdue anyway!

This has now changed with HM's revolutionary new service. The clocks, payer and provider are now synchronized to the same day - and no bill should be overdue. The 30% of automatic overdues are no longer and now fall into the current reimbursement cycle.

Bill Chesley added, "Getting paid promptly is much more than simple electronic bills. If this were the case then the traditional clearinghouse using EDI would have solved the problem. The problem is complex and includes attaching notes that justify and support the type and level of care rendered, an edit filtering process to cleanse bills to eliminate obvious reasons for the payer to reject the bill, an online portal to check the status of the bill and a way to fix any problems with bills immediately. Because we enable all these functions for the provider they get paid faster, their days and amounts in accounts receivable drop and their cash flow position is significantly improved."

Unlike the traditional process of billing, mailing and hoping, HM's service expresses clean bills to the payers' reimbursement cycle immediately. These bills are then tracked through the reimbursement cycle and the milestones on their journey are reflected as a status for the provider on a secure Internet inquiry portal.

HM's service is automated, paperless and touchless(TM). This means speed, reliability and an audit trail. It is accomplished simply by removing the slow speed elements of the mail, human sorting, indexing and delivery from the process.

Bill Chesley added, "This is exactly what providers have wanted for a long time. Now they can have it without needing to replace any of their existing office systems or buy new equipment. All bills submitted should fall into the current reimbursement cycle, the 30% of rejects because they can also be repaired and resubmitted same day. Giving providers the tools to manage their destiny is what makes the difference."

The impact for providers, PPOs and aggregators is profound in terms of cash management and collections. HM solves the cash flow and accounts receivable problems that have plagued healthcare. Reducing accounts receivable from 3-4 months to less than 45 days can put millions annually to the bottom line of major PPOs and aggregators. Best of all, there is no barrier to entry and costs to submit complex bills are reduced by about 50%.

Health Management Online (HM) is an ASP provider of specialty productivity services to the Property & Casualty Insurance industry and healthcare providers. For more information visit www.hmonline.com.