The Legal Perspective on PatientPay's Latest Financing Round

In the most recent edition of Lawyer Monthly Magazine, Karim N. Momin, Esq. discusses what went into putting together PatientPay's most recent financing. Some key points include integrating with existing investors, finding new investors who bring strategic vision to the company and ensuring the long-term growth of PatientPay.

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Transaction Report: PatientPay Secures $6M in Funding led by Teaghlach Family Office, with Esping Family Office & Mosaik Partners

PatientPay, the leading patient payments partner for specialty care, has secured $6 million in growth capital. The investment will be leveraged for significant company expansion and continued enhancements to its patient payments platform, establishing the patient billing experience as a natural extension to patient care.

Teaglach Family Office led the round with participation from Esping Family Office and existing investors, including Mosaik Partners, to support PatientPay’s industry focus on providing
end-to-end patient payment solutions for anesthesiology, radiology, labs and other specialty medical groups at every point of care.

PatientPay Announces the Appointment of Lou Silverman to its Board of Directors

Healthcare Veteran Brings Growth Experience to Continue Momentum

DURHAM, NC JANUARY 17, 2018 - PatientPay, the leading end-to-end patient payment solution focused on the financial challenges facing specialty healthcare, announces the appointment of Lou Silverman to their Board of Directors.

“Lou’s experience in building nimble companies that drive rapid growth and industry change is unparalleled,” said Tom Furr, PatientPay’s CEO. “I am thrilled to have such an accomplished visionary and respected industry leader join our board.”

PatientPay Secures $6M in Growth Capital

Funding to be used for significant 2018 expansion, driving adoption of reliable patient payments for specialty healthcare providers

DURHAM, NC (DECEMBER 6, 2017) – PatientPay, the leading patient payments partner for specialty care, has secured $6 million in growth capital. The investment will be leveraged for significant company expansion and continued enhancements to its patient payments platform, establishing the patient billing experience as a natural extension to patient care.

Teaglach Family Office led the round with participation from Esping Family Office and existing investors, including Mosaik Partners, to support PatientPay’s industry focus on providing end-to-end patient payment solutions for anesthesiology, radiology, labs and other specialty medical groups at every point of care.

PatientPay Appoints Shahzad Qadri Vice President of Operations

HIT Executive to Manage Growth for Healthcare Payment Solutions Company

DURHAM, NC, SEPTEMBER 06, 2017 -- PatientPay™, the leader in patient payment solutions for the healthcare industry, today announced the appointment of Shahzad Qadri as Vice President of Operations.

“Throughout his career in healthcare IT Shahzad has worked to manage strong corporate growth which is exactly what we require with the new clients we have recently signed up,” said Tom Furr, PatientPay’s CEO. “We are excited to have such an accomplished builder of businesses and customer relationships join the PatientPay team.”

Waiting on Congress to fix healthcare could be hazardous to physicians

With startling serendipity, a month to the day after the ACHA passed out of the House, Anthem joined Aetna, Cigna, and Humana in quitting the ACA health plan marketplaces in Ohio. The very next day, Premera Blue opted to end participation in two counties in Washington state, adding another region of the country poised to be without coverage through the ACA. Blue Cross and Blue Shield of Kansas City is also planning exits impacting some 25 counties in western Missouri.

And now that we’ve seen what’s in the Republican’s Senate healthcare bill, it’s unlikely those health insurers will reverse their business-driven decisions. In the process, the problems for individuals and families with coverage through an ACA marketplace will get worse in all probability. What’s more, those who have employer-provided health plans are contending with their own set of healthcare-related troubles.

According to the Kaiser Family Foundation, 83% of workers who are getting some form of coverage through their employers have plans with deductibles. That dollar amount has gone up nearly 50% in the last five years. Data from the Centers for Disease Control and Prevention show one-quarter of those covered have high-deductible health plans (HDHPs), and most anticipate this form of policy will soon become the standard. Kalorama Information, a medical market research firm, noted recently that Americans will be shelling out a stunning $608 billion from their own pockets by 2019.

Hospitals’ new reality: Patients as payers

Healthcare organizations have been slow to react to the fact that an increasing percentage of their revenue is coming from patients. It’s been occurring over the last ten years.

In 2006, just 5 percent of employer health plans had members enrolled in high-deductible health plans (HDHP). Last year, nearly one out of three covered employees was in an HDHP, according to Kaiser Permanente. Along with that enrollment growth is the rise of deductibles, which, notes Kaiser Permanente, is outpacing earnings and savings rates by a factor of six.

Four years ago, the management consultancy McKinsey & Company took a look at revenue cycle operations in hospitals and made the following observations:

Paper-Based Billing is Ancient History in Healthcare

"Today's realities are that managing a practice is more complicated than ever…"

That's how an assessment begins on what it takes to successfully run a medical group in 2017 by Triple Tree, a merchant bank focused on healthcare. In a recent report, the bank also looked at the forces driving mergers of specialty groups. Chief among them is the realization by administrators and their physicians that the healthcare business isn't what they hoped it would be.

The mounting pressures are affecting medical groups' top and bottom lines. The bank's report suggests that while opting to be part of a larger group might sound attractive to an independent practice, the non-clinical demands are the same, just more complex.

And that is why all medical group administrators must realize the way to manage their group should sync with the business environments in which they operate. According to TripleTree, a critical success factor is administrative and operational efficiency, due to the significant burden created by government regulation. It also noted that groups need to support and keep pace with changing consumer preference.

The key to understanding consumer-centric healthcare

The changes that have occurred thus far are likely to pick up speed, in part because of who will be working for the White House. Trump’s choice for Secretary of Health & Human Services, Tom Price, MD, is a supporter of consumer-centric health plans. Further, Vice President Mike Pence brings with him experience as governor of Indiana where he oversaw the implementation of consumer-centric healthcare policies. Adding to that, Pence’s health plan architect was Seema Verma, who’s been tapped to head the Centers for Medicare & Medicaid Services (CMS).

The essentials of consumer-centric healthcare include empowering the patient to make choices, be involved in the decision-making process for her/his care and, it should be emphasized, understand what the costs are upfront by way of transparent pricing and candid conversation.

The driver behind this consumerism is the emergence of high-deductible health plans (HDHP). Back in the day, a patient’s financial responsibility for their healthcare was often a single digit percentage of the cost, if that. Now, with HDHPs, a patient is confronted with 30% to 50% of the financial responsibility for their care.

NextGen-Powered Healthcare Provider Chooses PatientPay To Improve Cash Flow, Decrease Time to Pay

Jacksonville Children’s & Multispecialty Clinic Makes Move As it Grows, Seeks Greater Efficiencies

Durham, NC (February 21, 2017) -- PatientPay℠, the leader in paperless patient billing solutions for the healthcare industry, today announced Jacksonville Children’s & Multispeciality Clinic has paired the PatientPay Paperless℠ solution with its NextGen practice management software to collect more patient payments, faster and at less cost.

“After an evaluation of the clinic’s billing process, it became clear we managed a high percentage of self-pay balances, coupled with high statement and collection costs,” said Cheryl Myers, CMPE, the Jacksonville, North Carolina-based clinic’s Director of Revenue Cycle Management. “It was necessary to take new steps to improve communications with our patients and, as a result, collect payments from them in a more timely manner, with less effort and expense.”

The PatientPay Paperless solution integrates with most popular practice management software products to increase the speed, reduce the cost to produce and distribute statements and secure payments from patients electronically. It also affords automatic reconciliation of patient payments to a provider’s accounting system, just like it reconciles insurance payments today, so there is no change to existing workflows. 

PatientPay Drastically Cuts Time to Post Patient Payments For Chicago-area Speech Therapy Clinic

Pediatrics Interaction Saves 90 Minutes Daily with Auto-Reconciliation Feature

Chicago and Durham, NC (February 20, 2017) -- A speech therapy clinic serving the northern suburbs of Chicago has been able to cut the time to post and reconcile patient payments by 90 minutes per day because of a solution from PatientPay℠, the leader in paperless patient billing for the healthcare industry.

“Soon after Pediatrics Interactions implemented PatientPay as its bill-pay solution, the hour and a half taken up every day to post and reconcile payments to patient accounts disappeared,” said Kricia Doescher, Pediatric Interactions’ office manager. “PatientPay’s auto-reconciliation feature made it possible. However, more than fast, this feature is accurate. Payments are posted to the right balance of the right patient account.”

The growing private clinic, with facilities in Grayslake and McHenry, Illinois, prides itself on using creative approaches to help its young patients and their families. As such, it decided to step away from the status quo of healthcare billing, which is overwhelmingly paper-based statements sent to patients by the U.S. Postal Service, and move to a secure, HIPAA-compliant digital solution.

Don't Let Cybercriminals Infiltrate Your Practice

Reports have splashed across the pages and screens of media outlets with frightening regularity about security breaches at healthcare provider organizations as well as patient data being held for ransom by opportunistic cybercriminals.

The Ponemon Institute, an independent research firm, noted in its 2016 "Benchmark Study on Privacy & Security of Healthcare Data" that breaches of information systems at hospitals are occurring with increased frequency, and will likely continue at an unabated rate as cyber threats evolve and cybercriminals become even more audacious.

The survey provides the viewpoints of people responsible for, or involved with, digital security at hospitals and hospitals' partners. As a leader of a medical group, you cannot say, "'That's not me or my problem." If anything, a medical group has more to worry about.

Why ACA’s demise requires a fresh look at business practices

Immediately after the 115th Congress of the United States was sworn in, Republican leadership of both houses began their move to dismantle much, if not all, of the Affordable Care Act, also known as Obamacare, which sought to bring health insurance coverage to more Americans.

I am not qualified, nor interested in exploring what we might see in the ACA’s place, but with that said, as the CEO of a company offering solutions that bring greater operational efficiency to healthcare providers, particularly in regards to patient payments, my interest ought to be apparent.

If we blow away the cloud of confusion surrounding the effort to do away with the ACA, one thing is clear: uncertainty. Despite all that’s unknown, it appears clear that consumerism will be a major part of healthcare’s future, according to Rep. Tom Price, who is the nominee to head the Department of Health and Human Services; Rep. Paul Ryan (R-Wis.) the majority leader in the House; and President-elect Donald Trump.

How providers can capitalize on consumers’ preferences for mobile connectivity

Mobile devices will be the chief mode of access for the Internet, accounting for three out of every four minutes of connectivity in 2017. That forecast was made recently by Zenith Media, a unit of Publicis, a global marketing group. That represents a seven percentage point rise from this year’s 68 percent. It also projects mobile Internet usage will reach 79 percent by 2018, nearly doubling since 2012.

Gartner, the technology industry and advisory company, estimates that 50 percent of all digital commerce in the United States will be transacted on mobile devices in the new year.

None of this should be surprising. Marketers have always shown a savviness to engage customers in ways that reflect their preferences. Evidence of that, as well as a further indication of the importance of mobile, is another data point in Zenith’s forecast. It reports mobile advertising will overtake desktop ad spending next year and will account for 60 percent of all Internet advertising, making it bigger than newspapers, magazines, cinema and outdoor advertising combined.

Healthcare Needs More than One Moonshot

President Barack Obama called upon America to apply all its innovation to create a moonshot-like initiative to rid the scourge of cancer during his final State of the Union Address, Jan. 12, 2016.

The term "moonshot" comes from a speech given on May 25, 1961 by President John F. Kennedy. He asked America to undertake a space exploration program; landing men on the moon by the end of the decade. Interestingly, President Richard M. Nixon first used the imagery of a moonshot for healthcare in a 1971 speech where he too talked about finding a cure for cancer

Clearly, we're better able to meet the challenge than when Nixon put it before us. However, the point I wish to make with this blend of history and optimism is as fast and far as healthcare goes in research, discovery, procedures, treatments, and cures, that's how slow it moves with to make its operational side more efficient, easy and equitable. Take a stroll through the business office of group practice and you’ll see what I mean. The level of inefficiency, in terms of process and cost-effectiveness, is disturbing.

Why user experience is critical to advancing HIT adoption

I have a friend who lives in New York City. For the sake of protecting the innocent, let’s call him Sam. What follows is his experience during a recent appointment with his urologist for a post-surgery check-up as well as some pertinent observations.

Sam uses a big group practice affiliated with a large teaching hospital in Manhattan. He’s more technically savvy than most, so the idea of working through a portal to make an appointment or check on test results doesn’t faze him. He even uses the HIPAA-compliant messaging system to ask questions of the doctors in the practice. He finds it amusing that an emailed notice of a bill sitting somewhere on the portal shows up a day or two after the same bill in paper form shows up in the snail mail.

Avoiding financial disaster when collecting patient debt

You’re sitting in an exam room with a patient who’s been with you for years. There have been a wide assortment of maladies addressed over that time. And, to the delight of both you and your patient, the outcome has always been successful. From all outward appearances this looks to be a superb relationship. You understand him. He trusts you; even recommends you to folks he knows.

But now this patient asks you how much something will cost as he recently switched to a high deductible plan and the initial dollars are now coming out of his own pocket. Your conversations have evolved from discussing just clinical issues to costs. I strongly suspect most providers can’t answer cost questions as well as they can clinical issues and, more importantly, don’t want to answer since they see it as the job of administrative staff.

The Kaiser Family Foundation reports in its 2016 Employer Health Benefits Survey that the average insurance premium for a family covered by health plans offered by employers rose just 3% this year. This is actually a slowing of the rise of premiums for such insurance coverage, which is the biggest source of health coverage in the United States.

Why patient engagement will only rise in importance

From massive medical centers in the heart of major urban areas to small hospitals in rural areas well off the Interstate Highway System, there exists, in one form or another, a patient engagement initiative. Reflective of that are the 1,100 job openings that returned when I typed in “patient engagement” in the Jobs search box on LinkedIn.

Finding ways to engage with patients makes all kinds of sense in this day of high deductible health plans. More of the healthcare dollar must now come from what is increasingly someone referred to as a healthcare consumer. And that consumer is involved in healthcare in more ways than financial responsibility.

Since 1990, average life expectancy in the United States has increased from 71.8 to 76.4 years for men, and 77.8 to 81.2 years for women. During that same period, the uninsured rate has dropped from 13.9 percent to 9.1 percent. And the number of physician visits is increasing at a rate faster than this country’s population growth.

The three questions CFOs should ask their RCM partners

With pressure mounting to cut costs and improve finances, about 81 percent of hospital leaders have made outsourcing financial services a top priority. But cost-to-collect is not the only metric financial leaders should monitor in their revenue cycle service partnerships.

Tom Furr, CEO and founder of Durham, N.C.-based PatientPay, shared with Becker's Hospital Review critical questions he recommends CFOs ask revenue cycle service providers to ensure both return on investment and optimal financial efficiency.

HIPAA turns 20, and there’s no reason to celebrate

In 1996, The Spice Girls were at the top of the pop music charts. DVDs had just been launched. The number of Internet host computers increased from 1 million to 10 million. And the Health Insurance Portability and Accountability Act (HIPAA) was passed into law.

Now, 20 years later, two of the Spice Girls launched a website that celebrates the group’s two decade’s worth of “girl power.” A DVD is more likely used as a coaster for a cold drink than as an entertainment medium, and the number of host computers on the world wide web is well over 1 billion. And, most unfortunately, we’re still struggling with HIPAA.

When the law was enacted, its aim was to limit exposure or disclosure of personal information and enhance communications between doctor and patient. However, it was created well in advance of the ubiquitousness of the Internet, smartphones and social media platforms. In 1996, most if not all medical records were in paper form, the concept of data mining was a sparkle in the mind of a computer scientist, and the business of sifting through data to better analyze and predict was not yet conceived.

Healthcare And Kitchen Table Economics

We’re in full-blown presidential campaign season. This race is in stark contrast to prior ones which often featured talks by candidates that visualized a couple or family sitting at the kitchen table discussing where things stood for them economically.

This image has been used as a way to drive the complexities of a growing, global economy to a level all could grasp and appreciate. Whether it was Republican or Democrat, the ones driving for the Oval Office would use that setting as a way to relate to and connect with their fellow Americans.

Economists all across the spectrum of theory will argue the notion of kitchen-table economics is little more than a ploy by office seekers to have voters think they empathize with their plight. Nonetheless, this quadrennial competition, like earlier ones, finds Americans sitting at the kitchen table wondering where their money is going.