MediStreams chooses IBM cloud for healthcare provider billing solutions

MediStreams fills the niche of remittance processing in the revenue cycle of healthcare providers.

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 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…

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