RCM Tip of the Day: Collaborate with Payers

Becker's Hospital Review

The payer-provider relationship continues to evolve amid increased pressures to improve healthcare quality while reducing costs.

With this evolution comes the need for greater communication and collaboration between both parties, according to Steve Scharmann, vice president of finance and revenue cycle management services agreement operations at San Francisco-based Dignity Health.

Scharmann was one of three panelists who spoke during Guidehouse's annual Forum of Revenue Cycle Experts conference May 9 in Chicago.

He said payers and providers can't have the same relationship they have traditionally had and must work together to navigate healthcare transformation and improve patient experience.

"I think we [as providers] need to think outside the box from our normal routine and reach out to payers that will talk to us. Not from rate negotiation standpoint, but [ask], 'What can we do to make it better,'" said Scharmann.

He cited a specific initiative Dignity Health is piloting in Arizona aimed at reducing the administration burden for the payer and provider without changing the payment structure. 

"The patient comes to our hospital and we get the insurance company payment and then...the patient liability payment, our account is zero, and the insurer collects money from the patient," he said. "The insurer’s theory is they want to create a concierge service and when the patient gets their first statement, the patient will get a phone call, welcome packet, be treated with kid gloves through the process."

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