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The 120 plus health care delivery organizations in this study represent a total of over 1000 employees
nationwide and operations in more than 20 cities. They represent up to a 30 percent market share in some
areas. These groups have all turned to Secure Check to help their organizations manage return items (bad
checks) as well as improve collection percentages while outsourcing the associated service requirements to a
professional third party. The final results as well as the challenges, requirements and solutions for these
entities that were required follow. All facets were met and the results exceeded the expectations of the
organizations.

The Challenge
Offer the three elements that matter most to both the decision-makers and users of the services. Efficiency,
affordability and flexibility. When each organization or group approached Secure Check, the organization’s employee
based collections procedure, which involved employees spending non-qualified man-hours making collection calls,
mailing letters, re-depositing return checks, as well as making regular revisions to accounting entries, were failing
the organizations in each of these key areas:

1. Efficiency: The organizations experienced many performance issues with using in-house collection systems,
including redundancy of employee tasks and well as poor overall results per man-hour invested.

2. Affordability/Loss of revenue: The organizations routinely experienced excessive bank fees resulting from their
banks subsequent re-depositing of checks returned for non-payment. Additionally, the organization’s employees
realized loss of productivity which resulted in increased costs for the organizations in two areas: One being the time
not utilized by the employee completing their contracted duties, and two being actual revenue lost resulting from lack
of attention to more profitable areas such as researching and collecting unpaid insurance claims.

3. Flexibility: Developing a customized program compliant with HIPAA proved to be a solution that was difficult and
expensive. Additionally, The ability to make modifications to reflect changing needs for the organizations was not a
solution that could be found with another service provider.

For the managers interviewed for this sampling, the problem reached far beyond inefficiencies in their
current systems – Their collection systems were failing both the organization and their patients. The
average minimum hard cost per returned check was over 20 dollars. The average time spent per
collected item had risen to 2.5 hours at $9-$12 per employee hour. The patients were routinely being
charged fees by their banks of $25-$30 for each redeposited check. Based on these numbers and the
growing frustration with the current system, the managers began looking into alternative solutions.

The Solution
The decision was made to use the Secure Check RCK product which could be implemented without cost to the
organizations. Some of the unique requirements of the organizations were:

Some organizations contained as many as 50 or more locations.

Required daily updates to avoid multiple returned payments for single patients.

HIPAA regulations required strict policies for handling of information belonging to check writers.

Office administrators were routinely transferred, requiring the solution to have an extremely fast learning
curve.

Information on the status of check writers payments needed to be available to the office personnel
immediately, on line.

Because Secure Check RCK provides a completely outsourced solution that is tailored to each individual client, the
organizations were able to satisfy their requirements with a single Secure Check product. They used daily reports
either faxed or emailed to individual locations to assure that their patient information was current and accurate.
Safeguards were put in place to assure compliance with HIPAA regulations and to protect the organizations from
potential legal liability. The Secure Check online reporting system assured that payment information could be
retrieved at a moments notice and the “hands off” nature of the Secure Check system alleviated worries about the
learning curve for new employees.

Secure Check worked with the organizations to develop case by case protocol for managing return items. Each
system was customized to deliver the level of functionality that complimented each organizations specific service
model.

The Study Results
The organizations implemented Secure Check by utilizing forwarding agreements with their financial institutions
which directed return items from each organization’s bank to Secure Check. Secure Check worked closely with
each financial institution to assure forwarding arrangements were completed accurately and on time. All return
items now route directly by mail to Secure Check. When return items are received, they are entered into Secure
Check’s system where they are:

Scheduled for re-presentment through the Automated Clearing House (ACH). The checks may be submitted
up to two additional times by law.
Checks are imaged and all check writer information is made available to each organization’s authorized
personnel via secure online database.
Notification is sent to the organization by fax or email to advise of the returned item.
As checks are recovered the organization’s bank accounts are reimbursed via ACH for the face value of the
checks.
The check writer is charged the state allowed fee via ACH which is retained by Secure Check.
Should electronic representment attempts be exhausted, Secure Check begins phone and mail requests to
the check writer for payment as an optional service.

For each health care organization in this study the quantifiable and qualitative results of the system have been
very positive.

Most importantly, the return item recovery is back on track.

The average collection rate of the pool is over 90% and associated costs in man hours have been all but
eliminated.

Payment information is now organized and can be called up immediately in the event of a patient request.

Outsourcing has allowed the organizations to focus on their primary purpose of care giving rather than
collection issues.

The administrators report that the elimination of collection duties for their employees has both increased
their efficiency as well as improved moral.

Outsourced financial management tools and automatic electronic recovery are becoming a reality with the
power of today’s technology. The Secure Check RCK system is proving just that. Leveraging technological
know-how through the Federal Reserve System to facilitate the recovery, management, and associated
customer service for return items, significantly increases value to the organization while reducing the drain of
resources to employees. The possibilities are boundless – Secure Check is exploring other opportunities to
further the impact of automated and web-based tools throughout the medical community.