The Economy and Medical Banking

By Mark Brousseau

With the current economic slowdown affecting virtually every individual and business today, the need to keep costs as low as possible has magnified some of the key trends that were already brewing in the medical banking services field prior to the downturn, says Maureen Turo (maureen.turo@bnymellon.com), vice president, Healthcare Market Specialist, The Bank of New York Mellon. These trends include revenue cycle improvements that provide a clear business case for saving time and money, and a partner with proven success in finding the right solutions.

There are numerous medical banking services available to help both payers (commercial insurers) and healthcare providers (institutional and professional). The most widely accepted services focus on improving the efficiency and amount of payments collected and posted by providers, Turo notes. Such services include automated EOB data lift, point of service systems, electronic processing and payment-to-contract analysis services.

"Healthcare providers are paying particular attention to those solutions that automate their payment processes for faster outstanding accounts receivables resolution," Turo says. "Automating payment processing frees resources (both staff and technology) to focus on other important payment collection tasks, such as resolving denied and under-paid claims."

Turo says an increasing number of healthcare providers are also looking for vendors to help them build and analyze the business case supporting these new services. "Although many medical banking services do not have any capital expenditure outlay, the services nonetheless require multiple levels of approval due to their impact on numerous back-office functions and financial systems," she explains. "Projects with the strongest business cases are the ones most likely to capture the provider’s attention."

In addition to needing a strong business case to implement these high-impact services, providers increasingly require strong references of potential vendors. They want to talk to other healthcare organizations that have implemented similar services to learn about the process and results, Turo says. Dealing with multiple (and sometimes antiquated) systems, as well as limited IT and project management resources, providers need assurance that a new service will address their most critical issues.

"Until more is known about the anticipated federal healthcare reform, I believe these trends will persist, with automation continuing to drive efficiencies in the healthcare industry," Turo says. "As providers experience success implementing various medical banking services, more will do so. Healthcare providers may not want to be on the leading edge of using these medical banking services, but they will not want to be left behind."

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