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Tuesday January 31, 2023  |  Luke Marinac

The Front-End Steps to RCM Optimization

People tend to get attached to initial impressions and often find it difficult to change their minds, even when presented with incentives or evidence to the contrary.

Consequently, it's important for healthcare providers to be aware of how they come across to patients during an initial meeting and how it can impact patient service revenue.

These instances are an opportunity to deploy patient access services and solutions—reviewing and modifying any irritating parts of the front-end experience and accentuating strengths—to ensure that people leave the hospital with a favorable opinion they'll share with others.

Every part of front-end processes, from scheduling to benefits verification, can be adjusted to generate a better patient encounter, improve patient satisfaction scores, and drum up more business.

How Patient Access Fits into the Revenue Cycle Process

Many people think revenue cycle management (RCM) primarily occurs during hospital back-end operations, but early-stage patient engagement can make or break an organization financially. This is where patients book and register, form their first impression, and witness how others are received and treated by staff.

Training front-end personnel in appropriate data processing and giving them the proper tools to improve the patient experience is essential to creating a positive first impression at your facility.

Beyond the importance of a good experience for patients, the errors occurring on the front end of RCM can easily pop up later when collecting from insurers and patients. From the first interaction, front desk staff should think of how they can best set the hospital and patient up for billing success.

The financial portion of the patient experience begins well before discharge and includes the following:

  • Patient pre-registration
  • Scheduling
  • Eligibility and benefits verification
  • Price Transparency

Patient pre-registration

Favorable impressions rarely start with long stretches in a waiting room.

Patient pre-registration—collecting data such as names and medical histories—can become tedious when manual, on-site processes are the only option. Software that allows for pre-enrolment helps streamline throughput, cut down on clipboard time, and ensures a better user experience.

Having patients fill out paper forms isn't just unpopular and time-consuming, it's a significant driver of denials. According to research by 3M, nearly a quarter of all claims denials are caused by registration errors.

When you consider that over half of denied claims are never revisited, this oversight adds up to a significant amount of lost revenue happening before a patient ever sees the exam room.

Scheduling

Many hospitals still use manual administrative and clinical functions to handle scheduling. This can include paper calendars, whiteboards, or excel spreadsheets. These methods are prone to errors, which can add up on a hospital's balance sheet over time.

For instance, when practice management software that includes alerts and automated reminders isn't part of a facility's scheduling process, it's more likely that patients will miss appointments. While this may seem like a minor issue, one study found that for each no-show or missed appointment, a hospital loses, on average, over $200.

A scheduling platform gives registrars intuitive electronic systems to use, it is easier to train current and future staff on, leadership can set standards, and software providers can receive feedback that drives continuous improvement. Ditching manual processes is also a good way to reduce healthcare worker burnout.

Eligibility and benefits verification

Eligibility and benefits verification is another critical component of revenue cycle management. When this process is standardized and efficient, revenue cycle management staff can quickly verify income, policy coverage, and benefits, helping to prevent fraud, denied claims, and protect vulnerable community members from incurring unnecessary debt.

For instance, registration staff might miss that a patient's insurance doesn't cover experimental procedures or understand that worker's compensation will be used. Without proper authorization from the insurance company, it is likely the hospital will not be reimbursed in these instances

Price Transparency

If the most recent price transparency rules are confusing for medical business offices, imagine how confusing it can be for healthcare consumers.

Accurate price transparency can help circumnavigate many pre-payment issues. This is also another opportunity to let the patient know that prepayment is an important part of the care process, not just a transaction. MEDHOST Price Transparency helps you not only meet regulatory requirements but also helps increase patient satisfaction by helping to eradicate stress and confusion around anticipated costs.

Choosing the Right Revenue Cycle Management Partner

By preventing errors on the front end of the revenue cycle, hospitals are often less likely to encounter issues on the back end.

MEDHOST works alongside providers, enabling them to promote a positive front-end experience through EHR-based software and services that allow providers to meet the technological expectations of patients and move closer to a value-based service model.

By implementing revenue cycle management leading practices and solutions, we can help add accuracy and efficiency to patient intake, billing workflows, and payments while increasing customer satisfaction.

If you would like to improve your revenue cycle today, get in touch with us at inquiries@medhost.com or call 1.800.383.6278 to learn more.

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