Hamilton Todd is a section manager with Mayo Clinic based out of its Jacksonville, Fla. location. Since retiring from the Navy in the early 1990s Todd has worked in revenue cycle management for Mayo serving all of its locations. In this month’s Q&A, Todd reflects on the state of medical banking in the industry as well as specific projects at Mayo Clinic.
Q: You have been using lockboxes at banks since the mid 1990s. How is their use by providers evolving?
Todd: We use both retail and wholesale lockboxes. Retail being the patients and wholesale being the one for things coming from the payers. It is only recently that we have been able to take advantage of the wholesale lockboxes that can turn what comes in into an 835 that can post into our patient accounting system.
Q: How far along is the industry when it comes to electronically creating an EOB that can automatically post to a provider’s accounting system?
Todd: It is still a growing piece of medical banking that is not widespread yet. It is very complex and challenging. An EOB is not an EOB is not an EOB, even for the same payer because of differences in group contracts. For two separate contracts, those two EOBs could be similar or they might not be at all and that includes by region. A Blue Cross EOB from Iowa may look different from an EOB from Wisconsin. More recently banks have been able to offer through partnering with other companies a way to convert all of those paper explanation of benefits into an electronic 835 which you can post. We have a project at one of our sites right now working with US Bank. They and their partner convert all this paper into an electronic file and our site is able to post those payments from payers electronically into their system instead of doing the manual entry.
Q: What is the opportunity available for banks to help both payers and providers move less paper?
Todd: I think this is where banks may be able to partner between the payer and the provider. The opportunity is there for them to become the payment clearinghouse, if you will, between payers who don’t have compliant 835s and providers. Banks should be able to help them create that electronic 835 file.