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Healthcare is likely the most difficult example of accounts receivable on the planet. In other industries, invoices go out, and either some or all the money for that invoice comes back and gets posted. Then you move on.
In healthcare, you almost never receive the amount invoiced. For example, you go to the doctor and he does something that is billed to an insurance company at $100. What comes back is a check for $27, along with two pages explaining why.
That “explanation of benefits” (EOB) is very difficult to parse to determine what was denied, what was reduced due to provider contracts, what part is the responsibility of the patient to pay and so on. It all must be reconciled back to the amount of the check before posting to the practice management system at the hospital.
Not only do payments have to match the claims, but also healthcare billers must reconcile the day’s deposits to the amount of cash that came into the bank. They cannot post electronic information that has not been funded.
MediStreams, a healthcare revenue cycle management (HRCM) solution
MediStreams fills the niche of remittance processing in the revenue cycle of healthcare providers.
The company’s HIPAA-compliant solutions dramatically lower the cost of processing payments in the billing office where often a $2 human driven process can be reduced by 75 percent or more for paper payments.
IBM Cloud for redundancy
Initially, MediStreams owned all its hardware and infrastructure and was more than proficient in managing it. So when the idea of cloud-based services and infrastructure came along, the company wasn’t quick to go there.
MediStreams took a wait-and-see approach. As the technology matured, it became obvious that service providers such as IBM, who make their living by keeping hardware up and running, could offer us more reliability and scalability at less cost than we could continue doing for ourselves. Buying into the cloud is exactly the concept that MediStreams sells its own customers: “Why process payments in house, when MediStreams can do it in our cloud more efficiently?” We simply followed our own advice.
As MediStreams grows, it becomes increasingly important to have a multisite solution of dedicated servers for redundancy, disaster recovery and compliance. In the world where HIPAA strictly governs the protection of patient healthcare information, auditors frown on companies that co-mingle data on cloud-based services where multitenancy is used to offer cut rate pricing.
With IBM, we know we are the only company using the capacity and resources of the hardware on which we sit. Yet, the cost per virtual server remains market competitive as we deploy dozens of servers on each physical server.
The IBM Cloud supports the entire MediStreams architecture of networking and servers in a virtualized environment with subscription based pricing. Virtualization with VMware allows us to quickly deploy servers with the correct amount of CPU power and data storage needed.
Enjoying the benefits of IBM Cloud
The MediStreams migration to the IBM Cloud is going smoothly. We remain impressed at the level of assistance we receive from IBM. They come to the table with the human and technical resources to help us solve problems.
Our growth demands that we have a scalable infrastructure. MediStreams is confident that it can rely on the IBM team to deliver on-demand cloud infrastructure that keeps up with our rapidly expanding enterprise.
The services that MediStreams sells to our customers come with a promise of process improvement. To deliver on that promise, MediStreams must embrace that same goal of operational efficiency as we build our solutions. Moving from a traditional data center to the IBM Cloud has been pivotal in helping us go to market with a rock-solid solution that can grow rapidly, but keep incremental operating costs in sync with new revenues instead of incurring costly capital expenditures in advance of that growth.
Being able to buy infrastructure by the slice is one of the competitive advantages that allows us to win business from our competition.
As a bonus, we enjoy a compliance win by having IBM as a partner with their model of single tenant hardware. And MediStreams enjoys the reputation by association gained when the IBM name is a part of our story. This speaks volumes to our healthcare customers that MediStreams is a company that takes seriously the security and protection of their sensitive data.
Learn more about VMware on IBM Cloud.
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