Do you collect info in a 'patient-centric' way?
If you're not collecting accurate, complete information in a "patient-centric" way, you're not maximizing either cash collection or patient satisfaction.
There are three primary goals in patient access, says Joan S. Braveman, director of patient access and financial services at Tallahassee (FL) Memorial HealthCare. These are the complete, timely, and accurate collection of data; patient satisfaction; and assurance that all accounts are billable and collectible. The hospital has implemented these changes:
- Prior authorization
For all insurances/services requiring authorization, this is obtained prior to the patient receiving the service, except, of course, for emergency or urgent visits.
- Financial counseling
"With the growing uninsured and underinsured population, we have expanded our financial counseling," says Braveman. "These people are often able to connect the patient with resources, such as vocational rehab, for payment of the bill."
If nothing is available to the patient, personal financial information is collected, so that staff can see if the patient qualifies for charity.
- Online registration
"Since outpatient diagnostics and surgeries are scheduled, we feel confident that we have quality data for these patients," says Braveman. For the obstetric population, who, for the most part, are not scheduled, an online pre-registration form is offered. The patient completes the form online and it is then e-mailed to labor and delivery. This gives them advance notice, and the opportunity to verify the insurance benefits.
By completing all of this work prior to the patient's arrival, it's usually possible to send patients directly to the testing area with little more than a few minutes spent in central registration. During this time, the patient signs documents, and insurance and ID cards are scanned, along with signed forms. These forms and IDs are then available for future visits, which reduces the waiting time.
Braveman acknowledges that the above processes depict a "perfect world" where it's known who is coming and for what service. "Obviously, this is not always the case in health care. Therefore, we formed a verification team," she says.
These individuals are responsible for verifying demographic and insurance information for patients with urgent or emergent admissions, or unscheduled walk-ins. "This team works the account the day after the admission or registration, with coverage seven days per week," says Braveman.
The verification team consists of five FTEs. Benefits include timely admission notification to insurance companies and reduction in denials for non-coverage. "It has taken some time to prioritize their work and ensure the right tools are in place for them to do their job, but all of this work has led to a dramatic reduction in our account receivables," Braveman reports.
- Centralized scheduling
All outpatient diagnostic exams are now scheduled through patient access. At the time of scheduling, patient demographic and insurance information is collected.
Prior to centralized scheduling, each department scheduled its own diagnostic exams using a WordPerfect document. This limited information was made available to pre-admit to attempt to verify the patient demographics.
"Our verification team calls for benefits and verifies insurance coverage. This allows them to prepare a cost estimate sheet so patients are aware of their financial liability," says Braveman. "The evening staff in patient access call to inform the patient of that amount."
For more information, contact:
- Joan S. Braveman, Director, Patient Access and Financial Services, Tallahassee Memorial HealthCare, 1300 Miccosukee Dr., Tallahassee, FL 32308. Phone: (850) 431-6202. Fax: (850) 431-6737. E-mail: [email protected].
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