In this Business Profile, Shawn Yates, director, healthcare product management for Ontario Systems, discusses the value in leveraging technology to boost revenue recovery.

Shawn YatesHow do you help healthcare organizations?

Ontario Systems is a healthcare revenue cycle management company that offers a single-software solution that helps customers efficiently manage receivables and remain in compliance with market and government standards. We partner with customers to understand their challenges and implement progressive receivables strategies in both the payer and patient revenue streams. Our goal is to help organizations increase revenue while reducing the cost to collect. Our single-platform solution aggregates data across electronic medical records, automates follow-up to determine the resolution action, and integrates key data-enhancement tools for managing the revenue cycle.

What are some of the biggest challenges you see affecting healthcare organizations?

The loss of federal reimbursements and high-deductible health plans are big challenges because those issues are causing margins to shrink. This, in turn, is forcing healthcare organizations to seek methods for improving efficiency while also ensuring they are collecting all that they are owed. Basically, they are being tasked to do more with less. Automated solutions can help by streamlining revenue cycle operations and eliminating manual processes. For example, instead of having to call an insurance company to get the status of a claim, an automated solution could work behind the scenes to cut the time substantially, greatly enhancing productivity.

Another challenge is the increasing number of ways that patients want to access their health information. People are looking to use tablets and mobile applications, which can make data integration more complicated. Many other service industries have figured out a way around this issue. Take Amazon, for example. There are multiple channels through which a customer can access his or her account, whether through the computer, on a cell phone, via a tablet, and so on. No matter where a person accesses his or her account, the experience is the same, and the information synchs up. Healthcare providers want this same functionality. Patients are only going to become more tech savvy over time, and healthcare organizations need to catch up to make sure the patient financial experience is comparable to other service industries.

How does your product help address these needs?

One of the things that makes Ontario Systems’ solution unique is our ability to aggregate data across multiple media and systems. For instance, if an organization has an affiliation with a nearby hospital that is on a different health information system (HIS), and the organization wants to eventually move to a centralized business office, it can use our software to link the data.

Our software can also improve the patient financial experience, centralizing data so patients can access their financial information from multiple media and still receive consistent information. This includes details about the cost of care, whether insurance has paid or is pending, whether there is a denial that is being appealed, or whether a charity care application is in process. If the patient has been billed by a physician and a hospital in the same system, all information appears in one location so the individual can see a clear picture of what exactly is going on with his or her account. Even if a patient calls a healthcare organization’s customer service representative, the representative can access the patient’s account via our software and see everything in progress, allowing the representative to counsel the patient and help him or her better understand his or her financial responsibilities.

Another thing we’ve chosen to do is embed certain services into our technology like eligibility verification, scoring, charity identification, and claims status functionality. Not only does our solution aggregate data across diverse systems, but we also have these other enhanced services that customers can turn on. In the end, it’s all about increasing productivity so our clients can drive revenue faster and more cost effectively. We help organizations eliminate a lot of manual work so they can get faster answers and resolve accounts quicker.

What are some key considerations for healthcare leaders when choosing this type of product?

You want to be sure to select a healthcare revenue cycle management vendor that can deliver on what it promises. Many companies will say they can do x, y, and z, but when it comes time to deliver, they may fall short. It’s wise to validate what a company claims it can do by checking references. Even more important is to go on site and see the technology in action. It’s also critical that the vendor have a good track record over time. You want to be sure the company is committed to making the product as best as it can be—and that will mean pursuing continuous enhancements as the industry evolves and healthcare organizations’ needs change.

What advice would you offer so healthcare organizations can best set themselves up for success?

It’s essential to go into any software arrangement with an open mind and a desire to implement best practices. We find it’s valuable to have detailed discussions with clients on the front end to identify a best practice and determine how they can implement that in their organizations. In some cases, this may involve taking a phased approach, focusing on certain areas first with long-term goals to follow. If you try to tackle everything at once, you may end up spreading yourself too thin. When we work with clients, we start by identifying their major pain points—the issues they are trying to resolve today—and then look at how to best address those pain points using a step-by-step approach.

Are there any educational materials you would like to share to help healthcare providers in these efforts?

For more information about Ontario Systems and how we can help organizations reach their revenue recovery goals, go to www.ontariosystems.com. In particular, the resources page includes several interesting blog articles, e-books, presentations, webinar replays, and more.

Ontario Systems LLC is a leading provider of software and solutions to the revenue cycle management (RCM), accounts receivable management (ARM), and government markets. Ontario Systems’s robust software portfolio includes product brands such as Artiva HCx™, Artiva RM™, Contact Savvy®, and RevQ®. The company’s customers include five of the nation’s 15 largest hospital networks, eight of the 10 largest ARM companies, and more than 100 federal, state, and municipal government agencies in the United States. Established in 1980, Ontario Systems is headquartered in Muncie, Ind.


Ontario SystemsContent for this Business Profile is supplied by Ontario Systems. This published piece is provided for advertisement purposes. HFMA does not endorse the published material or warrant or guarantee its accuracy. The statements and opinions of those profiled are those of the individual and not those of HFMA. References to commercial manufacturers, vendors, products, or services that appear do not constitute endorsement by HFMA. 

Publication Date: Friday, September 01, 2017