Dr. Eric Fishman for EHRtv discussing revenue cycle management with Jerry Merritt, CEO & President of Zirmed.
Eric Fishman: This is Dr. Eric Fishman for EHRTV and we will be discussing revenue cycle management today with Jerry Merritt, CEO & President of Zirmed. We are in New Orleans at MGMA 2010. Jerry, thank you for spending a few minutes with us.
Jerald Merritt: Glad to be here.
Eric Fishman: Zirmed, as I understand it, is what I would call a revenue cycle management company; and in fact, if you be good enough to spend a couple of moments describing the difference between revenue cycle management and what I was doing when I saw it at my practice 24 years ago which is billing, and I understand that from your perspective there is a meaningful difference between those two.
Jerald Merritt: Absolutely. We consider ourselves – we pick up right after billing in terms of focusing on the technology that moves the billing up to the payers in order to get the practice or the physician or the hospitals paid faster.
Eric Fishman: And so there is probably a number of steps in a relatively sophisticated process with revenue cycle management and if you could address some of those to indicate whether it’s better to be done in an office, if it’s done outsourced where the clearing houses fit into all of this.
Jerald Merritt: Sure, the billing process begins whether it’s in the office or it’s outsource and from that point the thing is so challenging for revenue cycle management that even if you do your coding and your billing the best that you possibly can, only 65% of that’s going to actually make it through the payers process. So, you are going to have a 35% challenge and it’s that revenue cycle management cleaning those challenges up, correcting those situations that cause all the delays and so that’s really where we focus on.
Eric Fishman: And what specific steps do you take to help your clients accomplish that?
Jerald Merritt: Actually one of the keys is that a lot of times you will make the same mistake or the same thing over and over. So, we will put in special edits that might work just for your practice like “Dr. Jones will always be doing it this way” and then in fact we will all know that that’s just a carryover from how they used to do it. So, we will put that edit in there and fix it so that every time he goes through that cycle, it’s always going to come through clean.
Eric Fishman: How long a process does it take between having a practice decide that they want to use your services and actually have your rules being utilized to improve their cash flow?
Jerald Merritt: Well, the short answer to that is it can be as quick as 30 days. There are a lot of consistencies. We have customers all over the nation, so we see things over and over. When you look at it just from the practice standpoint, you think maybe you are the only one that’s going through this challenge when, in fact, if we have that same challenge for someone else down the road, we can apply those to the practice fairly quickly.
Eric Fishman: Do you specialize in any particular medical specialties, any specific geography?
Jerald Merritt: Well, the great thing about what we do is that because we pick it up after the billing right at that edge, our expertise is really in that technology. So, we go across the board and we have a lot of partners that specialize in various different practices and we specialize in that technology, in that interchange and the complicated stuff that goes on after that to try to get all the codes lined up with the payers to make sure that we get paid quicker regardless of what practice management system you might be using.
Eric Fishman: Pretty good. Jerry, are you comfortable talking about some of those partners that you worked with?
Jerald Merritt: Well, absolutely.
Eric Fishman: Please.
Jerald Merritt: So, Workflow for example is one of our partners out of Cleveland and they had released the brand new patient management system that goes across a lot of different practices. Med Informatics is out of California and they have radiology specialties and we have host of partners, many of which are sometimes our competitors as well. It’s interesting that I am a Pepsico guy and we learned to hate Coke, but I got in back into healthcare about six years ago and I have this thing called <<inaudible>> which is a little bit interesting. So, just about everybody in this field has to work together to try to make sure that the payers are doing what they need to do and we are making sure that we can get the providers paid as well.
Eric Fishman: Jerry, I thank you for being up the <<inaudible>>, if you will. A lot of physicians really don’t understand this industry, and if you are comfortable discussing who the people, the participants in this industry are that would be wonderful.
Jerald Merritt: Absolutely. Well, we all know that the money and some of the conversation revolves around the payers, the insurance companies, and a lot of the insurance companies will have divisions to potentially do revenue cycle management because they are trying to be as efficient as they possibly can; but because there are divisions of that insurance company, that might create a little confusion or <<inaudible>> and maybe some of the providers don’t want to have too many of their eggs in that one basket; and at the same time, we all know that it’s a regional business. When we talk about coming to Louisville because we have certain specialties there, there are different regions of practices; and so the practice management systems will revolve around those regions. The insurance companies revolve around those regions. So, you have a lot of fragmented players in the market place; but at the end of the day, we are working against the same set of standards, we are trying to be as efficient as we can, we are using the same codes. So, we have this highly complex technology data interchange and the only way that works is if we all work together similar to the banking system, that’s a single standard and we have a single standard; but all the players need to be on the same filed at the same time. We all want to be competitive and we want our companies to grow and we want it to be successful; but at the same time, we all have to operate against the same set standards. So, we have to work together.
Eric Fishman: I am understanding that, that’s very good. In a related way, in EHR industry there has been a tremendous amount of consolidation expected, there may even be some deals announced here at MGMA. Is a similar set of processes going along in the revenue cycle management industry?
Jerald Merritt: Absolutely and it comes in two phases – there will be some vertical consolidation where you will be able to go do the entire practice whether it’s revenue cycle management or patient management as the larger companies as well as areas of specialty. So, there is always efficiencies to be gained through consolidation. It may adopt some of the creative ideas if we have fewer companies, but I am pretty confident that those will continue to emerge with some of the smaller companies coming up with these great ideas that will drive efficiencies.
Eric Fishman: Great. Jerry, anything else you want to tell the viewers of EHRTV?
Jerald Merritt: Well, I am excited to be here. We believe that we can save billions of dollars and nickel at the time and that’s our goal to try to help everybody be more efficient.
Eric Fishman: That’s a great expression. This is Dr. Eric Fishman. We have been speaking with Jerry Merritt, President & CEO of Zirmed. Thank you.