Adding a human touch to medical billing

Billing innovator RevSpring deploys advanced analytics and machine learning to reimagine the patient billing and communication process

Dealing with medical bills can be a mystifying and frustrating experience for patients. Insurance plans vary widely — each with its own rules, deductibles, and nuances. Healthcare costs also differ by provider and insurer, causing many patients to scratch their heads when medical bills arrive.

RevSpring, a leader in providing technology-driven medical communications, billing, and payments solutions, is simplifying the patient experience with analytics. The Michigan-based company serves more than 2,000 healthcare providers, delivering over a billion medical communications every year.

The company uses advanced analytics and machine learning to enhance the patient financial experience, and patients are treated individually. Patients receiving communications by RevSpring are now billed according to their unique financial and transactional history, signifying a quantum leap in a sector known for its confusing billing practices.

Optimizing the communication stream

RevSpring’s Intelligent Workflow Solutions (IWS) uses the SAS^® Platform; and, for hospitals and health systems, RevSpring’s solution makes it easy to automate and personalize many aspects of the billing process. The result is increased payments and higher overall revenue.

“Data and analytics are at the heart of everything we do,” says April Wilson, RevSpring’s Vice President of Analytics and Marketing. “The analytical products we’ve developed have become our company’s biggest growth engine.”

RevSpring relies on the SAS Platform for data management, predictive modeling, business rules, and business intelligence. Wrangling the data is step one. With each new client, the company starts by collecting data on the hospital and its patients. This information is then fed into a data warehouse that fuels RevSpring’s financial products and services.

RevSpring’s analytics team uses SAS^® Enterprise Guide^® and SAS^® Enterprise Miner™ to calculate a propensity-to-pay score for each patient, which determines their probability of paying. Based on this score, an automated patient engagement workflow kicks off, which uses predictive analytics and machine learning to determine the best medium and message for each patient communication.

“Using various modes of communications at different points of the revenue cycle leads to a more profitable outcome,” Wilson says.

Immediate performance improvements

SAS Visual Analytics is incorporated into RevSpring’s IWS to provide reporting and benchmarking options. Once a client goes live, RevSpring uses SAS Visual Analytics and puts their performance metrics in a dashboard, allowing healthcare facilities to track how they’ve progressed against their patient financial goals.

For many, this is their first glimpse at how their patient communications have performed. “Most hospitals have no idea what percentage of patients pay their first bill, or how many people make partial payments and should be on a payment plan,” Wilson says. “Seeing this information is a real eye opener for them.”

Clients also value the ability to benchmark themselves against their peers. From large acute-care facilities to children’s hospitals, Wilson says every provider is curious about what is normal and appreciates seeing how they stack up against competitors.

“Our clients love SAS Visual Analytics,” Wilson notes. “If I could express that in a font, it would be size 48 bold.”

Humanizing medical billing with ‘compassionate analytics’

Realizing that medical bills often underscore an already stressful time in people’s lives, RevSpring sees personalizing the communication process as a way of expressing compassion for those in turbulent times. RevSpring calls what it does “compassionate analytics.”

“We want every patient to have a sense that we know who they are and what they’re going through,” Wilson says. “To keep our finger on the pulse, we use visual analytics and provide deep-dive, quarterly reviews with clients to make sure our billing solutions are as robust and sensitive as they should be.”

Their strategy is paying off. One healthcare provider achieved 114 percent of its payment goal within the first 30 days of implementation. Another went from collecting 8 percent on all outstanding statements to 29 percent — an increase of $1.4 million. Overall, the company reports its clients have boosted collections efficiency by 10 times, adding more than $10 million to the bottom line each year.

Expanding analytics capabilities with SAS^® Viya^®

Serving the health care sector is RevSpring’s primary focus currently. In the future, the company seeks to extend its proprietary billing technology into financial services, particularly around accounts receivables management and debt collections, to see how compassionate analytics could benefit those industries, as well.

To aid in their expansion, RevSpring recently added SAS Viya, a cloud-enabled, in-memory analytics engine that will bring a new level of power and capability. “We’re super-excited about SAS Viya,” Wilson says, explaining that it will give more users access to the power of SAS. For example, RevSpring plans to give hospitals a view into their KPIs to see how they’re performing, how they compare to similar hospitals, and how they’re progressing against their goals for patient finance.

“We’re giving them a way to see their revenue cycle in a way that’s more consumer-oriented and making it easy for them to solve complex problems on their own with data,” Wilson concludes.