Patient communications IT increases self-pay collections for Hackensack Meridian

Hackensack Meridian Health believes the patient experience begins with the point of scheduling. Once services are rendered, staff want to ensure statements and other communications are clear and understood.

Staff also want to give patients all available payment options and the ability to pay their bills 365 days a year, 24 hours a day, using online technology.


“We had a statement vendor in place and an online payment solution with another vendor,” said Anne Goodwill Pritchett, executive vice president of revenue operations at Hackensack Meridian Health. “We wanted a single vendor that could handle these and additional functionalities to help us operate more efficiently and become more patient-friendly.

“For example, we created the look and format of our patient billing statements, but there are times when you have to modify the content,” she continued. “That was difficult for our previous vendor, and it took a long time to make changes.”

Hackensack Meridian also wanted to tell patients why they are receiving a bill or what the billing amount represents.

“If it’s just a deductible or co-insurance, ANSI codes come back on the remit, which is the patient responsibility defined by the insurance company,” Pritchett explained. “But if it was for another reason, such as benefits are exhausted, our Epic EHR system generates a comment code and descriptor.

“We wanted that patient responsibility comment code and the definition of what it means inserted on the statement,” she added. “The former vendor couldn’t do that.”

“If your aim is to be patient-centric and patient-focused, you must ensure your statements and messages are easy to read and comprehend.”

Anne Goodwill Pritchett, Hackensack Meridian Health

Lastly, Hackensack Meridian wanted a digital image of every statement, so if a patient calls with questions, the customer service team member can pull it up and see exactly what the patient received.


Hackensack Meridian turned to Nordis Technologies, a vendor of cloud-based customer communications management technology.

“Nordis’ Expresso platform offered the composition, delivery and management capabilities we desired with the speed and efficiency required,” Pritchett said. “The solution lets users create and edit print and email templates using common data, content and business rules.

“They offered print and mail production and return mail processing, statement archiving, and convenient retrieval of patient communications,” she continued. “Their platform also tied seamlessly with TD Bank’s online payment solutions, enabling fully integrated electronic bill presentment and payment capabilities.”

The vendor demonstrated to Hackensack Meridian staff how they could quickly make any statement adjustments or changes and how they’d incorporate personalized messages on patient statements that staff could edit as required.

“Having an image of the statement that we can attach to the patient account was really important to us as well, and that’s just standard practice for them,” Pritchett noted.

“Much of this is about improving communications with customers and offering personalized experiences,” she said. “Nordis showed us they could do all those things for us, so not only can a patient make a payment online, but that money goes directly to our TD account.”

The IVR system allows patients to pay using the phone without speaking to anyone. Or they can pay online, mail a check, or call the customer service department.

“We strive for great patient satisfaction,” Pritchett said. “A patient’s experience is not just the service they receive but the full gamut, so these things were important to us.”


The Epic EHR system securely sends the electronic billing files to Nordis for formatting into multiple branded statement layouts. All this software exists in the cloud, which adds to the security and efficiency of the process, Pritchett contended.

“Nordis composes, prints and mails the statements, and TD Bank presents the statement electronically in the payment portal,” she said. “The Expresso dashboard is easy to access, and we can track and report on everything.

“Customer support is involved in our processes, and IT supports us on the Epic side,” she added. “We use other vendors to scrub and confirm real-time eligibility to know about the patient’s coverage, what they will owe, their deductibles, and so on.”

A recent example of statement changes, Pritchett related, involved the surprise billing law.

“We conduct financial clearance for scheduled services before patient arrival, so we’ve always told patients what their out-of-pocket expenses will be,” she explained. “However, per the federal government, certain language now has to go into the statements.

“Using Expresso, we quickly modified the statements to include that language,” she continued. “We also wanted to send patients a letter with their first statement explaining their rights under the No Surprises Act. We gave Nordis the letter, and using Expresso, associated the letter to the patient statement, which printed in-line with the statement itself.”


In addition to helping revenue operations work more efficiently across the organization, staff have accelerated payments and reduced phone calls, all while enhancing patient satisfaction, Pritchett reported.

“Much of our self-pay collections happen pre-service and at the point of service,” she noted. “Once we began utilizing Nordis and began generating patient statements that were clear and easily understood, and in conjunction with increased payment options, we saw an increase in our self-pay collections. Many patients were paying in less than 30 days.

“In addition, because the statements explain why the patient is receiving a bill, it significantly reduces the number of phone calls we receive,” she added. “If the bills are clear, patients don’t have to call.”

Hackensack Meridian implemented the Nordis/TD Bank program at its flagship hospital several years ago. As the health system merged and added hospitals, it rolled out the technology to align workflows, processes and technologies.

Today it’s in place across the health system, in all 12 hospitals. Staff are actively working on expanding the use of these technologies to use to send statements for approximately 500 physician and/or professional locations.

“We’ll use Expresso to develop, customize and deliver 1.8 million statements, letters and other patient financial communications this year alone,” Pritchett reported.


“If your aim is to be patient-centric and patient-focused, you must ensure your statements and messages are easy to read and comprehend,” Pritchett advised. “And you need to take advantage of the tools available to make it fast and convenient for patients to pay their bills.

“The other thing is not to make a change for change’s sake but to use technology to improve overall efficiency and performance,” she added. “Use automation to get rid of as many manual processes as you can.”

A provider organization needs systems that give it flexibility and control and help increase financial engagement and patient satisfaction, she said.

“How will what you’re doing benefit the patient?” she concluded. “That’s the real question to ask.”

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.

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