Retrieves Billing Details

  • Patient may receive statements via physical mail, email or online patient portals depending on the department or service provider.
  • Billing statements are generated by Cerner and mailed or made available online to patients after their visit or service.
  • Statements are tied to separate account numbers due to entity specific billing.
  • Statements highlight the amount due, payment deadlines and accepted payment methods, but do not offer a unified view of all outstanding balances.
  • Statements include patient identifier, service details and a unique payment code for accessing the RevSpring portal.
  • The statement includes the website link, an Easy Match code for access and account-specific details.
  • The Easy Match code is a onetime use code tied to the statement, allowing patients to view a specific account or statement.
  • Patient receives separate statements for each service or department.

Logs into
Portal

  • Using the website address from the statement, patient logs into the portal.
  • Statements delivered electronically may require patient to log into separate portals, such as a Cerner-based system, to access their billing details.
  • Smaller affiliates, such as Behavioral Health or Home Care, may not offer digital statements, relying solely on physical mail.
  • The website interface prompts patient to input the payment code found on their statement to locate the associated bill
  • Patient must repeat this process for every unique account or statement, because no unified account view exists.
  • Patient manually toggles between accounts for payment or record review.
  • Any errors made when entering the code prevent patient from accessing their billing information, often requiring a call to customer service for resolution.

Examines
Billing Statement

  • Patient compares statements with Explanation of Benefits (EOB).
  • Patient notes discrepancies in charges or balances.
  • Patient confirms that personal details, such as name, address and insurance coverage, are accurate before proceeding.
  • Some patients report receiving duplicate or incorrect statements due to system glitches.
  • Staff investigate the issue, verify account details and reissue corrected statements.
  • Patients with balances exceeding $450 are directed to Commerce Bank for financing options, such as payment plans or loans.
  • Patient must navigate outside of the Memorial Health portals to Commerce Bank’s system.
  • Some patients may contact customer service to verify balances or clarify charges before proceeding.
  • Discrepancies lead to confusion and prompt calls to both the billing office and the insurance company.
  • Smaller affiliates may direct patients to different portals or rely on phone payments.

Contacts
Customer Service

  • Patient decides to contact customer service.
  • Calls range from basic payment inquiries to complex issues requiring resolution.
  • Common reasons include questioning charges, clarifying balances or confirming payments.
  • Multiple contact attempts are often required due to high call volumes.
  • Patient may leave a voicemail due to long wait times.
  • Average wait times often extend beyond the department’s capacity to handle them.
  • Staff must document each interaction thoroughly to avoid repeating steps.
  • Patient must often make multiple calls if their issue is not resolved during the initial contact/s.

Makes Payment

  • Patient checks the bill for accuracy and determines the amount to pay.
  • Patient selects their preferred payment method, such as credit card, debit card or bank transfer, and enters the required details.
  • Payments are submitted based on the account tied to the Easy Match code.
  • Patient submits the payment.
  • Patient confirms the amount they wish to pay, which may be less than the total balance if partial payment is allowed.
  • Options for scheduling future payments or setting up automatic payments may be available on some payment portals.
  • Payment processing occurs, but the portal does not reflect updated balances in real time.
  • Balances remain static until the next billing cycle or statement generation.

Confirms Payment Completion

  • Once the payment is processed, patients receive a digital confirmation, either on-screen or via email.
  • The confirmation includes a transaction ID, payment date and updated balance details.
  • Payment portals will reflect payments and new balances at a later date once information has been reconciled and synchronized.
  • Patient must rely on external confirmation, such as an email receipt or printed confirmation page, to verify the payment.
  • For errors or failed transactions, patient must contact RevSpring or the billing department to resolve issues.
  • Failed payments may require patient to reenter their payment details or wait for further instructions.
View Technology Map

Step

Technology/Touchpoints

Retrieves Billing Details
  • Cerner
  • RevSpring
  • Postal Delivery
  • Experian
  • Easy Match Code
Logs into
Portal
  • RevSpring
  • Easy Match Code
  • MyEasyView Portal
  • IVR System
  • Cerner
Examines
Billing Statement
  • Manual Communication with Billing Office
  • Commerce Bank Payment Platform
  • Insurance Provider Portals
  • FollowMyHealth
  • Cerner
Contacts
Customer Service
  • Cerner
  • FollowMyHealth
  • My EasyView (via RevSpring)
  • Commerce Bank
  • Interactive Voice Response (IVR)
Makes Payment
  • RevSpring Payment Portal
  • RevSpring Payment Gateway
  • Online Bill Pay
Confirms Payment Completion
  • Email Confirmation System

Step

Pain Points

Retrieves Billing Details
  • Patients receive separate statements for each service or department with its own unique payment instructions, adding to the complexity.
  • Postal delays cause patients to receive billing statements after due dates or close to deadlines, reducing time to make payments. Some affiliates, like Behavioral Health, only use physical mail, which exacerbates these issues.
  • Clinics not checking insurance eligibility delays the process.
  • Patient access is not standardized; structures vary by clinic and leader.
  • Some colleagues may not know the tools available.
  • Dependent on various departments; reliant on current Cerner buildout that can create delays.
  • Cerner works for hospital and primary care billing inefficiencies. Epic will pull everyone into the same pool. Determine how to optimize the Epic environment to improve patient satisfaction.
Logs into
Portal
  • Users are forced to transcribe the URL from the paper bill, which risks typos or navigation errors. There is no direct link, QR code or easy shortcut to the portal.
  • All payments are consolidated through RevSpring, but to access statements, patients must go to different portals.
  • RevSpring does not store login credentials or codes for future use, forcing patients to repeat the process each time they access their account.
  • Lack of real-time balance information because updates only occur in monthly statement cycles.
  • Missing balances with no indication of system errors or mismatched data. Statements sent to guarantor. Dad and mom might be coming in at different times, so the information is separate.
  • Patients paying for multiple family members face additional complexity, as account numbers are not linked.
  • Each family member requires a separate login, even if one guarantor (e.g., a parent) is responsible for payment. This lack of integration forces users to juggle multiple credentials and reenter information for each account.
  • If the same portal is previously used for another family member’s bill, the system overrides the login credentials. The code cannot retrieve the correct bill without creating a new account.
  • Lack of a unified environment for a central hub to execute financial statements.
  • Inability to see other statements is how Cerner is set up.
  • Statements are not branded like Memorial; looks like an invoice.
  • Limited in what can be controlled in RevSpring, because only contract for the payment portion.
  • If a statement is 4-5 months old, the code expires.
  • Patient may not always be viewing the current statement and has difficulty confirming.
Examines
Billing Statement
  • Mismatched timelines between EOBs and statements. Insurance companies release EOBs earlier than Memorial completes its billing cycle, causing patients to be confused about charges and financial obligations.
  • Lack of unified billing.
  • Multiple account numbers for a single patient encounter, which could include individual account numbers and bills for X-rays, labs, urgent care, etc.
  • Accounts are not all tied to a medical record number.
  • Lots of complaints on the ambulatory side. Bills age out because they are on a different account number.
  • Requires three different logins, unique user IDs.
  • Users struggle to identify the correct payment URL and My Easy Match code due to inconsistent formatting or placement.
  • Updates to personal or insurance information must be directly communicated with the Memorial billing office for changes, as the current system does not allow for seamless updates through the portal. This adds steps to an already cumbersome process.
  • Commerce Bank’s payment platform requires patients to navigate away from RevSpring or Cerner portals, creating a disconnected experience. Patients must also provide additional documentation, which adds complexity.
Contacts
Customer Service
  • Patients must contact the billing office directly to address incorrect charges, which adds extra steps and complexity to the payment process.
  • High call volumes lead to long wait times, requiring many patients to leave voicemails. Staff often struggle to return calls promptly, further exacerbating patient dissatisfaction.
  • Cerner creates separate accounts for different services, requiring manual effort to locate and reconcile patient information. This fragmentation complicates account reviews and prolongs resolution times.
  • Staffing is down 40 people from reduction in force, affecting the entire revenue cycle.
  • Patient adoption of technology (30%) would have a major impact on operations.
  • Each billing entity generates its own statements, requiring patients to engage with multiple representatives for resolution.
  • Lack of family account aggregation. Parents managing accounts for children often face difficulties in ensuring payments are correctly applied, causing them to contact the billing office.
Makes Payment
  • Limited payment options, such as an integrated IVR system, force patient to call customer support or log into portals for payments.
  • Payments made with outdated statement numbers result in credits being applied to the wrong account. Resolving these errors requires staff intervention.
  • Family members cannot group multiple accounts under a single profile for simplified management, making information hard to obtain and causing misapplication of payments.
  • Patient cannot pay at time of service, because they don’t know what the cost is going to be because of HDHP.
  • The subscription to Experian has not been expanded across departments for a consistent experience
  • Hospital and physician accounts are created at different times, causing prepayments to be applied to the wrong entity. This results in delays or unresolved credit balances.
  • Several different customer service entities with so many points of access for patient. If patient does not say the right thing, they are sent around to different facilities.
  • Each payment requires patients to input their credit card or bank details manually, even for repeat bills. This lack of stored data eliminates convenience for patients managing multiple payments.
  • No account history for manual payments.
Confirms Payment Completion
  • After submitting payment, the system generates a confirmation number but does not update the balance status in the portal in real time. Patient is left uncertain about the success of their payment.
  • Patient cannot easily confirm payment status after submitting a payment, as the portal does not show real-time updates or historical payments. This forces them to rely on confirmation emails or manual tracking (e.g., screenshots or printed receipts).
  • The portal generates email confirmations that often take time to arrive, leaving patient without immediate proof of payment. Patient must manually monitor their inbox for the email receipt.
  • IVR can’t exist unless patient can pay in real time.
  • Biggest issue is payments posting in real time.
  • The system allows patient to reenter payment details and pay the same bill multiple times. No safeguards or warnings are in place to prevent duplicate payments.
  • Biggest issue is not trusting the portal because it is not up to date.
  • No $0 statements are issued.
  • Payment confirmations are stored separately for each bill, requiring patient to maintain a manual record (e.g., screenshots or printed receipts).
  • Expand subscription to Experian across departments where applicable
  • The lack of integration between entities means patient cannot confirm overall payment status without contacting each provider directly.

Step

Thinking

Feeling

Quotes

Retrieves Billing Details

“I can’t believe this is so expensive.”

“Should I expect any more bills?”

“Why do I have so many statements?”

“Why is this so complicated?”

Stressed

Confused

N/A
Logs into
Portal

“Why do I need a separate login for each account?”

“Am I using the correct Easy Match code?”

“Why is this code invalid when it worked before?”

“This is a waste of time.”

“Why can’t I manage all family bills from one account?

“This is unnecessarily complicated.”

Annoyed

Confused

Impatient

“No QR code, which is fine, but there’s a website somewhere. You have to type that in. Then there’s a My Easy Match code you have to enter. If you mess up, it doesn’t work.”

Examines
Billing Statement

“Has this gone through my insurance?”

“Is this accurate?”

“Can I afford to pay for all this right now?”

“Does this bill include my labs?”

“Am I paying the right amount to the right account?”

“Should I dispute anything?”

“Why isn’t my bill displayed when I know there’s an amount due?”

Overwhelmed

Confused

“My doctor was in network for my surgery but found out after billing my anesthesia service was not. It would be nice if the doctor is in network, all services would also be too.”

Contacts
Customer Service

“How do I solve this issue?”

“I hope they can answer my questions.”

“Why is this taking so long?”

“Why can’t I fix this myself? This system is far too rigid.”

Frustrated

Anxious

“Called on Tuesday before operation to pre-pay what insurance did not pay before June 17 day of surgery overpaid still waiting for refund August 12, 2024.”

“I just have to hope and pray that they get it and put it to the right account, which I’ve had issues with before.”

“I have no way of knowing that my login is attached to my son’s account. Now I’m just confused. So I won’t pay my bill. Then I get the bill next month, go in and do the same thing, and it’s still showing $0. Then I get frustrated because I have to call somebody or I get sent to collections because I just keep ignoring it. ”

Makes Payment

“Can I make a payment quickly/easily?”

“Why do I have to reenter my information?”

“Is my information correct?”

Frustrated

Relieved when it works

“It took me two hours over a course of probably four days to figure out how the hell to pay Memorial. I said I’m a willing person wanting to give them money. I want to give them my money. And they’re making it so damn difficult. ”

“ If I go to make a payment, I click it. It says I don’t owe anything. Oh, well, that’s funny, because I have a paper here that says I owe $175. So right out of the gate, I am confused.”

Confirms Payment Completion

“Did this process all the way through? ”

“Why is my balance the same? ”

Reassured when it works

Frustrated when there are delays or lack of clarity .

“I paid the statement in full, but when I go back, it still says I owe it.”

Step

Quick Wins

Opportunities

Retrieves Billing Details

Standardize the format of billing statements across departments.

  • Memorial Health can adopt a unified billing platform, such as Epic, that centralizes all charges into a single statement.
  • Implement a digital-first approach where patients can opt to receive bills via email or SMS.
  • Standardize process and structure.
  • Implement a tool that allows customers to validate their own action, such as identity, cards, etc. This has not been activated.
  • Broaden contract with Experian to get more capabilities.
  • Explore how we can empower people on mobile devices to reduce call volumes
  • Develop a statement timeline tracker.
  • Add clear contact information to statements.
Logs into
Portal
  • Pre-populate the RevSpring URL on patient devices.
  • Simplify payment code format.
  • Display a consolidated list of unpaid bills.
  • Include Easy Match code instructions on portal login page.
  • Create a simplified account navigation tutorial.
  • Provide manual linking of family accounts via support staff.
  • Replace one-time Easy Match codes with reusable codes.
  • Add a persistent payment link to FollowMyHealth.
  • Add a QR code to billing statements.
  • Include a shortened, easy-to-type URL.
  • Provide a dashboard in the portal displaying all patient accounts in one view.
  • Enable autofill for personal details.
  • Understand how management of multiple tax ID numbers will work in Epic to ensure the buildout does not create customer experience issues.
  • Implement fast toggling between family accounts within Epic. Address how this is enabled within processes and operations.
  • Embed direct payment links into email and SMS communications for easier portal access.
  • Consolidating all patient interactions into a single portal, such as a robust Cerner or Epic solution, would eliminate the need for patients to navigate multiple systems.
  • Implementing SSO across RevSpring, Cerner and other systems would simplify access for patients, requiring only one username and password. This eliminates redundancy and improves usability.
  • Learn from areas of deficiency and ensure they are addressed in Epic.
  • By leveraging secure account identification (e.g., using demographic or account information), payment codes could be eliminated entirely. This simplifies access and ensures a smoother login experience.
  • Allow users to access multiple family member’s bills under one comprehensive family account management portal with one login via SSO functionality.
  • Allow users to link their accounts across related billing systems (e.g., urgent care, lab services and primary care).
Examines
Billing Statement
  • Provide direct links to payment portals in electronic statements.
  • Implement session persistence for payment codes.
  • Include a prominently displayed statement date to help patients understand that their balances may not reflect recent payments.
  • Add a statement note explaining possible timing differences between EOBs and billing statements.
  • Include a link on billing statements to FAQ about managing multiple accounts.
  • Offer a single online form for requesting payment plans for all accounts.
  • Add a search feature for statements.
  • Add a real-time error message for missing balances.
  • Display a warning when accounts are associated incorrectly.
  • Enable insurance and personal updates online.
  • Use AI to flag potential discrepancies in charges before statements are sent.
  • By integrating with insurance providers, the system could dynamically verify patient coverage and flag issues before sending statements. This prevents errors that lead to claim denials.
  • Integrate Commerce Bank into Epic once implemented.
  • Integrating Commerce Bank’s financing solutions into the RevSpring or Cerner portals eliminates the need for patients to navigate external platforms. This provides a seamless experience from billing to financing.
  • Include a note on billing statements reminding patients to update their account numbers when using online bill pay.
  • Advanced analytics could show patients their payment history, outstanding balances and upcoming due dates in a graphical format. This helps patients better understand and manage their financial obligations.
  • Use machine learning to automatically match payments with intended accounts.
Contacts
Customer Service
  • Add a “Request a Callback” feature for disputes.
  • Designate a team or individual to handle escalations involving multiple billing entities.
  • AI chatbots or virtual assistants can provide real-time payment updates, offer troubleshooting tips and send reminders for overdue bills.
  • Layering in automation will help drive adoptions. Ideally, supercomplex interactions is where staff will focus their time and effort.
  • Centralize billing call centers.
  • Integrate a cross-entity billing system.
  • Expand Escalation team training.
  • Develop family account aggregation.
Makes Payment
  • Offer a “Save Payment Method” option.
  • Pre-fill user data fields.
  • Patients can use their phone’s keypad to pay bills by entering account numbers, routing numbers or credit card details. This reduces reliance on staff for basic payment inquiries.
  • Enable partial payments across all accounts.
  • Add a payment error notification system.
  • Implement a dedicated payment resolution contact line.
  • Patients could enroll in recurring payment plans directly through the portal, making it easier to manage high balances over time. The system would automatically process payments on scheduled dates.
  • Add more staff to handle customer service issues.
  • Enable Interactive Voice Response (IVR) for payment processing.
  • Allow payments via Apple Pay, Google Pay and other digital wallet services.
  • Introducing automated payment options enables users to schedule recurring payments for bills like payment plans.
  • Allow users to search and filter statements by criteria, such as date range, service type or provider.
  • Offer full portal integration with IVR.
  • Consolidate multi-entity payment plans.
  • A fully functioning price estimator could get an estimate vs. call and get answer on the phone.
Confirms Payment Completion
  • Every time a payment is made, an email can confirm the amount and date of the payment, reassuring patients that their payment has been received.
  • Add a downloadable payment receipt option.
  • By implementing real-time synchronization, patients could see updated balances immediately after payments are processed. This will eliminate delays caused by batch processing.
  • Enable real-time payment notifications via mobile app.
  • Displaying statements in real time would be the biggest win. It would require Cerner fixes and engagement with RevSpring.