HRG is a leading revenue cycle management company that provides customized solutions to healthcare clients. It has grown over the past two decades by adapting to changes in technology and customer needs. HRG developed its own proprietary software called Helix AI that uses artificial intelligence and data analytics to streamline workflows. This has helped HRG provide more efficient and effective services to clients. During the COVID-19 pandemic, HRG transitioned nearly all employees to remote work within three days while continuing to deliver high quality services. The company advises those entering the RCM space to focus on specific solutions and client types initially before expanding.
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10 most trusted revenue cycle management solution providers
1. Healthcare Revenue Cycle Management Redefined
Healthcare
Resource Group, Inc
REVENUE
CYCLE
MANAGEMENT
SOLUTION
PROVIDERS
1 Most
Trusted
Greg West President
|
2021
VOL. 05
ISSUE 03
Social Media and
Healthcare : what kind
of content should
we trust?
Consuming Wisely
The Role of RCM in
Healthcare Organizations
Managing the Backstage
2.
3.
4. he medical field has been an ever evolving one.
TAnd when it comes to adopting the latest
technologies, be it care or administrative, the
medical field has been at the forefront.
One of the most complicated processes has been that of
billing and maintaining the billing records of a patient.
Constant developments in technologies have thrown an
array of possibilities in easing the gargantuan and
monotonous tasks of healthcare establishments. One such
technology is the revenue cycle management.
Even as the healthcare establishments were on a tech-driven
spree, the Covid-19 pandemic only shoved them further and
faster into it than one could imagine. Revenue cycle
management was one of the rescuers to an already
overworked medical fraternity. Those who had not yet
adopted to this this technology or were in the nascent stages
of adopting, also swung into action.
Management of funds, collecting payments, billing, and
maintaining a foolproof record have never been easy. To
make these processes smooth and simple for healthcare
establishments, RCM solution providers came across as
messiah for them.
Managing patient’s billing records have become easier with
RCM, a medical billing software to track a patient’s data
from registration process to the final payment. RCM makes
it easy for a healthcare organization to store and manage the
patient’s data by synchronizing personal information and
the insurance provider with treatment and health care
information.
The major task of RCM is to communicate with the
insurance companies, check the patient’s insurance
coverage during admission and if necessary, do a follow-up
with the insurance company in case a patient’s insurance
amount is rejected or withheld. RCM significantly reduces
amount of time between providing care and treatment and
receiving payment. It also has the responsibility of ensuring
the safety of employees.
In fact, administrative duties like reminding patients of
appointments, pending payments and the like that were
handled by the staff can be automated through RCM, saving
manpower and time. In this regard it is also a perfect tool
for digital patient engagement.
But with rising demand for a service or technology, the
market also gets overcrowded with suppliers and
subsequently a cutthroat competition, making it difficult to
choose the competent one. Some RCM solution providers
rose above the rest and set a benchmark for others to
emulate.
Our latest edition of Insights Care, 10 Most Trusted
Revenue Cycle Management Solution Providers, throws
light on how these solution providers paved the way for
easy billing through technology to healthcare
establishments by delivering quality services.
Have an interesting read!
Revenue Cycle Management
Solution Providers Easing
the Billing Process
Sumita Sarkar
6. 32
The Most Preferred Name
in HealthTech Space
Vee Technologies
20
Articles
16
Social Media and Healthcare: what
kind of content should we trust?
Consuming Wisely
28
The Role of RCM in
Healthcare Organizations
Managing the Backstage
24
How to Translate Data
Into Revenue Growth
CXO
Automated RCM Solutions that
Empower Physician Practices
MedEvolve
Expert Opinion
7. C O V E R S T O R Y
C
O
N
T
E
N
T
S 08
Revenue Cycle Management Redefined
9. Description
Featuring
All Right Medical
Management Services
allrightmedical.com
Scott Decker
CEO
All Right Medical Management Services' goal is to be a
partner and collaborate with healthcare organizations to
provide the best possible experience for patients.
Cantata Health
cantatahealth.com
Alan Tillinghast
CEO
Cantata Health Solutions provides EHR & RCM software
for Health & Human Services, Acute & Post-Acute Care.
ClaraPrice
claraprice.com
Jory Hatton
Co-founder and CEO
Healthcare Business
Insights
healthcarebusinessinsights
.com
Brad Cording
VP Commercialization
& Product Management
More than one thousand hospitals and health systems
nationwide are using Healthcare Business Insights (HBI) to
access research and resources critical to every aspect of their
business operations.
MedEvolve
medevolve.com
Matt Rolfes
President and CEO
MedEvolve empowers physician practices to work smarter with
data-driven solutions that provide unmatched transparency,
automation and accountability.
Richard Shawyer
Managing Director
Patient Billing is an innovative medical billing agency
developing technology that puts the patient at the center.
Patient Billing
patientbilling.co.uk
Sean Joyce
CTO
Patientco is a payment technology company
headquartered in Atlanta, GA founded specifically to re-
think the healthcare payment experience.
Vee Technologies
veetechnologies.com
Chocko Valliappa
Founder and CEO
VisiQuate
visiquate.com
Brian Robertson
Founder and CEO
VisiQuate’s user-friendly end-to-end revenue cycle management
and analytics solutions let virtually anyone in a healthcare
organization explore complex data from multiple sources to
quickly gain insights and create actionable workflows.
ClaraPrice provides RCM and Chargemaster Management
solutions for hospitals and health systems with a focus on
price transparency compliance and improving patient
access with innovative software platforms.
Vee Technologies works as a trusted business partner to
enterprises and organizations around the world, delivering
production solutions for extraordinary outcomes in quality
and cost.
HRG
hrgpros.com
Greg West
President
Healthcare Resource Group’s expertly crafted revenue cycle
management services provide customized solutions for
associated healthcare facility’s unique needs.
patientco
patientco.com
Company Name
REVENUE
MANAGEMENT
SOLUTION PROVIDERS
1Most
Trusted
10. Revenue Cycle Management Redefined
HRG is an
employee-owned
company, and all
employee-owners
share in the
ownership and
financial success.
“ “
C O V E R S T O R Y
12. For any business to thrive,
evolving with time becomes an
essential part of its growth
strategy. Comprehending the avenues
of progress—around the likes of
adopting updated technologies, change
in customer demands and
preferences—plays a catalyst in the
process of achieving ascension in
revenue and overall growth.
Companies across the spectrum of
healthcare services have witnessed
firsthand the importance of
acknowledging and adopting change
during the initial period of the
COVID-19 Pandemic. Such companies
have thrived in terms of delivering
quality services, in catering efficiently
to the customers, and in contributing
towards the safety of employees and
development of the community.
Among such prominent companies,
one brand that has carved its
stronghold in the revenue cycle
management niche is Healthcare
Resource Group (HRG), Inc.
Headquartered in Spokane,
Washington, HRG's expertly crafted
revenue cycle management services
provide customized solutions for its
associated healthcare clients' unique
needs.
In the following interview, Greg West,
the company's President briefs us
about the company's journey of more
than two decades and how it continues
to prolong its competency in the
revenue cycle management market.
Below are the highlights of interview:
Please brief our audience about
HRG, its values, vision, and mission.
Healthcare Resource Group (HRG)
was founded in 1994 as a staffing
service, aimed at hospital revenue
cycle, by Colleen Hayes. From 1994
until 2003, the primary business was
placing interim revenue cycle experts
onsite at hospitals. The company
started in Northern California and
moved to the Inland Northwest when
Ms. Hayes relocated to Sandpoint,
Idaho
.
In 2003, HRG decided to open their
Outpartnering™ Center and focus on
the outsourcing of hospital billing and
collections. Since that time HRG has
become a premier revenue cycle
service company with best in industry
processes, state of the art technology,
and our people and culture. HRG is an
employee-owned company, and all
employee-owners share in the
ownership and financial success.
The employee-owners and leaders who
have made Healthcare Resource Group
successful have done so with a spirit of
passion for the work they do. We are
about working hard and providing
unprecedented client delight. This
10 Most Trusted Revenue Cycle Management Solution Providers
13. passion is what makes us successful
and helps us build our signature HRG
culture.
Growth will continue in this same
spirit ensuring the work we do remains
meaningful and makes a difference for
our clients. HRG has been named a top
place to work both regionally and
nationally.
HRG has several important missions
that drive us:
Ÿ To bring financial stability to our
healthcare clients so they can
provide the best possible care to the
patients' communities they serve.
Ÿ To assist rural hospitals so the
underserved communities can
continue to get healthcare close to
home.
Ÿ To assist our Tribal Heath facilities
with their revenue cycle needs so
they can grow and continue to serve
their tribal members and
communities.
HRG provides the following services
to achieve these missions:
Ÿ Complete Business Office
Ÿ Extended Business Office
Ÿ Early Out Self-Pay
Ÿ Medical Coding and Coding
Auditing
Ÿ Denial Management
Ÿ Consulting and Interim
Ÿ Management of Revenue cycle
What aspects make your company
standout in the healthcare sector?
Tell us more about how your services
add value to associated companies
and the healthcare industry.
Helix AI™ is our technology platform
that was developed and built with the
vision and leadership of Steve McCoy,
HRGCEO. HRG has made a
substantial investment in building our
own proprietary software, Helix AI™
which uses artificial intelligence and
data analytics to streamline workflow
and minimize labor.
Healthcare revenue cycle management
involves a myriad of steps to submit
insurance claims to the
government and
commercial
payers. Obtaining
prompt
reimbursement
from the payers
requires
checking and
rechecking the
stages that a
claim passes
through in
order to be
paid. Much
of that
verification
process has
been
automated.
Each
evening,
Helix AI™
activates a
multitude of
BOTs that
perform tens of
thousands of queries that validate
insurance eligibility,
authorizations, and claim status.
Artificial intelligence then evaluates
the result of the query and determines
if human interaction is necessary given
the situation. If human interaction is
required, Helix AI™ determines the
HRG has
been named
a top place
to work both
regionally
and
nationally.
“ “
14. best person to take action, queues the
account in workflow, and recommends
the action to be taken.
Our software captures a mountain of
information as each claim progresses
through the process of being
reimbursed. This data is analyzed to
determine how workflow can be
streamlined and if the timeframe to
resolution can be shortened.
In essence, this platform identifies root
causes of problems and highlighting
potential solutions, thereby allowing
HRG to do a better job, quicker and
less expensive than our competition.
Behind our technology is our people,
our training, and our TQA model that
makes HRG's performance
outstanding. No matter how much
technology grows, healthcare will
always be a people business and
continues to need the type of caring,
dedicated employee-owners that HRG
is comprised of.
The entire team is engaged and
invested in the success of our clients
and projects. Winning many awards for
best places to work and top performing
revenue cycle vendor is a by-product
of this engagement and growth.
HRG has grown by providing
innovative and flexible solutions that
are tailored to each client and their
individual needs. Our business
development team is not the typical
sales team. Instead, they are comprised
of seasoned and experienced revenue
cycle experts, who help develop the
perfect solutions for each client.
In summary, HRG is the perfect blend
of technology, people, and flexibility
so that every client gets maximum
value and achieves their goals.
Being a leader in the healthcare
sector, share with us your opinion on
how the adaptation of modern
technology in the healthcare
discipline has transformed the
industry and what more could be
expected in the near future?
Helix AI™ is HRG's technology platform that uses
artificial intelligence and data analytics to streamline
workflow and minimize labor.
“
“
15. Healthcare is finally catching up with
other industries in adapting technology
that automates the repetitive and low
value tasks.
Taking into consideration, the
current pandemic, and its impact on
global economies, how are you
driving HRG to sustain operations
and ensuring safety of your
employees at the same time?
Prior to the pandemic, we had 90% of
our workforce working from our
corporate headquarters in Spokane,
WA. In March 2020, we moved this
entire team to a remote workforce in
three days' time. Our IT and support
staff were amazing in this transition
and we did it without interrupting our
service to our clients and their
patients.We now have become very
good at working and performing in this
environment.
This is allowing us to recruit and hire
talent from all over the country which
has strengthened our ability to scale
and adapt to our clients' needs faster.
We have a small team of employee-
owners who still work out of the office
and we have assured their safety with a
screening and distancing program that
keep everyone at a safe distance,
wearing masks, and screens out anyone
with COVID symptoms or any recent
contact.
As we head out of the pandemic we
have decided to continue with the
remote workforce when it's a good fit.
Security of data and productivity of our
staff will be the key factors when
deciding if a future employee will
work from our office or remotely.
Our sales and marketing team started
doing quick ½ hour webinars on
revenue cycle topics and we started a
podcast, interviewing revenue cycle
experts from all over the country. The
webinars were so well attended and
received by the community. The sales
team also made a large effort to
provide PPE to hospitals all over the
country. These efforts allowed us to
keep assisting hospitals even in our
downtime when we were not allowed
to fly and visit clients and prospects.
What advice would you give to those
aspiring to venture into the RCM
space?
I would give the following advice:
Ÿ Focus your service on a very
specific solution and client type at
first and then grow from that skill
set.
Ÿ Invest heavily in two areas:
Technology and Marketing.
Ÿ Always remember this is a patient
care industry and don't let your
team ever forget that. Every
interaction we do still impacts the
patients and their perception of our
clients' services to them. That fact
is so important on how we do our
business.
How do you plan to scale HRG
and/or its operations in 2021?
We are adding to our technical
capabilities in all of our services with
more AI being built into our Helix
AI™ system so that we can help our
clients manage their pay or
relationships, adapt to the new
payment methodologies, and provide
their patients the best financial care
available.
We have grown our Business
Development team into parts of the
country where traditionally we have
had less of a footprint.That will allow
us to reach more potential partners
with our solutions and build on the
great reputation we have in our more
developed territories.
As the Pandemic slows, we plan on
attending conferences and visiting
clients and prospects at a pace that gets
us back to telling our success stories.
About the leader
Greg West, President of HRG, started
in healthcare in 1988 in the insurance
payer business. His first healthcare job
was working for a Blue Cross plan in
the Northwest as a Manager of
Customer Service for the program that
provides benefits to retired military and
16. military family members
(CHAMPUS).
“That was a great place to start my
career in caring for others in the
finance area of healthcare. Assisting
military personnel with their healthcare
needs was an honor and privilege,”says
Greg.
Greg then moved to the provider side
of healthcare in 1991 when he became
the Business Office Manager for a
large multi-specialty physician clinic
and rural critical access hospital. This
introduction to the provider side and
rural healthcare was where his passion
for helping rural facilities started. Greg
rejoined the payer side as a Director of
Provider Contracting and Network
Development in 1998 and then
spearheaded building a provider
network in rural eastern Washington.
In 2000, Greg joined HRG first as
Revenue Cycle Consultant and then
became the Director of Interim Staff,
matching clients' needs with the best
people. He worked in that position and
in business development until 2005.
“Due to personal reasons, I needed to
travel less so I rejoined the provider
side of healthcare as a Vice President
of Revenue Cycle at a large healthcare
system in the Northwest,” Greg added.
During that time, he was using HRG as
a vendor to support the team and he
kept a close relationship with the HRG
leadership. In 2008, HRG asked Greg
to return as Vice President of
Operations running the
Outpartnering™ Center and he agreed.
“Since rejoining HRG I have moved
from Vice President to Chief Operating
Officer, and in 2011 was named
President. I am active with several
healthcare associations and am
privileged to do a lot of public
speaking on revenue cycle and
leadership topics,” Greg expresses.
Exhibiting Excellence
“At UCSD Health, some of our ongoing challenges
include filling unique positions, identifying and
implementing process improvements, and
continuous education of our team. HRG has been
with us through it all. They have been a partner of
ours for over three years, assisting with projects
across the revenue cycle. HRG's flexibility and
ability to deal with diverse projects and challenges
truly sets them apart from other vendors we have
used in the past. With healthcare, you never know
what's around the corner but knowing we have a
partner we can count on gives me peace of mind.”
– Laura Handy-Dineen, Executive Director of
System Revenue Cycle | UCSD Health, San
Diego, CA
“The HRG team has exhibited excellent leadership
and exceptional organizational skills. They are,
without exception, motivated and dedicated to
managing our accounts efficiently and effectively.
As a result, our patient accounts receivable
balance and average time-to-collect has been
reduced by 30%. We are very impressed.”
– Ed Engesser, CFO | Barlow Respiratory
Hospital, Los Angeles, CA
“HRG has exceeded our expectations, and with
their expertise, we continue to rank as a top
hospital in revenue cycle metrics within
Washington State.”
– Larry Cohen, CEO | Ocean Beach Hospital,
Ilwaco, WA
17.
18. Anything new is taken to be innocent and a source of
authenticity in its initial days. This includes the
social media, the youngest source of
communication, and these days a source of information
that’s not always known to be authentic, original or even
verified. Yet people believe in it with disastrous
consequences sometimes.
An offshoot of the entire digital communication
conundrum, social media these days is taken to be the
‘de-facto’ standard when it comes to authenticity of any
information, health-related or otherwise. That said,
Governments the world over have put in place reasonable
means such that articles that can cause damages of any kind
are put to the test of authenticity and those purveying wrong
ideas, notions and so-called news are dealt with strictly and
sternly.
But given the speed at which things circulate the world over
on social media sites, the best of governments’ steps to stem
what kind of content
should we trust?
Social Media
Healthcare:
and
16| May 2021|www.insightscare.com
20. the tide can sometimes be stymied and at times even
circumvented persistent purveyors of falsehood, sometimes
abject falsehood.
That said, social media has its advantage when it comes to
speed and sheer approachability. Given its ‘Chinese
whisper’ quality, it does come in handy to spread the right
words at the right time. In sum, a double-edged sword,
social media, and more so in the context of healthcare ought
to be trusted while taking the following steps:
1. As a general rule, if it’s too good to be true, it MUST
be a fraud! Responsible governments the world over have
been breaking their heads trying to get the Covid-19 virus
back into the bottle from where it leaked and wreaked
havoc. But it just refuses to be contained, and besides these
days is finding newer and more virulent strains that can
strain the best of healthcare systems.
And in all this, if someone comes up with bizarre idea that
promise a near- instant and permanent cure, it ought to be
taken with a big pinch of salt, which unfortunately most
don’t. A case in point is the death few days back in the state
of Andhra Pradesh in India of a man who claimed 'miracle'
drug cured him of Covid-19!
Even without waiting to authenticate his claims, people in
droves descended upon the village. Where it all went out of
the window was when the news and details of a ‘miraculous
& instant’ cure hit social media sites prompting people to
just pick themselves up and land up at his door!
2. Rely ONLY on the words of reputed health-care
professionals! Despite everything the world says of
doctors, the profession requires constant reading and
updating, and this is more evident in those who head bodies
of eminence and repute. Their words in most cases can be
taken as truth or their words in the context of any social
media posts can be considered authentic and worth
depending upon.
Thankfully, most known and admired healthcare
professionals have their own social media presence (Twitter
handles, #hashtags, social media pages and the likes) which
if not hacked into – a real threat these days, can be expected
to display authentic information worth depending upon.
3. Governments worldwide have their own Health
Departments! Governments can be held to task for
purveying or even brining about facts that aren’t backed by
the right kind of information that comes invariably from
research.
Owning to this, any information that’s available from
timely bulletins of government agencies and departments-
unless it’s absolutely and patently false, can be taken to be
true. That said, it should also be crossed-checked with
details given by bodies like WHO, newspaper organization
like the Washington Post, New York times and the likes.
4. Worldwide bodies including the World Health
Organization, Consortium of Universities for Global
Health (CUGH), The Global Health Network, International
Society for Infectious Diseases (ISID), Planetary Health
Alliance and The Earth Institute.
These bodies’ continuing research for decades means they
have details on every known disease anywhere on earth in
all its details. Anything that they say (or do) is always
backed by research, data and facts, and can be used to
cross-check anything that is being said on social media on
the subject of health.
5. Reputed News Agencies like Associated Press News,
BBC, The Bureau of Investigative Journalism, The
Economist, Reuters, Washington Post, New York Times to
name some. In a world clogged with fake news and news
meant to incite hatred, the stated news organizations are
known for their impartiality in imparting quality news
including health-related ones. Anything they say on matters
of healthcare can be taken to be true to a very large extent
without the fear of purveying fake news.
In the end, social media is as social as one takes it to be.
And for that, and in the content of something as pertinent as
health and healthcare, the best strategy when it comes to
believing content, is to be safe with the right information
from the right sources.
- M. Purushoutham
18| May 2021|www.insightscare.com
21.
22. Leading with expertise
Matt brings to MedEvolve over 17 years of expertise in
accounting and finance, as well as corporate development
and operations experience in both public and private
companies. He began his career with Grant Thornton, LLP
in Audit and Assurance Services while working with several
private and publicly traded companies in the technology,
service, banking, and consumer industrial products sectors.
During his 17 years of career span, Matt served as the
Controller of Streamline Health, a publicly traded,
healthcare IT provider. While at Streamline Health
Solutions, Matt led the company's accounting and reporting
function through a time of significant growth, including the
planning, integration, and reporting on two strategic
acquisitions.
He joined MedEvolve as Chief Financial Officer in August
2013 and was promoted to President and CEO in 2017.
Since becoming CEO, Matt has led the company through a
transformation by expanding MedEvolve's solutions beyond
practice management software and revenue cycle
management services to advanced healthcare revenue cycle
technology.
Under Matt's leadership, the company has developed AI-
powered workflow automation, data transparency, and
convenient patient payment solutions to drastically improve
margins for the company as well as help its physician
practice clients to reap the benefits.
Sustaining the pandemic with automated solutions
The company, under Matt's leadership, had designed the
revenue cycle workflow automation solutions before the
pandemic. This ended up being the perfect solution to
enable MedEvolve's RCM services business to go virtual
immediately after the lockdown was imposed.
The solution auto-generates worklists for the company's
billing team members, which has helped the team members
analyze and prioritize the work. “We can prioritize at-risk
claims or those claims that have the highest returns for the
practice. In addition, it enables our management team to
Revenue management is essential for every business
including healthcare. Hospitals and physician
practices find it difficult to collect revenue due to
higher regulations and legal ramifications. Moreover, some
traditional or outdated billing processes make revenue
collection further difficult for healthcare institutes.
Thus, hospitals and physician practices these days have
opted for revenue cycle management services from a
plethora of enterprises. Among these service providers is
MedEvolve which, under the leadership of President and
CEO Matt Rolfes, has set itself apart by empowering
physician practices via provision of data-driven solutions
with unmatched transparency, accountability, and
automation. It is these solutions that have helped its clients
reduce the cost to collect, streamline processes, and drive
transparency, which further helped physician practices to
stay independent and profitable.
Making a mark with excellence.
MedEvolve, since its inception, has been constantly
innovating its products and offerings to meet the market
demands. And this has been possible with the team's
expertise in building solutions that drive profitability for
medical practices.
“Our solutions are built to optimize the revenue cycle
process and allow for faster payment of insurance claims
and better patient experiences,” says Matt “we are
constantly changing and innovating with the healthcare
industry to ensure providers are collecting every dollar
owed at the minimum cost for them.”
Over the years, the company has focused on building
automation, data transparency, and patient payment
solutions to empower its clients with more control and
insight over the entire process with less work and fewer
resources.
“We realized years ago that our core strength was in the
business side of the practice; therefore, we integrate our
PM software with any EHR so we can concentrate our
efforts on the business side of healthcare. We learned to
focus on the areas where we excel,” explains Matt.
Automated RCM Solutions that Empower Physician Practices
10 Most Trusted Revenue Cycle Management Solution Providers
20| May 2021|www.insightscare.com
23. The closing of ORs delayed surgeries and in turn
deductibles later in the year. January 2021 brought the
signs of the COVID situation calming down driving up
patient balances precipitously.
Due to the sudden surge in patient care and balance
collection, physician groups who did not have an effective
patient AR engagement strategy are struggling with
collecting those patient balances effectively. Realizing the
changing trends and client needs, in 2021, MedEvolve is set
to expand Patient Call Center Services to include Patient
Financial Counseling Services and Mobile Engagement
Services.
MedEvolve has expanded its Little Rock-based call center
to provide patients with explanations of benefits and
medical bills, as well as providing convenient payment
options. The team attends inbound calls with clients' billing
office and provide mobile outreach to increase patient
payments. “We look at this as a crucial service to improve
the overall patient experience and will apply the great
customer service to the patients as we have for our clients
for the last 23 years,” says Matt.
always monitor staff productivity and effectiveness with
transparency into what our staff is producing every day.
This ensures all claims are being worked at the right times
and nothing slips through the cracks,” explains Matt.
Along with the technology to streamline business
operations the company leadership has always believed in
the power of transparency. “During the height of the
pandemic from April through August and as things calmed
thereafter, we remained extremely transparent with our
employees, and let them know the challenges we may face,”
Matt shared, “we did our best to make sure all our
employees were well taken care of both for their physical
health as well as their financial health.”
Most of the company's operations are currently remotely
handled by the respective teams and MedEvolve aims to
provide remote working as an option moving forward. The
company is also working on safely reopening the office in
the coming weeks.
Future-ready with counseling and care
COVID's wake, when it comes to the business side of a
physician's practice, has certainly affected in-patient care.
I believe success or
failure of RCM business
hinges on having the
right technology in
place and alignment of
your team to the
technology. Matt Rolfes
President, and CEO
21| May 2021|www.insightscare.com
24. In addition to the call center, MedEvolve provides outbound
past-due balance payment services to help facilitate patient
payments through phone calls, text messages, and mobile
chat. MedEvolve now will accept a variety of convenient
payment options to help clients decrease outstanding patient
balances, including payments via text, web, mobile, over
the phone. The company is further setting up payment plans
in case immediate payment is not an option.
Matt shares how these approaches will benefit the
company's clientele. “MedEvolve's Patient Services have
achieved a 97.1% patient satisfaction rating since its
inception. We are confident these new services will help
decrease our clients' patient A/R and improve patient
engagement for their practices.”
Words from the wise
“Even though RCM is a people-based business, I believe
success or failure of RCM business hinges on having the
right technology in place and alignment of your team to the
technology,” says Matt when addressing those
entrepreneurs aspiring to enter the RCM space. The CEO
further explains that a good technology aligned with the
team benefits in a more predictable and managed work
environment, as well as better analytics to reward people
for good performance.
Apart from aligning with the right technology, staffing is
another big challenge in the RCM services business.
Finding and retaining quality billers and collectors is a
struggle due to the high-turnover nature of the role. Matt
explains, “Our tools provide a very structured work
environment and relevant performance analytics to our
people. New employees coming to MedEvolve cannot
believe how much more simplified their day is because the
system plans it for them. It takes the guesswork out of your
day, and you can just get to work.”
“MedEvolve has revolutionized our revenue cycle
processes. Besides seeing how many accounts the
teams are touching, we have transparency into the
effectiveness of those efforts. At the end of the day,
you know the effectiveness of a revenue cycle engine
by what you bring in the door and how much it's
costing you to do it.”
Kevin Don
Executive Director of Global
Business Services with Falck US.
“I think what makes these solutions so successful,
especially for a practice like Key-Whitman, is that
MedEvolve has deep experience providing both revenue
cycle services and innovative technologies. They know
what independent practices need and how to lay the
best foundation for improving operations and overall
financial health.”
Matthew Chapman
MHA, COE, OCS, Director of
Revenue Cycle, Key-Whitman Eye Center
“Our relationship with MedEvolve has always been a
strong partnership characterized by open
communication. We appreciate that they have listened
to our needs over the years and consistently prioritize
product innovation to improve processes and
workflows.”
Theresa Hammack
Office Manager, South County Urological
“[MedEvolve RCM Workflow Automation] is like a GPS:
representatives sit down, log in to MedEvolve RCM
Workflow, and hit go, and the system leads them. We've
already seen a 15% reduction in A/R and we anticipate
additional long-term improvements as the machine
learning algorithms continue to identify new
opportunities.”
Jonathan Parisi
Director of Business Operations and
Strategy Neurosurgeons of New Jersey
Exhibiting Excellence
22| May 2021|www.insightscare.com
25.
26. Most health system executives will agree there's
no shortage of data in the healthcare industry.
The problem is knowing what to do with it. In
just three years from 2016 to 2019, healthcare organizations
saw the volume of health data increase by 878%. Despite
the abundance of data, bridging information silos and
extracting useful insights that improve patient workflows
remains a challenge.
Advanced data analytics and greater connectivity present
opportunities for health systems to automate processes,
minimize revenue leakage and create a better patient
financial experience.
In the wake of COVID-19, the health systems that act on
these opportunities will gain a head start on their financial
recovery from the pandemic, so this begs the question:
what's holding the revenue cycle back from translating data
into meaningful insights for better decision making?
What are the hurdles?
Healthcare organizations spend multi-millions of dollars on
clinical and financial IT systems each year. Yet, those
systems often create a disjointed experience for patients and
revenue cycle teams because they aren't truly integrated and
therefore, the data remains in silos.
Today, it's common for large health systems to have
multiple electronic health record (EHR) systems, along with
separate systems for scheduling patients, generating price
estimates, checking a patient's insurance eligibility, offering
affordable payment plans and more. Essentially, every
touchpoint is often powered by a different software product
with its own data silo.
Also, many healthcare IT companies have merged and
therefore "bolted together" solutions via acquisitions to
create their product offerings. For example, conventional
patient payment companies typically "bolt together" portals
and billing statements that only minimally connect to the
underlying payment technologies.
As a result, there's rarely a single source of truth for patient
financial activity. This can lead to discrepancies in what the
patient sees on their bank statement and what the revenue
cycle team sees. As a result, it's difficult for revenue cycle
teams to work with patients and address their financial
needs while ensuring the health system gets paid for the
services provided. Even worse, the breakdown in
information does irreparable harm to the trust between the
patient and the health system.
What needs to change?
To make data more reliable and actionable, revenue cycle
teams need an integrated payment platform that connects
data from various sources and creates a truly patient-centric
experience.
An integrated payments platform acts as an information hub
between different IT systems, including the EHR, estimator
tools, insurance information, and more. Think about it this
way – before smartphones, you left your house with your
wallet and keys, plus you had a map, GPS (miss you,
Garmin), notebook with a list, or written directions to your
destination.
Today, you just carry your smartphone, which provides
directions, contact information, lists, and even your credit
card information for contactless payments. An integrated
payments solution consolidates information the same way
24| May 2021|www.insightscare.com
27. your smartphone consolidates your
personal items. Patients can view
their up-to-date bill balance, review
a price estimate or their payment
history, sign up for payment options
that match their personal financial
needs, message their provider and
more – all from one place.
By leveraging an integrated
payment platform that consolidates
data from multiple enterprise
systems, healthcare organizations
make it easier for their patients to
understand, manage and pay for
healthcare expenses. This data
creates the foundation for a
personalized and adaptive
experience that empowers patients
to confidently navigate the financial
responsibilities associated with their
care while improving revenue cycle
outcomes for health systems.
Why act now?
Healthcare billing and payment
experiences continue to be leading
sources of frustration for patients.
According to Patientco’s 2020 State
of the Patient Financial Experience
survey, when paying healthcare
bills, four out of five patients have
felt confused or frustrated. Patients
have felt confused and frustrated for
various reasons, from the lack of
upfront pricing before treatment to
receiving multiple bills after one
visit. Meanwhile, over one-third of
patients have been frustrated
because it was difficult to
understand what their insurer
covered.
Patients are also concerned about
the cost of their care. In fact,
About the Author
Sean Joyce is Patientco's chief technology officer (CTO) and is
responsible for the ongoing product, engineering, and innovation
initiatives for Patientco's patient financial engagement platform.
For over 15 years, Sean has focused his career on enhancing the
consumer healthcare journey across all stages of engagement
with a health system.
Prior to Patientco, Sean launched the first advisory software for
small businesses navigating the Affordable Care Act as a product
leader within ADP's TotalSource business. Earlier in his career,
Sean built software at startups that pursued his passion for
detangling the complexities of healthcare through technology.
Sean received his B.S. in Computer Science from Eastern Michigan
University and his MBA from Emory University.
Expert Opinion
25| May 2021|www.insightscare.com
28. patients often defer necessary medical care over financial
concerns – 45% have delayed medical care or skipped it
altogether over concerns about their out-of-pocket costs.
While such concerns about healthcare expenses are not new,
the COVID-19 pandemic and the economic recession that
followed has amplified them.
Many of the frustrations felt by patients are actually the
result of point solutions that health systems rely upon for
various revenue cycle processes such as scheduling, cost
estimates, and eligibility. With so many siloed systems,
patients don't know which source of information to trust.
Patients get overwhelmed trying to figure out the nuances
of why they owe what they owe and make sense of their
financial obligations. Ultimately, they become disconnected
from the health system and patient loyalty is compromised.
Meanwhile, for busy RCM teams, responding to confused
patients who have questions about their financial
responsibilities can seem daunting, manual, and time-
consuming. Health systems employ hundreds of team
members to handle high volumes of manual tasks, such as
answering patient phone calls, responding to email and
patient portal messages, accepting, and posting payments
and more.
As a result, when patient visit volumes grow, so does the
workload for these team members. There is an opportunity
for technology to streamline these tasks, so team members
can focus on other efforts and enable the health system to
care for more patients without significantly increasing
operational costs. Realizing this opportunity is key,
especially following the COVID-19 pandemic as many
health systems will have a backlog of elective procedures to
reschedule.
Technologies, such as chatbots with natural language
processing and personalized self-service payment options
can empower health systems and their team members to
focus more on patient care and less on administrative tasks.
For instance, if a patient is anxious about the cost of their
care and has a question about their price estimate, the
patient can easily be guided by the chatbot to a personalized
view of the cost information they need including easy
instructions on enrolling in an affordable payment plan and
links to self-service scheduling. This all takes place with no
added burden on the health system's team members.
However, these technologies require an integrated payments
platform and advanced data analytics.
What Does Success Look Like?
With a payment platform that consolidates data across
different systems, healthcare organizations can personalize
each patient's financial care in a scalable way. At the same
time, this makes data actionable and enables revenue cycle
team members to better assist patients navigate their
financial options.
Health systems can leverage data including a patient's
preferred communication, such as email or text, along with
other data, like bill balance amount and prior payment
history to tailor outreach and payment options to each
patient. For example, health systems can encourage a
patient who has a large bill balance to sign up for a payment
plan with messaging on their bill and influence a patient
with a smaller balance to pay in full with a prompt payment
discount.
Data that's consolidated and actionable allows health
systems to predict the best ways to drive patient
engagement, proactively meet patients' preferences and give
patients an easy way to manage their current and future
expenses with tailored, self-service affordable payment
options. This also empowers team members to offer better
support when patients need assistance most.
Collectively, by doing this for all patients in a health
system, health systems use what traditionally was
transactional data to outline a better, more tailored financial
experience that delivers meaningful financial results for
their organization.
26| May 2021|www.insightscare.com
31. Managing healthcare organizations, be they
hospitals of any kinds, clinics or tertiary outlets
call for dedicated resources that help sustain and
grow. Such resources have implications on the financial
efficacy of the organization as also the kind of care they
provide.
Grants and handouts besides, what helps is to make every
step in the process of healthcare as monetarily efficient as
possible. Revenue Cycle Management, RCM in short is the
one system most hospitals worldwide look up to when it’s
about deriving maximum efficiency, revenues and the best
possible care from existing systems.
The role of an RCM starts right the time a patient (or a
visitor) arrives at the doorstep of a medical facility. At every
step thereafter, a combination of patient’s information be it
identification-related or related to the medical issue at hand,
mode of payment (if it’s through insurance, the
predominant case, details of the insurer and details of the
policy or policies. If it’s through cash, then details of the
bank or funding body), and codes assigned by the industry
are put to use to generate invoices.
To streamline healthcare provisioning besides reducing
likely gaps, data collection is done centrally within the
organization to ensure efficient and speedy reimbursements
for the treatment and proper care of the patients.
Essential steps in the process include:
Detailing charges: Be it standardized costs or costs that
differ according to treatment, these are recorded basis the
Medial Practitioner's detailing of work. Beside capturing
the element of costs, this step also helps document the
treatments a patient might have undergone with the
system’s API into EHR. In a way this step creates a link
between costs and medical procedures undergone.
Creating and using universally recognized codes: Every
element of the costs incurred, and the treatment undergone
are recorded in universally accepted charge codes for easy
Managing the Backstage
29| May 2021|www.insightscare.com
32. referencing by everyone including the insurance companies,
and the medical field itself for future medical interventions.
Submitting claims & related communication: RCM
essentially boils down to this step where the healthcare
organization sends it bills (in the acceptable formats) to the
insurance companies that represents the patient.
Given the system’s accuracy and the clarity it provides,
claim settlement has seen a marked upswing in recent
times. Besides helping make claim settlement smoother and
efficient, the RCM helps both the healthcare organization
and insurers communicate better with each other on health-
related information and levels of cover available to a
patient.
Reviewing service levels: In the end, a system that has
truckloads of data is also the best place to gauge points
where the system can be made more efficient both in terms
of money, and in product offering. In this the RCM plays a
stellar role given the kind of information it generates and
stores.
With AI and Big Data, treatments and customized
communication can be made far sharper and quicker than
ever before and do so with either existing or even lesser
manpower.
That said, the process does have its share of challenges.
Among others, this is a complex cycle of a system where
the usual culprits include:
• Wrong EHR entries. Being an API-based system that
picks up information from other sources, wrong entries
at sources including EHR can have repercussions in the
RCM, and more so when it starts to affect receipts from
insurance companies.
• Wrong entries by healthcare staff. Codes for
payments, processes and procedures are central to the
efficient working of any RCM. Series of wrong entries
can change scenarios besides delaying receipts from
insurance companies. It doesn’t stop here. Payments can
also be stopped by insurance companies.
• Changes in legislations and regulations. Health being
a sensitive national issue, governments across the world
are constantly working towards policies that lower
medical costs and focus more on outcomes. These may
affect a healthcare provider's existing financial systems
including RCMs, despite their being the best. In the US,
the ascent is increasingly towards end-results that
matter. To this end, reimbursements are now based in
demonstrated care and not simply the presentation of
bills.
Challenges apart, the RCM present a plethora of
positives that include.
• For Healthcare providers, the RCM provides the right
means of clarity and efficiency in billing, and ensures
the right information goes to insurance companies and
patient themselves. It helps automate parts of billing
cycles and thus reduces dependence on employees and
has better and faster outcomes.
• For patients, the RCM provides better, faster, and error-
free claim settlement. Being integrated to patient’s
insurance records, it also provides both the hospital and
insurance company the exact status of insurance
available to patients, and helps process claims faster.
• For an insurance company, and to an extent healthcare
companies, an RCM system gives instant information
about types of diseases being treated, when and where.
That besides, it helps with detailed information on
patients and their profiles. All this helps the medical
industry in particular focus on areas that need high
priority.
- M. Purushoutham
30| May 2021|www.insightscare.com
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34. S
trong foundations, unmatched
competence, and a ceaseless
drive for achieving excellence
are the aspects that exemplify Vee
Technologies as a leading name in the
global business process management
space.
Headquartered in New York, USA,
with a powerful blend of people,
processes and groundbreaking
technology enabled solutions, Vee
Technologies works to streamline
operations, increase cash flow, reduce
costs, and maximize compliance while
giving associate organizations a
leading edge over the competition.
Pertaining to our edition titled, 10
Most Trusted Revenue Cycle
Management Solution Providers, we at
Insights Care had the opportunity to
interview Mr. Chocko Valliappa, the
Founder and CEO of Vee
Technologies.
In the following interview, Mr.
Valliappa briefs us on the company’s
journey to becoming an industry
leader; the challenges he and his team
had to overcome during the pandemic
to sustain operations and market
competency; his vision for the
company’s future, and more.
Below are the highlights of the
interview:
Please brief our audience about Vee
Technologies, its values, vision, and
mission.
Vee Technologies delivers technology-
enabled health information
management and revenue cycle
management outsourcing services to
prominent organizations throughout the
United States. Recognition of our
excellence comes in many forms –
competitive and sustainable business
and industry-wide acclaim.
Most recently, the International
Association of Outsourcing
Professionals recognized Vee
Technologies as a ‘leader’ in its list of
the Best 100 Global Outsourcing
Companies. This follows four
consecutive years of being given this
award. Additionally, Inc. Magazine
recognized Vee Technologies as one of
the fastest-growing American
companies for the fifth year in a row.
Our client base includes prestigious
healthcare organizations in the U.S.
and is comprised of large integrated
delivery networks (IDNs), academic
medical centers, health systems,
independent hospitals, ambulatory
facilities, physician groups, software
companies, and other medical facilities
and healthcare provider organizations.
Vee Technologies’ experience outside
the healthcare vertical brings a unique
perspective to improving business
processes in healthcare. The result has
been tremendous growth year after
year. As an example, one large
academic medical center client has
grown from a single service to over 40
statements of work across the revenue
cycle management spectrum in just six
years.
Vee Technologies has offered coding
services with significant experience in
coding for acute care and ambulatory
settings since 2010. We have coders
who are experts in inpatient,
emergency, observations, infusions,
rehabilitation, home health,
ambulatory, same-day surgery, medical
oncology infusions, radiology,
interventional radiology, labs, recurring
outpatient, outpatient clinics, and other
ancillary chart types. Vee Technologies
also performs prospective, concurrent,
and retrospective risk adjustment
coding reviews.
Charge capture is a regular part of our
coding process. A full suite of clinical
documentation improvement (CDI)
services utilizing both offshore and
onshore staff is available. The
overwhelming majority of our staff
hold Bachelor of Science degrees in
Health Sciences or Life Sciences with
certifications from AAPC or AHIMA.
Credentials vary, based on the type of
work and the client requirements.
What aspects make your company
standout in the healthcare sector?
Tell us more about how your services
add value to associated companies
and the healthcare industry.
Vee Technologies differentiates itself
from the competition by being laser-
focused on delivering exceptionally
high levels of quality and customer
service to our clients. With an
Vee Technologies
The Most Preferred Name in HealthTech Space
32| May 2021|www.insightscare.com
35. emphasis on accuracy, competency,
and teamwork, we are well aligned to
deliver extraordinary outcomes. This is
a conscious and thoughtful decision by
Vee Technologies’ leadership to serve
our clients in this way.
University-Enabled Growth
Achieving high levels of accuracy and
productivity starts by recruiting and
hiring highly skilled individuals who
work well in a team environment. Vee
Technologies owns a private university,
Sona College, with more than 10,000
enrolled students. The university offers
undergraduate and graduate degrees in
management, health sciences, and
engineering. Vee Technologies
administers a coding school at the
university where we recruit the best
students and provide additional
training prior to being assigned to a
client project.
Competency
Vee Technologies employees are
career-driven and highly motivated.
Our turnover rates are some of the
lowest in the industry due to the
support we provide. Because of this,
our clients benefit from this stability as
employees continually apply their
institutional knowledge and experience
developed over time servicing the
same client leading to even higher
levels of quality.
Knowledge Sharing
Knowledge by Vee Technologies is an
e-Learning platform built with gaming
techniques that reinforces classroom
concepts with visual aids to enhance
learning. Online assignments are
completed daily to monitor everyone’s
level of understanding of assigned
topics.
Candidates advance to the next level of
training once they complete assigned
modules. The Knowledge platform is
also used on an ongoing basis to
communicate client changes to
guidelines and industry updates,
ensuring that all employees are
utilizing the most current guidelines
for coding.
Accuracy
Distinguished in the industry, Vee
Technologies uses a two-layer quality
assurance process with 12% of all
work performed undergoing this
review. Trending analysis is performed
at the coder level, hospital level, and
provider level.
Deep domain expertise
in population health,
value-based care,
and coding is what sets
Vee Technologies apart
from our competitors.
“
Chocko Valliappa
Founder & CEO
10 Most Trusted Revenue Cycle Management Solution Providers
33| May 2021|www.insightscare.com
36. Deviation from the norm or failure to
meet a 95% level of accuracy triggers a
root cause analysis. Once identified,
coder retraining is completed, and a
100% quality review is conducted until
a coder demonstrates the level of
competency required. We consistently
experience levels of quality that exceed
the client’s requirements.
Value Proposition
Vee Technologies’ leadership team has
created a culture to deliver
extraordinary outcomes to our clients.
Our focus on accuracy, competency,
and teamwork creates an environment
with very high expectations, bringing
together extremely intelligent people
who consistently exceed our clients’
expectations.
Increased financial pressures on the
hospitals and provider groups have
elevated the importance of managing
the working capital. Through our
revenue cycle services, Vee
Technologies directly helps alleviate
these pressures by ensuring a
consistent cash inflow. We cover every
aspect of the revenue cycle, from
scheduling a patient to making an
account zero.
Through our services on patient access,
we contribute to improved patient
experience and ensure that the claims
are billed timely to the correct
insurance(s). Our strong coding and
billing experience helps us ensure
accuracy in our delivery, thereby
reducing the time and money spent on
reworks.
Being a leader in the healthcare
sector, share with us your opinion on
how the adaptation of modern
technology in the healthcare
discipline has transformed the
industry and what more could be
expected in the near future?
Vee Technologies’ technology
solutions increase output, improve
quality, and offer our clients
tremendous year-over-year return on
investment.
The result: lower costs, better risk
management, and more resources
available for improving healthcare
services.
There is no doubt that the entire
healthcare landscape is shifting, and
health systems must find new ways to
reduce overhead costs while delivering
world-class patient care and healthy
financial outcomes. In this new
environment, more is expected of
suppliers such as Vee Technologies,
particularly a smarter service model
with smarter solutions.
Vee Technologies is at the forefront of
value-based care and population health
initiatives and offers solutions to many
of the prominent health systems in
America. There are few, if any,
companies that process more coding
transactions than Vee Technologies.
Since 2012, Vee Technologies has been
a recognized leader in the coding arena
and continues to be an industry-leading
force. This is in large part to the
company’s ability to process large
numbers of coding transactions quickly
with impressive levels of accuracy
(minimum 95%).
Deep domain expertise in population
health, value-based care, and coding is
what sets Vee Technologies apart from
our competitors. Our proven processes,
which have been tightly honed over the
course of a decade, are the wellspring
of our company’s development and use
of technology. We perfected the
processes first, and then we determined
where automation can add value.
Our competitors’ solutions address
efficacy depending only on their
technology. With these proposals,
clients will still have to identify
separate solutions or resources to
complete the work that is unable to be
fully processed by the technology.
In contrast, the Vee Technologies
solutions comprise the very best
technology and staffing to bring in the
efficacy clients look for. Vee
Technologies utilizes certified clinical
reviewers and coders to address cases
and processes that cannot be handled
through technology alone. Our
34| May 2021|www.insightscare.com
37. combined solution of technology and
highly skilled resources allows us to
bend the production curve and affords
economies of scale.
Our clients gain more than just cost
savings from the relationship. Vee
Technologies helps clients become
more efficient and use better, more
accurate information. This means that
caregivers can focus staff resources on
what they do best: care for patients.
Businesses turn to Vee Technologies
for our complete understanding of the
parameters that control payer
reimbursements and for our help in
creating processes that produce an
accurate payment from insurers while
facilitating better patient care through
coding, documentation, and
accompanying provider education.
From the perspective of the revenue
cycle, modern technology has directly
helped on two significant aspects:
improving patient experience and
reducing the cost to collect for the
hospitals and the provider groups.
Taking into consideration, the
current pandemic, and its impact on
global economies, how are you
driving your organization to sustain
operations and ensuring safety of
your employees at the same time?
The Coronavirus changed everything
overnight as a lockdown was enforced
and social distancing became thae new
norm. With the lockdown in place, we
moved around 3000+ employees to
work from home overnight and set up
systems for connectivity. We
accomplished this with minimum
impact on our client deliverables while
ensuring security and compliance.
Compliance and Security: Internal
policies reworked to ensure the
maximum level of security for our
clients’ data.
Stable Power and Connectivity: Vee
Technologies facilitated UPS for
employees at home and also provided
broadband/high-speed internet for
stable connectivity.
Internal LMS Tool: Even while
virtual, our employees have continued
learning and training. Our internal
LMS is loaded with self-paced training
and assessments to help the team
remain up to date.
Time Management: We use the time
tracking tool “Teramind” to help
monitor the time spent at work by each
CSR.
Internal Communication: In a work-
from-home environment,
communication is key. MS Teams has
allowed for seamless communication.
Virtual RNR programs: To keep our
employees motivated, we offer regular
rewards and recognition.
What advice would you give to those
aspiring to venture into the RCM
space?
The RCM market is fast changing.
New entrants to this market must be
agile and ready to adapt to changes.
The market is shifting to a more
technology-based solution, so the days
of the labor arbitrage are gone.
How do you plan to scale your
company’s operations in 2021?
In times of change, the next step is not
always easy.
The entire healthcare landscape is
shifting, and health systems must find
new ways to reduce overhead costs
while delivering world-class patient
care and healthy financial outcomes.
This evolution leads to the natural
progression of strategic partnerships
that will consistently deliver excellence
in the short and long-term future while
continuing to grow together and
independently.
In this new environment, more is
expected of suppliers such as Vee
Technologies, particularly a smarter
service model with smarter solutions.
A sustainable partnership model in the
pursuit of excellence must be built on a
solid foundation of like-minded,
interdependent individuals working
towards the same outcomes. Just as
important, each organization must have
a core value that lends credibility and
strength to the other, reflected in a
unified delivery of excellence.
Vee Technologies is planning to add
nearly 1,000 people to our team. We
also plan to have ten centers in smaller
towns. After the pandemic ends, people
need to be closer to their hometowns.
We plan to also move people closer to
where they work. Another major
change will be our move to the
Philippines this year, with operations
commencing in Manila at the end of
April.
35| May 2021|www.insightscare.com
