An outdated approach to patient access and financial clearance operations can result in inefficiencies, delays, and revenue loss because of time-consuming, cost-intensive processes. Our previous blog explored the challenges faced by healthcare providers in managing the patient journey from the initial point of contact to the date of service, underscoring the importance of streamlining processes to ensure that patients are financially secure and have timely access to necessary medical services as shared in our recent webinar.
A well-designed and efficiently operated patient access team will accelerate revenue by reducing payment delays caused by front-end errors, reducing rescheduled appointments, and improving patient satisfaction. New technologies and innovative solutions are streamlining patient access operations through a synchronized methodology that engages people, processes, and technology through collaboration and communication. Healthcare organizations can also capture more revenue by proactively identifying and addressing patient eligibility and coverage issues before they become denials.
Optimizing patient access services and financial clearance operations
Enhance your patient access processes and improve revenue by combining services and technology and adhering to the following best practices.
- Define a clear patient access strategy: A clear patient access strategy ensures all processes are aligned with the organization's goals and objectives. The strategy should define the key performance indicators (KPIs) and metrics to measure the success of the operation. It should also outline the roles and responsibilities of each team member involved in the process to drive accountability and ownership.
- Invest in technology: Technology plays a crucial role in optimizing patient access operations. The use of electronic health records (EHRs), patient portals, and other digital tools can streamline the process and improve patient satisfaction. Automation of routine tasks such as online appointment scheduling and insurance verification can reduce wait times, improve efficiency, reduce errors, and improve the overall patient experience.
- Standardize processes: Standardization of patient access procedures across the organization ensures consistency, increases productivity, and minimizes mistakes that result in re-work. Standardized workflows should outline each step of the process and the expectations for each team member involved. Future process changes or optimizations are more easily adopted when the processes and underlying training are already standardized.
- Train and educate staff: Proper training and education on the use of technology and other tools used in the process are essential for the success of patient access operations. Staff should receive ongoing education on changes in regulations and compliance requirements as well as policies related to insurance coverage.
- Measure and monitor performance: Establish metrics to track patient access performance, such as appointment wait time, insurance verification rate, prior authorization turnaround time, and patient satisfaction. Measuring and monitoring performance against goals is critical to identifying areas for improvement and optimizing the patient access process. Key performance indicators (KPIs) should be defined, and metrics should be tracked regularly against benchmarks to identify trends and patterns. Performance should be reviewed regularly to ensure that the operation is meeting its goals.
- Foster a patient-centric culture: Creating a patient-centric culture is essential to improving patient satisfaction and loyalty. Staff should be trained to focus on the patient's needs and provide a positive experience throughout the process. Patient feedback should be solicited regularly to identify areas for improvement and address any issues promptly.
An effective patient access operation requires a clear strategy, investment in technology, standardization of processes, proper training and education for staff, measurement and monitoring of performance, and establishment of a patient-centric culture. By following these best practices, healthcare organizations can optimize their patient access operations, increase revenue, reduce costs and denials, and improve the overall patient experience.
As an example of these best practices in action, AGS Health and US Radiology Specialists implemented a tool (Intelligent Authorization) to automate and optimize prior authorizations, creating operational efficiencies, reducing denials, and improving overall patient satisfaction. As a result of automated authorizations, daily staff production has doubled from an average of 60 to 120 cases per associate while also reducing the percentage of exams that need manual intervention to just 5-10% of all scheduled exams! The team is also able to work authorizations further in advance from the date of service, improving from an average of 3 days out to 9 days out.
Hear more from Matt Bridge, Senior Vice President of Strategy and Solutions at AGS Health, and Julia Snyder, Director of Patient Benefits and Authorizations at US Radiology Specialists in our webinar, "Revolutionizing Patient Access: A Synchronized Approach to Financial Clearance."
Matthew Bridge
