1. An Introduction to Commerce Bank
Over 150 Years of Service w Super-Community Bank w Billion in Assets*
Focused on Healthcare since 1991
36th largest U.S. bank by assets
7th largest purchasing card issuer in the U.S.
Strong capital position and diversified portfolio make us a stable, active lender
Consistent local management empowered to make decisions
Moody’s ranks Commerce among the top 7 banks in the country with a baseline credit assessment (BCA) of a1
High percentage of employee shareholders motivated to help you succeed
We ask, listen and solve
*Commerce Bancshares, Inc. 2nd Quarter Financial News Release 6/30/16.

2. Health care industry forum: Are You Paying Too Much To Get Paid?
Amy Rinard
October 18th , 2016
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3. Cash flow Payments & bank fees

4. Payment Types 3 Common Payment Types Check Payment Card Payment
Oldest form of payment
Largest volume of payment in the industry
Second most expensive form of payment
Slowest form of payment
Card Payment
Growing in the industry
Most expensive form of payment/favored by payers
Mixed methods of delivery
Can be slower than check payments
EFT/ACH
Most cost effective
Quickest form of payment
Highest dollar volume
Difficult to get turned on
New fees hitting the market

5. Cash Flow and Bank Fees Best practices: Maximize ERA enrollment
Most organizations have an effective clearinghouse
Organizations are 90% or better for automated claims filing
Organizations are typically 50% or less for ERA posting and/or enrollments
Posting is very manual and paper based
Manage posting platform setup and maintenance for ERA posting files
Identify and reduce mismatch payment and remit types
Check/ERA, EOB/EFT, Card/ERA
Slows cash flow, increases resource costs and bank fees
Check/ERA cause for duplicate remit cost
EOB/EFT often cause for balancing pain points (suspense account posting)
Card/ERA or EOB caused for delayed cash flow and increased fees
Reduce duplicate copies of remits being sent to your lockbox
Large annual statements or summaries

6. Cash Flow and Bank Fees – EOB Value
Best practices Continued:
Implement an EOB conversion product
Converts items in lockbox to ERA posting file
Reduce the number of websites, s, faxes being used for remittance retrieval and payment retrieval
Slows processing and creates paper based workflows
Streamline all documents/payments to one remittance address
Speeds cash flow/deposits and reduces manual paper based processes
Reduces risk and prevents payments from being misplaced
Leverage a robust automated payment, remittance and correspondence repository for easy retrieval
Ability to retrieve remittances, payments and correspondence
using key data points
Reduces resources time and maximize FTEs

7. Patient payment options

8. Patient Payment Options
The consumer: The new “payer” at the table
The healthcare industry is experiencing a shift from the traditional managed care model…
…To a consumer-centric model in which individuals have more control over their healthcare spending
Consumers
Government
Employers
Consumers
Payers
Physicians
Financial Institutions
Hospitals
Employers
Government
Payers
Hospitals
Physicians
“Consumerism” results in more educated patients
who will shop for price, quality and convenience

9. Patient Payment Options
Provide Convenient and Flexible Options
Out of pocket estimation
Explain patient out pocket responsibilities at the time of service
Education and transparency around fees
Online patient portal
Understand mobile capabilities
Understanding patient experience
Statements with ability to mail payment or make online payment
Know your patients needs and patient population
Over-the-counter payments
Take any form with the ability to give refunds
Payment plan options
Be flexible and communicate when payments will be with drawn
Financing options for patients
Patients cannot often pay for the services at the time of service
Automate patient payment posting
Online payment portal
Statement payments

10. Amy Rinard Amy.Rinard@commercebank.com
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Amy Rinard