The medical billing industry serves as the cornerstone for the financial health of the United States’ healthcare system, bringing in revenue that’s critical for the survival of healthcare institutions and service providers. Because of the U.S.’ unique, hybrid, multiple-payer setup, the industry has become increasingly fragmented and virtually broken, leading to inefficiencies and losses throughout the chain. With the cost of medical care rising faster than overall consumer prices, many providers are feeling the crunch, with some being forced to close down locations or reduce their service offerings.
Michael N. Brown, the founder and CEO of Fellow Health Partners (FHP), a leading medical business solutions company, says he founded the company after observing how “archaic” and “broken”, often by design, the billing landscape was for healthcare providers. The process of resolving outstanding claims was so complicated, that many doctor’s offices and facilities did not have the resources to resubmit or appeal insurance claims after being denied. Furthermore, he discovered that a doctor could do the same procedure five times, and get paid different amounts for four of them, and not get paid at all for the fifth. The various difficulties and barriers in handling claims led to healthcare providers leaving up to 12% of their revenue on the table.
According to Brown, most providers, especially independent practitioners and smaller hospitals/clinics/ambulatory surgical centers (ASCs), do not have the resources to go after these claims, with their office administrative staff lacking the expertise or the bandwidth to perform the appropriate tasks. This left them with two inefficient choices: work with boutique billing companies that are unable to scale with clients’ growth and keep up with changing rules and regulations, or partner with large billing organizations that solely rely on high volume, filing as many claims as possible without following up on them, resulting in a lower success rate.
Prior to establishing FHP, Brown was in the professional services industry, including stints at PricewaterhouseCoopers and Loughlin Management Partners + Co. He had more than 15 years of experience in creating operational and financial business strategies for various industries, such as healthcare, retail, manufacturing, and technology. One fateful encounter with the owner of a small medical billing company sparked a profound interest in the industry as they discussed business intricacies and shared the challenges they faced, which piqued his interest in the industry. Due to his interest in solving business problems and creating efficient systems, Brown began researching the needs of healthcare providers.
“Little did I know that chance encounter would lead to the formation of Fellow Health Partners, which fulfills the unmet needs of healthcare providers and helps them pursue millions of dollars in revenue that would otherwise be lost due to the complex and fragmented nature of healthcare billing in the U.S.,” Brown says.
Having gained insight into how providers are financially struggling due to complications within the medical billing industry, Brown set out to create an organization that offered a new operating paradigm for the industry – one that resolved the pain points of hospital systems, ASCs, and physician groups via technology and business solutions, ensuring profitability and sustainability for providers, while being able to keep up with the changing medical landscape.
In order to accomplish this, FHP created a new billing framework by acquiring several smaller billing companies, and then implemented new billing processes and various technological solutions to streamline the experience. These solutions include SimpleSwitch™, which allows providers to maintain their cash flow while switching to FHP’s new system, and SAVi™, a proprietary technology designed by FHP to streamline workflow, improve client access to data, and optimize business processes.
Through its new and unique framework, FHP can help its clients reduce costs to collect by up to 20%, increase net patient revenue by up to 35%, and capture up to 98.5% of revenue against contract.
“Fellow Health Partners is dedicated to providing innovative medical business solutions that will help our clients grow their business and maintain profitability amid today’s numerous challenges,” Brown says. “By combining technology, talent, and training, we have created a multi-faceted support system to meet our clients’ needs, with an approach that’s both high-tech and high-touch, resulting in more transparency, more revenue, and less stress.”
