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ACE 2016
AUGUST 9 – 11, 2016
Allscripts Payerpath:
Roadmap to a Healthy Financial Core
08.09.16
Steve Mueller
Expert Product Owner
08.09.16
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 4
Agenda
• Roadmap to a Healthy Financial Core 9:45am – 10:45am
• Introductions
• Market Observations
• Regulatory Impacts
• Patient Responsibility and Readiness
• Claims Management and Productivity
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 5
Market Observations
Patient
Responsibility
GrowthProjected to grow to
more than 40% of
average practice’s
overall revenue by
2018
ICD-10
MACRA leading to
VBC through MIPS,
APMs
Regulatory
Pressures
Value
Based Care
59% of payments
projected to be value
based by 2021
Regulatory: ICD-10, MACRA?
Allscripts Payerpath: Roadmap to a Healthy Financial Core
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 7
Payerpath Delivered on ICD-10!
• Because Payerpath prepared extensively for ICD-10
– Fully tested with Allscripts Practice Management Systems
(Allscripts PM, Vision, Tiger, CompuSystems)
– Claredi certified professional and institutional 5010 claim
files ICD-10 compliant
– 100% of payers tested were able to successfully consume
ICD-10 files generated by Payerpath
• October 1st came and went without a hitch
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 8
MACRA• You’ve seen the headlines: The Medicare Access and Chip Reauthorization Act (MACRA) is soon to
be a reality.
• Experts are calling it the most significant change to clinician reimbursement in more than two
decades. And that means you have to be ready.
• The MACRA timeline is aggressive—performance measures go into effect in 2017—and you
need to get up to speed on how this complex program will impact your organization.
• MACRA’s impact is unique to each provider. The first step is to understand the proposed rule and
how it may affect you. Allscripts offers webinars for clients that can help explain these programs
in greater detail.
• Again, while this rule will not be final until the fall, it is important to begin preparing for the
changes ahead to be ready for the first performance year in 2017. Contact Allscripts
Consulting if you would like to schedule an introductory consultation on what this means for your
organization.
Patient Responsibility
Allscripts Payerpath: Roadmap to a Healthy Financial Core
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 10
Impact of High Deductible Health Plans
• Over 17 million patients now enrolled in HDHPs
– 21% of Covered Workers Enrolled in HDHP – growing 15% annually
• Average deductible for individual coverage is $1,217– More than doubled in last 10 years (from $518 in 2003)
– 18% of workers have a deductible of $2,000 or more
• For family coverage, deductibles average $4,059– 30% of covered workers have an aggregate deductible of at least $5,000
• 38% of employers considering HDHP ONLY
• In 2015, >80% of public exchange enrollees selected HDHP plans2014 Employer Benefits Survey from
the Kaiser Family Foundation/Heal th
Research & Educational Trust (HRET)
Copyright © 2014 Allscripts Healthcare Solutions, Inc. 11
Patient Payment Trends Affecting The Revenue Cycle
Premiums at 10-Year High
• $6,025 for single coverage
• $16,834 for family coverage
• Outpace Growth in Family Income
Increase in Employee
Premiums in last 10
years
84%
Practice’s Total Patient
Responsibility Growing
Of Practice
Revenue from
Patient
Responsibility
32%
Of Income Paid
for Premiums &
Deductibles
9%
Rising Risk of
Bad Debt
Less Effective
Traditional
Collection
Methods
Provider Lost
Revenue
Decreased
Patient
Satisfaction
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 12
Solutions for a Healthy Financial Core• Allscripts provides solutions that streamline workflows across clinical, financial
and operational processes
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 13
Patient Payment Solutions Strategy
Improve
Effectiveness of
Traditional Tools
Expand Payment
Offerings
Improve Patient
Utilization
• Improve Patient Statement
Designs
• Payment Lockbox
Enhancements
• Onserts
• eStatements PLUS w/
FMH
• Patient Payment Manager
• Mobile Payments
• Patient Financing
• Single merchant
processing platform
• Actionable information
• Transparency
Clarity to patients on what they owe and payment
options they have
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 14
Multiple Payment Channel Options
14
Patient IntakePatient Payment
ManagerPaper Statements
E-Statements w/Bill Pay
Patient Portal Payments
Receipt /Payment Lockbox
Comprehensive Approach Required
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 15
Patient Payment Manager – Q4 2016
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 16
• Payerpath Patient Payment Manager is an integrated revenue
collection tool for front desk and billing office personnel to
process and record time of service patient payments (cash,
check, or credit cards)
• Equips you to:
• Have an effective, information backed conversation with the
patient while they are in the office to speed up collection of
revenue
• Manage payments, view transactions and process
refunds/voids
• Reconcile time of service payment and end of month
reporting
Patient Payment ManagerEquip your Front Desk with the Tools they need
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 17
Patient Payment Manager
You’ll also be able to see• Updated patient information
• Payment method and status
• Total collections
• End-of-day balance reconciliation
Verify Active/Inactive Insurance
Calculate Co-Pays & Balances
Deductible Meter
Information you can use!
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 18
Patient Payment Manager – Integration to Ease your
Workflow
• Import patient schedule, demographics and balances from your PM
• Collect and post payments right back into your PM
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 19
Improve End-of-Day Balancing and Financial Controls
• Track cash, check and credit in one place
• Financial transaction reporting
automatically linked to Allscripts Patient
IDs
• No need to manually settle batches each
night
• Consolidated Merchant reporting
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 20
Payerpath Receipt (Lockbox)• What’s New?
– Single Mail Stop per client
– Integrated Payment History
– Improved security, reporting and tracking
– Reduced time to deposit
• Benefits to practice
– No mail to sort, open and credit
– Auto deposit
– Auto posting of payments to PM
– Reduction in Risk- limits cash and/or credit card exposure
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 21
More Statement Designs – Q4 2016• Color code options
for quick
identification
• Multiple areas for
custom messaging
• Ability to insert
custom logos
• Statement date
clearly separated
from due date
• Highlighting
enabled on
“amount due”
areas
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 22
More Statement Designs – Coming Q4 2016
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 23
Payerpath StatementsNew Features Coming Soon
• New statement formats – Q4
• Collect and Reminder Letters – Q4
• Color, bilingual and more formats - 2017
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 24
Payerpath eStatements with Online Bill Pay
• Payerpath eStatements with Online Bill Pay
through PayMyDoctor.com provides an easy
and convenient payment option for patients
• A 2014 study reported 43% of consumers
indicated that access to multiple statement
delivery and balance payment channels
increased their satisfaction
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 25
PayMyDoctor.com
25
Link accounts
View payments
View statements
Edit email/password
Options
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 26
eStatements FollowMyHealth Integration
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 27
Payerpath eStatementsNew Features Coming Soon
• Support for Allscripts PM Departmental Billing
• Support for eChecks
• eKit for in-office education
• Digital Delivery Toolkit
Performance and
Optimization
Allscripts Payerpath: Roadmap to a Healthy Financial Core
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 29
How Do I Improve Performance?
Optimize Current Solutions
Use of Automation
Analytics to Improve Decisions & Processes
Leveraging Services
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 30
Optimize: Knowledge Center
News, Featured Videos,
Knowledge Resources
Client Connect
Best Practices, eLearning,
Training Materials
1
1
2
3
2
3
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 31
Automation: Improve Your Processes
• Eligibility Verification
– Reduce denials & re-work/re-bills
– Leverage payment information to improve patient collections
– Improved UI and expanded payer list for Allscripts PM
• Reminder Calls/Notifications
– Reduce missed appointments
– Increase revenue
– Text Opt-In Rule Changes – 83% increase in confirmation rates when patients who prefer
text are offered it
• Payment Collection & Posting
– Patient Payment Lockbox
– eStatement & POS payments
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 32
Increased Efficiencies through workflow improvements• Communication improvements
– Receive important Payerpath announcements, alerts, broadcasts into your email folder
– Subscribe and unsubscribe to the announcement types that you need
• Self-Provisioning functionality as an Admin user
– Add / delete users in Payerpath
– Enable enrolled services for users
• Claim / Remittance Reconciliation improvements
– Improved claim / remittance matching
– Ability to mark each claim in a batch as done
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 33
Claims Management Tools
• Top Edit Errors
• Denial rate
comparatives
• Payer Reports
• Improved Claim
Reconciliation
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 34
Embedded Analytics – Coming Soon
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 35
Practice Performance 2.0Comparing & Analyzing Denials
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 36
New Features in Practice Performance
• Year over year trend analysis
• Customizable experience for the different roles in your office
• New Insights - Patient Responsibility Reporting
Email AlertsBenchmarksDashboards
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 37
Leveraging Services: Augment Your Efforts
CAR 2.0
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 38
CAR 2.0 New Features
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 39
Leveraging Services: Augment Your Efforts
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 40
Payerpath Education TrackTIME TOPIC PRESENTER
Tuesday August 9th
1:30 – 2:30 Keep your finger on the pulse using Practice PerformanceAmber Civitarese,
RemitData
Wednesday August 10th
8:30 – 9:30 Patient Responsibility Solutions - Maximize Patient Payment Revenue Opportunities Lisa Temporale
9:45 – 10:45 Allscripts Payerpath: Roadmap to a Healthy Financial Core Steve Mueller
1:30 – 2:30 Optimize Electronic Remittance Posting Anne Havlina
Nicole Beulah
2:45 – 3:45 Integrating Allscripts Payerpath using Office Manager Paola Turchi
4:00 – 5:00 Payerpath Pre-visit solutions: A Healthy Revenue Cycle before Patient Visits Anne Havlina
Thursday August 11th
1:30 – 2:30 Payerpath 101 - Tools and Techniques for Effectively Reconciling and Tracking Claims Carrie Murphy
2:45 – 3:45 The 15 Most Common Allscripts EDI Support Questions Nicole Beulah
Roadmap Review
Allscripts Payerpath: Roadmap to a Healthy Financial Core
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 42
Payerpath Highlights
Product
Improvements
• Practice Performance 2.0
• Eligibility UI
• Claim Reconciliation workflow
improvements
• Directed client communication
• CAR 2.0
Patient Payment
Solutions
• Improved Patient Statement
Designs
• eStatement Enhancements
• Lockbox Enhancements
• eStatement Integration to
FMH
• Collection Letters
• Patient Payment Manager
Regulatory
ICD-10 Enablement
• Formats
• Infrastructure
• Content
• Payer Readiness Indicator
• Production Stabilization
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 43
Descriptions of solutions, features, and functionality in this document reflect Allscripts’ general product direction on the date noted and do not constitute a commitment by Allscripts to develop or provide any such items. The
development, release, and timing of any features and functionality remain at Allscripts’ sole discretion, and are subject to change (with or without further communication). This material is for information purposes only, should
not be relied on in making a purchasing decision, and does not constitute solution documentation or a commitment, promise, or legal obligation to deliver any material, code, or functionality.
Allscripts Payerpath Roadmap2016 H1 2016 H2 Future
Release • Payerpath 16.1, 16.1.1 • Payerpath 16.2 • Payerpath 17.x
Theme • Regulatory: ICD-10
• Features: Claims Management, Eligibility, Payments
• Feature/Function
• Payment Processing
• PM and SFM Integration
• Feature/Function
• Acute RCM Solutions
Key Features
• Claims Management Enhancements
• Practice Performance Enhancements
• Statement and eStatements Enhancements
• Multi-dept. eStatements
• Eligibility v2 Solution – Phase 1
• Patient Payment Manager
• eStatements Enhancements
• APM Collect & Remind
• Merchant Processing Enhancements
• Call Enhancements
• CAR Enhancements
• Point of Service Payment Access
• Map/Edit Framework
• Custom Edit Rewrite
• Claims Management UI Redesign
• Receipt Enhancements
• Payer Remittance Lockbox
• Homecare Statement Enablement
• Acute AM Call Enablement
• Acute/SFM Statement Enablement
• Acute/SFM Claims Management Enablement
• Acute/AM Eligibility Enablement
Regulatory Features • ICD-10 Production Stabilization • Workers Comp & Attachments
Technology,
Integration &
Innovation
• Eligibility Platform Consolidation • Financial & Clinical Data Integration
• Statement/Call Platform Consolidation
Questions?
Thank You!
Allscripts Payerpath: Roadmap to a Healthy Financial Core
Copyright © 2016 Allscripts Healthcare Solutions, Inc. 45
This presentation has been sponsored by our partners at
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