Is Patient Access the Key to Improving Your Revenue Cycle?

As high-deductible health plans proliferate, many patients find themselves paying more for their own care. And since they’re paying more, patients are expecting more – they want greater access to care and a clear idea of how much they’ll be shelling out for it.

This rise in patient payment obligations also intensifies the need for healthcare organizations to optimize their revenue cycle functions. Payments that aren’t collected at the point of service become much more difficult to recoup later, and data errors are more complicated to fix.

Organizations are responding to patients’ demand for increased access with a number of strategies:

  • Implementing online patient portals
  • Developing call centers
  • Expanding telemedicine tools

They’re also identifying opportunities within the revenue cycle to improve insurance eligibility, prior authorizations, and patient collection capabilities.

But enhancing access and optimizing collections don’t need to be mutually exclusive. High-performing organizations that are able to centralize people, process, and technology on the front end stand to increase collections and decrease bad debt – all while improving the patient experience.

What Centralization Means

The spectrum of centralization will vary based on broader organizational goals relating to patient access and revenue cycle as well as available resources. Some organizations may choose to simply redefine front-end staff roles and responsibilities to encompass both scheduling and pre-visit functions, while other progressive health systems may adopt a more integrated approach aimed at developing a stand-alone call center that acts as the centralized hub for enterprise-wide patient access and revenue cycle functions and supports streamlined communication across the organization.

Each of these strategies can be enhanced by the establishment of standard policies and practices for scheduling, preregistration, authorization, and financial counseling. Incorporating technology platforms that support coordinated communication across care settings is also a key component in centralizing these functions. Reducing the use of disparate IT systems for patient scheduling, registration, and charge entry not only improves timely access to care but also prevents revenue leakage by ensuring data integrity and supporting reconciliation of scheduled and billed charges.

These efforts are neither easy nor cheap, but centralization offers several potential benefits.

Increased Collections

Unfamiliar and confusing payment processes are to blame for roughly 20% of unpaid patient healthcare bills.1  Automated appointment reminder systems are one way to inform patients of their payment obligation in advance of their appointment. These systems can be used conjointly with emerging technologies that analyze historical charges, payor contracts, and patient benefit levels to predict a patient’s financial responsibility and increase the likelihood of payment collection.

Enhanced Billing Accuracy and Reduced Bad Debt

Busy front-office staff are usually tasked with multiple duties, such as checking in patients and working through claims. Processing billing information has a tendency to get de-prioritized, which may lead to administrative errors prior to the patient encounter and affect total cash collected. By assigning designated staff to the scheduling and pre-visit registration process, your organization can establish a data validation checkpoint and still focus on ensuring a positive and efficient patient experience at the point of service.

Furthermore, centralized scheduling and front-end revenue cycle work flows support the creation of standard policies and procedures to ensure staff are collecting necessary information. These control mechanisms increase data quality and reduce claim denials on the back end.

Enhanced Patient Satisfaction

A centralized patient access strategy can enable your organization to streamline appointment scheduling and the collection of patient billing information. Patients are asked for information only once, even when scheduling appointments for multiple services across the system.

In addition to convenient access to services, patients are demanding transparency in pricing. Implementing up-front reminders to inform patients of their financial obligation prior to the encounter can increase patient satisfaction and allow patients to take advantage of financial counseling or payment plans before their appointment.

Centralizing patient access and revenue cycle functions may have a positive impact on performance, but practice leaders need to decide what strategy is best for their organization. Overhauling processes may not make sense if a sufficient infrastructure is in place that achieves the same efficiencies. But as patients become more responsible for their care, organizations that recognize the overlap between convenience and collections stand to improve both.

1 www.instamed.com/wp-content/uploads/Trends-in-Healthcare-Payments-Annual-Report-2014.pdf

This entry was posted in Patient Access, Revenue Cycle Management and tagged , , by Jennifer McCraw. Bookmark the permalink.

About Jennifer McCraw

Jennifer has assisted her clients with creating solutions to the challenges they face as a result of the dynamic environment of healthcare reform. She has extensive experience with strategic and financial planning, ambulatory operations, project management, and hospital/physician employment transactions. She has supported many organizations with physician alignment strategies and, more recently, with the development of patient access strategies and operational improvement in the ambulatory care setting. Prior to joining ECG, Jennifer worked at a large healthcare consulting and technology firm, where she created strategic plans for lead generation for several physician performance benchmarking tools and supported the sales team with the development of marketing collateral. While earning her graduate degrees, Jennifer worked with a prominent Maryland medical center to redesign its clinical referral process. Additionally, she published a paper in Academic Medicine on the evaluation of accountable care organization (ACO) readiness in academic medical centers.

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