This Week in Surgery Centers: Mike Tompkins – The Magic of Automatic Payment Posting

Mike Tompkins – The Magic of Automatic Payment Posting

Here’s what to expect on this week’s episode. 🎙️

Manually reconciling payments on the backend of your billing system can lead to unnecessary labor costs, delayed payments, billing inefficiencies, inadequate reporting, and many other challenges.

We talked through the intricate world of payment posting with Mike Tompkins from in2itive, mainly focusing on commercial payers. Here are a few highlights from our discussion:

➡️ Many ASCs, possibly over 60%, still rely on time-consuming manual processes for payment posting. This can be tedious and error-prone, impacting everything from day-to-day operations to end-of-month reconciliations.

➡️ Manual posting can consume an entire full-time employee’s (FTE) monthly workload, translating to around 160 hours of manual data entry.

➡️ Shifting to automated posting processes can significantly reduce errors and time spent on administrative tasks. This shift can free up staff to focus on other revenue-enhancing activities like credit balance refunds, contract reviews, and follow-ups on denials.

➡️ A significant step towards improvement is understanding and leveraging the capabilities of your existing software. Many ASCs are unaware of their software’s full range of functionality, which could include automated payment posting features.

➡️ It’s crucial for ASCs to continually evaluate their processes and technology to ensure they’re leveraging the most efficient methods available for their revenue cycle management.

Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.

Episode Transcript

02:05.57
Nick Latz / HST Pathways
Mike Welcome the show.

02:15.30
Mike Tompkins
Yeah, yeah, I’m ready. Thank you Thank you so much for having me.

02:22.61
Nick Latz / HST Pathways
Mike you tell us a little bit about your background in the ASC industry.

02:25.79
Mike Tompkins
Sure so my name is Michael Tompkins I’m a client services revenue manager at intuitive business solutions I’ve been with intuitive just under 3 years intuitive is a boutique style company who focuses on revenue cycle management services as well as consulting we are. A little bit when I say boutique we focus more on service and process optimization. Um, so it’s definitely a major technology focus right now for us.

02:54.23
Nick Latz / HST Pathways
Um, so on our show Mike we’ve talked about different aspects of the revenue cycle on different episodes.

02:56.73
Mike Tompkins
This is why not.

03:08.18
Nick Latz / HST Pathways
In this week with you want to drill in specifically into payment posting and specifically kind of the commercial pay or side of payment posting. Ah can you walk us through this process from your experience how it works.

03:21.50
Mike Tompkins
Sure So on the manual side This can be pretty tedious and most surgery centers. It is a process of gathering by logging into your clearinghouse downloading all the ribbons devices that are in your deposit for the day possibly going to a lockbox or a mailbox to gather correspondence. And then organizing everything to be entered into your system manually. So Then you’re going to go into your practice management software enter in each transaction and often you have to go to and each independent end of individual patient ledger excuse me.

03:52.43
Nick Latz / HST Pathways
Yeah, that.

03:55.00
Mike Tompkins
Um, which can take quite a bit of time and can create a little bit of an administrative burden as well.

04:00.55
Nick Latz / HST Pathways
Yep, and that’s that’s more more cumbersome or more time intensive than I would have expected. Yeah yeah.

04:05.70
Mike Tompkins
Yes, depending on your your size of your center as well. You know sometimes you’re entering in $100000 a day and to do that on an individual basis can really really slow you down.

04:16.12
Nick Latz / HST Pathways
And and do you have a good feel for what percentage of the market What percent of ASCs have you know, kind of a time intensive manual process like you’ve just described.

04:28.75
Mike Tompkins
Um, you know I don’t have a percentage I would say that the the percentage of software that requires you to do the manual would probably be greater than 60% so it depends on really the software that you’re using.

04:37.74
Nick Latz / HST Pathways
Wow. Okay, so you so you’ve got a good percentage of ASCs out there that that have some highly manual steps in this commercial pay or process. Um, what are the challenges.

04:47.75
Mike Tompkins
What.

04:52.35
Nick Latz / HST Pathways
With this. What are the kinds of this approach.

04:53.27
Mike Tompkins
I think time is a big piece. You know with everything that they’re doing. It’s it’s an individual manual process generating each transaction can can take quite a bit of time. It also leaves room for errors in the payment posting world every single penny counts. Um, so you know if you are off by keying a variance at a transaction date or a dollar amount and you have to go search for that. It can cause quite a bit of confusion at month end trying to balance and close out your remits.

05:22.17
Nick Latz / HST Pathways
Yep in in based on that based on errors I mean this could even impact the the AR that you’re able to to collect right in terms of the the volume of dollars collected.

05:30.58
Mike Tompkins
Right? And when you’re talking about the overall health of your organization. You know the the collections and the dollars are really one of your key factors there too. So it’s very important to have everything as accurate as possible.

05:43.79
Nick Latz / HST Pathways
Got it. So if you were to put yourself in the shoes of an ASC that does commercial payment posting in-house right? Ah, an ASC that’s doing revenue cycle in-house they’re doing it on their own. Have any sense of how long this could take you know on a monthly basis. The payment posting process like if if they’ve got a manual process how how many minutes or hour minutes or hours could that take a month

06:07.85
Mike Tompkins
Um, you know it can take the full amount of working hours in a month so if you have an average of let’s say 22 business days. You know they’re working 8 hour days every day it can consume their entire day.

06:20.27
Mike Tompkins
Um, so you can see an average of you know, 2 to 3000 transactions entered in and manually could take the full hundred and sixty hours that they had allotted for for their work month. Yes, depending on your volume. Yes.

06:30.98
Nick Latz / HST Pathways
So This could this could be a whole fte.. That’s that’s posting these things in there manually. Wow okay, um, but it sounds like there’s ah, a silver lining you said approximately 60% of the market has has manual steps. Um, but. That that means a certain percentage of the market is doing in a more automated manner is that right.

06:50.45
Mike Tompkins
Yeah, so there’s the new automated put payment posting process. So if you’re not familiar. It’s your practice management software pulling in the electronic remittance file or an eight thirty five electronic file and it’s going to read it automatically for you so it will take the payments per accounts. Ah, create those payments in your system and apply them automatically. So from there your your your employee or your your billing team member is really only going to have to go verify that it all went in correctly, possibly add some contractual adjustments. Maybe a sequestration adjustment. Um, and then they can create all of those transactions from 1 consolidated screen and from there. It’s going to leave quite a few variance issues or room for any kind of errors. So their accuracy rates going to improve as well. They’re going to be able to do more because they’re not having to enter in as much manually.

07:44.58
Nick Latz / HST Pathways
Yep, so that definitely makes sense on the accuracy side right? take the manual steps out. You get a much more accurate process on on on the time side you mentioned this could be a full fte doing manual posting. What? Ah what? what would this.

07:48.89
Mike Tompkins
Illness.

08:00.33
Nick Latz / HST Pathways
Fte do in a world where they don’t have to do the manual posting anymore.

08:04.98
Mike Tompkins
Um, so we can move our focus we can work on credit balance refunds we can work on reviewing the contractuals that are coming in are we having to are our contracts loaded in our software correctly or are we doing additional adjustments during that ah automated process that we can kind of. Streamline and correct on the backend.. There’s also other items you can do for follow up helping with denials working on the correspondence from the insurance you know often they want medical records or or. They’re doing audits or anything like that so you can really move your focus on the revenue side versus what’s already been collected and just recording it.

08:40.53
Nick Latz / HST Pathways
Yep, that makes sense. Um, so the automated approach sounds sounds much better mike and so if if if you’re an ASC listener out there and say hey you know I think we’re doing it more on the manual side today.

08:45.43
Mike Tompkins
Yes.

08:52.84
Nick Latz / HST Pathways
What would you need to think through what would your next steps be to switch over to a more automated process.

08:58.96
Mike Tompkins
Um, well your technology and your software is going to be the first part I would always look at what I currently have and what’s offered as well reaching out to to your training portals or anyone that you work with at the current software and and technology companies seeing what’s available and what’s included in the packages that you’re provided. And then connecting in with the other parts of your technology like your clearinghouse and making sure it’s all compatible because often surgery centers are finding that there’s all this technology included in and subscriptions they’re paying for that. They just have no ideas available to them.

09:30.95
Nick Latz / HST Pathways
Yup, yep, and what have you seen because I’m sure that you guys at intuitive had customers that you’ve helped go from you know, doing all this work in-house and doing kind of the manual processes and and then you guys kind of. Help alleviate a lot of that burden. What what have you seen in terms of the benefits either from you know staff satisfaction or Physician Satisfaction what are some of the benefits that surgery centers could expect from taking this burden off of their team.

09:58.93
Mike Tompkins
Yes I think one of the biggest feedbacks that you get from your staff is. There’s not enough time to do all of the tasks in a day so by alleviating some of the administrative burdens of gathering and organizing all these documentation. It’s automatically pulled in for you. So you’re. You’re taking tasks and steps off of their day-to-day which is going to improve their satisfaction and as well increase their tenure. Um, and when you’re talking on a physician side. Most physicians are invested in their surgery centers so they want to see you know all of the revenue return to them as quickly as possible. So by posting those payments faster to your primary Payer. You can move on to your secondary tertiary or move it to your patient balance get those claims out the door send the statements to the patients and in turn get those collections turned around faster.

10:46.84
Nick Latz / HST Pathways
Great and that’s the name of the game where it is reducing Ar and and getting those Ar days down so you get faster cache.

10:53.56
Mike Tompkins
Exactly get closer to those those prescription doctors that get paid within 5 minutes of sending a claim now you’re in the pharmacy and they’re paid before you leave the door. Yeah.

11:00.51
Nick Latz / HST Pathways
Sounds pretty good. Nice, okay, and so Mike we’ve been talking about commercial payments right? pay or payments insurance company payments in that side of the house.

11:11.71
Mike Tompkins
Um, look.

11:16.73
Nick Latz / HST Pathways
Oftentimes now these days though that doesn’t make up the the total portion of the surgery bill because you still got patient payments and that can be in some cases up to a third of the total cost. What about those patient. Responsibility payments are are you seeing those come in manual today or do those come in in a more automated manner.

11:37.17
Mike Tompkins
Yeah, so if you’re utilizing the same credit card portals from 10 even five years ago it’s possible that you’re not able to do the same features as with the commercial payers but that that part that goes back into making sure you know what your technology offers. Um, so ensuring that the clearinghouse you use offers that technology. Um and that the the practice management software that you use will accept it. Um, so it is an available feature but it is actually pretty limited right now and recently started growing. Um, I do know that we’ve started using and an nhst but I haven’t found that option in many of the other practice management softwares. We use.

12:13.35
Nick Latz / HST Pathways
Got it. Okay and final question for you Mike and we do this every week with our guests. What’s 1 thing our surgery centers can do this week to improve their performance.

12:26.32
Mike Tompkins
To improve performance research start looking at what’s available what you already have that you don’t know you have um often we sign subscription agreements with our software. You know we’re we’re in a contract or or some sort of agreement and it will list out all of the options that you have. Um I know with clearinghouses you can have different um, different pieces of plans. So There may be portions in there that you have that you’re already paying for that you you don’t know of or that you want to pay for and you want to add on because you can see the benefit and the cost savings for your center. So doing that research and talking to you know whoever you have in contact at your surgery centers with with those technology partners making sure that they’re in constant contact and and aware of any updates available for you.

13:07.97
Nick Latz / HST Pathways
Excellent Mike thanks so much for joining us today.

13:11.50
Mike Tompkins
Yeah, thank you so much for having us. You have a great day. Awesome That was shorter than I thought.

13:15.14
Nick Latz / HST Pathways
All right? and that’s it.

13:23.37
Nick Latz / HST Pathways
Nice shout. Yeah, especially on these more nuanced ones we kind of try to keep it basic and and into the point so that was good. We only had one that will go back and edit um with no no no problem no Mark um, cool.

13:33.90
Mike Tompkins
Um, no mark. Yeah.

13:40.46
Nick Latz / HST Pathways
And any questions on your side.

13:43.44
Mike Tompkins
Um, note um, just want to see the the final version under with it all. Yeah, did you see anything you wanted me. No no think you did’t really great. The only one I might think of um Nick is I would redo it because what he said was. Awesome! Um, but he stumbled over individual Could we kind of seen it so that he just says individual. It’s that first it was the first question. Yeah, he eventually says individual but there was a few. Yeah, he was just kind of stumbling over the word just for respect. He was getting the nerves out.

14:06.77
Nick Latz / HST Pathways
Individual. Yeah, first question.

14:18.10
Nick Latz / HST Pathways
Yeah, you know, um I’m sure the a I bot in the background will be able to ah to morph that right over.

14:20.32
Mike Tompkins
And good at math. Not words. Yeah.

14:28.58
Mike Tompkins
Her event. Okay, and that’s that everything else sounded great for both of you guys. Perfect.

14:36.84
Nick Latz / HST Pathways
Well thanks so much. Mark is good to meet you. Mark had I don’t know what the hell is wrong with me Mike.

14:45.76
Mike Tompkins
Um, may fight that off we both thought you were just do I know you you had it for a second. But absolutely.

14:47.93
Nick Latz / HST Pathways
Yeah.

14:50.67
Mike Tompkins
Umd’s a pleasure. We we love partnering with you guys here I don’t I don’t like I didn’t want to say it on the podcast but you’re you’re my favorite software so it was it was a talk. Yeah good I think you have a great day right.

14:55.64
Nick Latz / HST Pathways
No, we appreciate that at take care.