Mike Peluso of Rectangle Health: “Digitize payments”

Digitize payments. We use ‘card on file’ to pay for other necessities like Netflix and similar subscriptions, why not integrate this type of thinking into healthcare and the way we make payments. The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare […]

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Digitize payments. We use ‘card on file’ to pay for other necessities like Netflix and similar subscriptions, why not integrate this type of thinking into healthcare and the way we make payments.


The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.

In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.

As a part of this series, I had the pleasure to interview Michael Peluso.

Michael Peluso is a career-long revenue cycle professional with advanced skills and expertise in the specification, development, and implementation of software technologies to accelerate the revenue cycle for health plans and healthcare providers ranging from small practices up to large regional enterprises..

Mike’s portfolio of accomplishments includes the establishment of the Rectangle Health Enterprise Solutions division that serves health plans, hospitals and large multi-site physician groups by providing unique and customized patient payment solutions. He also migrated the Practice Management Bridge technology to a secure cloud-based platform that supports pre authorized healthcare processes and the latest chip-technology (EMV) credit and debit cards.


Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?

I started down this career path in college because I dreamt of making an impact in healthcare, not on the clinical side, but to facilitate the business side of healthcare. I went to University of Connecticut because they offered a program and degree in Health Systems Management. It was unique to the University at that time, and it combined both of the things I wanted to do as a career.

Can you share the most interesting story that happened to you since you began your career?

Early on, I wrote a program for a hospital that identified when the amount being written off for a patient didn’t match negotiated rate for the procedure. My findings were met with disbelief that there were errors in input and reconcilement. This resulted in culture shock at that organization, and we see that this type of disconnect exists, even today. There is a business side of healthcare, and it has an obvious large impact to society at large. The lesson I learned then, and is true today, is that I could write any technology, it could be best in world, but it’s useless if no one uses it, or implements change because of it.

Are you working on any exciting new projects now? How do you think that will help people?

At Rectangle Health, we continue to innovate features and functionality to make it easier for providers to take patient payments. We anticipate how market trends and expectations will evolve so that our software will meet the needs of the patients and allow providers to adopt and adapt new technology.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider is passionate about care, has great interpersonal and communication skills, has the ability to take care of multiple tasks and patients, solves problems, and is empathetic and compassionate.

Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?

From a healthcare technology perspective, there is a patient payment expectation issue — payment is expected at time of purchase or service in all other industries outside of healthcare. We serve to solve the gap to ensure payment arrangements are made in the early stages of the patient journey, making them seamless and convenient. There is a significant challenge of the adoption of new tools into current practice workflows. Patients’ fear of affordability and are reluctant to visit a provider due to cost. Price transparency/unknown cost serves as a hinderance to making and taking payments. Disparate data and the mismatch of legacy systems create manual processes and inefficiencies that require staff labor to solve.

Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.

In regard to the pandemic, we saw healthcare organizations move fast to implement changes; and they were successful. This is as important, as it is hopeful. Providers and practices surprised themselves at what they could accomplish in days, rather than weeks and years. The usage of telemedicine/telehealth visits has had significant benefits and reach: to those in rural areas, unable to transport themselves to visits, in need of convenient options, and the control of infectious illnesses. This, too, has been a major leap forward in offering alternate ways to see providers and get care needed.

Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

Overall, the healthcare system should lean into the use of digital tools to improve the way we work. For example, healthcare providers can:

  1. Solve for systemic gaps. Utilize a system to improve office efficiencies which would allow providers to track, manage, report, and reconcile patient payment information. This type of solution is easily adoptable and helps to manage workflow processes.
    For example, many practices work with multiple vendors to meet their needs. With our clients, we ultimately become the one vendor who addresses and solves for gaps in technology, process improvement, or adding valuable services.
  2. Digitize payments. We use ‘card on file’ to pay for other necessities like Netflix and similar subscriptions, why not integrate this type of thinking into healthcare and the way we make payments.
    Here is a stat from our own portfolio of clients on adoption of digital methods — our online payments and Text to Pay functionality is currently running at over a 90% adoption rate. This means that when practices offer these easy, convenient ways for patients to pay, and let them know they are available, they are using it.
  3. Generate awareness. Communicating with patients via their mobile devices is the most convenient way to reach them. And most people have their mobile phones within an arm’s reach at all times.
    In our latest survey with PYMNTS.com, Gen Zers and bridge millennials are more likely to switch providers should they offer digital solutions. Therefore, it’s important to ensure patients know the ways they can pay and interact with your practice.
    Recently, we have been creating patient communication materials for our clients so their patients know they can utilize convenient, everyday methods such as Text to Pay, through their mobile device, or on the website at the practice.
  4. Promote digital check in and registration. Visits to the doctor’s office can be time consuming, especially filling out forms. However, if this task can be completed ahead of the appointment, providers can enhance the patient experience by avoiding filling out paper forms while at the office and gathering their preferred payment method ahead of the visit. Patients don’t want to go back to sitting in a waiting room or filling out paper forms on a clipboard. However, we’ve heard from some practitioners that they are falling back to previous ways of interacting with patients. As the environment is changing, we encourage practices to keep digital processes and continue the momentum of a convenient, contactless environment.
  5. Offer patient-friendly financing options. Offering patients convenient ways to make payments for their healthcare needs includes options for paying balances over time. Some types of healthcare practitioners already do this well, for example, orthodontists have been doing this for years. Every person who has had braces can attest that the treatment amount is paid off monthly, over time.
    This is particularly relevant in light of the prevalence of Buy Now, Pay Later in the retail sector. At Rectangle Health, we’ve enabled providers to offer Care Now, Pay Later to their patients to offer a patient-friendly payment option as well as address payment retention. This solution also enhances the patient/provider relationship.

Our recent survey shows that 56% of patients want payment plans should their bills be higher than expected or if insurance does not cover the cost. Providers can offer ways for patients to pay in ways that make it affordable, flexible, and keep the patient coming back to the practice for care.

How do you think we can address the issue of physician burnout?

As with many aspects of healthcare, physicians and providers face serious and sensitive challenges. We focus on the ways in which we can help:

  • Our technology and systems are designed to make office processes flow smoothly. Where and when we can automate, this helps to alleviate manual effort and avoid errors. With that, comes relief and frees up staff to perform other critical functions and priorities at the office.
  • Our technology and systems are also designed to make offices realize more revenue, so the weight of financial burden becomes reduced. By leveraging technology, we work to eliminate the worry that comes from sending patients to collections, figuring out how to manage write-offs, even sending paper statements that go uncollected.

What concrete steps would have to be done to actually manifest all of the changes you mentioned? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

  • Corporations can help — We strive to implement the ways for people to pay for healthcare as they would for their everyday purchase by leveraging technology to make that a reality, which includes digital options that people use in their everyday lives, such as Netflix and Amazon.
  • At Rectangle Health, we compassionately understand healthcare. We work to support practices and organizations to solve the delivery mechanism — by reducing the effort to get paid, perform analyses, and execute work-arounds to solve complexity issues.
  • From a patient perspective, we aim to resolve what we consider a patient expectation problem — meaning, let’s address why patients don’t always know when, where, or how to pay for care. Often patients leave after services are rendered, without specific financial arrangements to resolve payment responsibility.
  • Digital payment technology is transforming the healthcare industry by alleviating its payment predicament — clearly communicating and offering options and plans intended to make it easier for patients to pay.
  • Most importantly, providers are the agents of change — no more turning over to collections, no more tip toe-ing around capturing payments, and eliminating any negative connotations around balances owed — so that providers can deliver the best care and patients agree to pay for services rendered. Insurance companies, collection agencies, payment processor, and the government can help those who can’t afford it; patients can’t fix this because they receive care they way we are told to consume it. Change can effectively come from those who are delivering care.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I enjoy the revenue cycle and how an efficient, end to end revenue cycle can positively impact patients.

The biggest industry obstacle continues to be getting providers to embrace something different. Providers may not be able to solve consumer out-of-pocket spending at 491B dollars but they can solve their own patient payment-collection problem by utilizing modern payment tools.

Inspiring healthcare organizations to leverage technology — for both their own sake and their patients’ sake — in a world where it’s easy to buy things on Amazon or pay in increments over time, in order to significantly help drive payment acceleration and drive down medical debt.

How can our readers further follow your work online?

We can be found at www.rectangleheatlh.com to learn more about our company and services.

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.


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