Joe Polaris, MBA 

With the COVID-19 vaccine becoming more widely adopted, the US is slowly starting to emerge from the pandemic. While some things, like in-person gatherings, are starting to go back to pre-pandemic normal, there is still a long way to go when it comes to financial recovery. This may seem especially daunting for physician practices, with gross revenue losses estimated at 

At the same time, average Americans continue to face unprecedented financial challenges as well. Even before COVID-19, 

nearly one-quarter delayed care due to concerns about out-of-pocket expenses

.Then 2020 hit and 29% of Americans lost their health insurance. And 

more than half of those affected remain uninsured in 2021

For physician practices seeking ways to rebuild volume with current patients and consumers shopping for care, understanding the ongoing impact of financial worries is critical to designing a plan that helps patients better manage care decisions as well as costs. Consider that the key public-facing touchpoints, such as pre-registration, intake, and payment, are also the interactions that often cause frustration for patients. Yet, these touchpoints are critical to the revenue cycle and financial recovery. Thus, being sensitive to consumers’ needs goes hand-in-hand with long-term growth.

Becoming consumer-focused starts with removing the friction and making it easier for consumers and patients to find and interact with your practice. Just as important is seamlessly coordinating the additional diagnostic and treatment services your patients need from other providers. Digital tools are designed to make complex interactions user friendly, transforming the patient’s entire care journey. This article highlights four strategies that leverage the technologies provided by patient experience solutions to enhance patient loyalty and satisfaction while driving better financial performance for physician practices.

How to become a superstar practice manager

Consumers already expect to understand prices when they shop, and that information is readily available for most things except healthcare. Even though estimating patient financial responsibility can be complex, giving patients as much information up front as possible about out-of-pocket costs, such as copays and coinsurance, will pay off in building trust and loyalty. Using a solution that offers price transparency tools, patients can better understand the cost of care before they proceed with scheduling, which makes planning and paying for care easier. At the same time, when patients are informed about their options, including insurance benefits and in-network alternatives, downstream denials can be avoided, and payment collection improved.

When shopping for services and managing associated administrative tasks, consumers expect to use mobile self-service as they do for travel and banking. Leverage revenue cycle technology to let consumers search for your providers, schedule appointments, and complete paperwork up front.

Unlike paper forms, digital tools ensure previously provided details are accessible from visit to visit. Letting patients complete pre-registration and intake tasks online at their convenience, such as adding or verifying demographic and insurance information, signing consents, and providing current health status data eliminates common frustrations with paper-based processes. In addition, it helps practices gather complete and accurate data to streamline and accelerate billing and reimbursement.

Encourage patients to pay at their convenience

Throughout the pandemic, making payments online has become much more prevalent. Not only do more patients opt for making payments online, but many also prefer to pay co-pays at the time of service rather than waiting for a mailed statement. By accepting payments online at multiple points in the care journey, such as during online pre-registration or at the time of service, practices will receive more early payments. This is not only more convenient for patients, but also reduces billing and collection costs. In addition, by making flexible payment plans easily accessible as part of the self-service process, patients will appreciate the accommodating approach, while practices increase collection rates overall.

When a patient needs additional services for diagnosis and treatment, such as an imaging study, the typical approach of handing the patient a paper order leaves too much to chance. Will the patient follow through in a timely manner? How will the physician know if care was received? For both employed and independent practices, health systems in your market may offer digital care coordination tools, including electronic orders, prior authorization processing, and direct scheduling on behalf of patients.

Submitting orders electronically assures accuracy and completeness as well as immediate delivery to the rendering provider. Automated prior authorization processing confirms when an authorization is required by the payer and obtains the authorization quickly and efficiently to eliminate care delays and free up office staff time. Direct scheduling allows office staff to schedule the patient’s appointment, such as for a CT scan, online in real time. The patient can then be scheduled for a follow-up visit with the physician to review results, so the patient leaves the office feeling reassured that clear next steps are in hand. By working with the rendering facility to coordinate care, you can create a well-orchestrated process that gives patients confidence in their care team and improves operations for the practice.

As physician practices look for ways to build volume and engagement, it’s critical to thoughtfully consider it all from the point of view of patients and consumers. By transforming key revenue cycle touchpoints to make them as smooth as the interactions people experience with other industries, you can make it easy and convenient for patients to manage each step of their care journey. Actively engaging consumers and offering them the options they want will result in more volume and a solid path toward financial recovery.

Joe Polaris, SVP of Product & Technology, R1 RCM

Articles

As physician practices look for ways to build volume and engagement, it’s critical to thoughtfully consider it all from the point of view of patients and consumers.

Why the revenue cycle is vital to exceeding patient expectations and driving financial performance

Given CY 2020’s Hospital Price Transparency Requirements, which take effect January 1, 2021, there has been a huge push in the healthcare industry to not only provide financial clarity to patients, but also deliver on rising overall consumer expectations in order to stay competitive. While price transparency requirements don’t apply to physician practices just yet, the shift toward transparency and overall consumerism will affect providers because the way their patients approach their healthcare experience will be entirely different.  

Because the revenue cycle encompasses patient touch points across the continuum of care it must be standardized in order to create the consistency needed to optimize the patient experience and increase patient revenue. This article will look at ways practices can utilize automation to not only meet consumer-driven transparency demands, but also serve three key objectives of most physician practices: 

Increasing revenue collected and lowering bad debt expense 

Digitizing the Revenue Cycle to the Patient’s Delight

Today’s patients want more control. They want self-service options that allow them to manage their own appointments and make payments easily online. They want to know how much services will cost, have the ability to receive care sooner rather than later, and not be surprised when they receive their final bill. While these features are commonplace in other industries like air travel, retail, and banking, unfortunately they are often missing from physician practices.

By introducing digital self-service platforms, patient-facing transactional processes such as scheduling appointments, updating patient information, or paying a final bill can be radically transformed. Digitization creates an easier, more convenient interface for the patient, allowing them to choose when and how to engage, keep up to date while on-the-go, and always feel connected to the practice. 

Get up to speed with Medicare’s MBI shift

Additionally, digitization provides a level of personalization, which will elevate your patients’ experience even further. For instance, data algorithms can determine a patient’s preferences for how to check in and make payments, and then offer these preferences to patients at the right time in their care journey, giving them the tailored, expedited experience they want while also streamlining staff’s work. 

Using Automation to Realize Revenue Faster and at a Lower Cost

One of the biggest advantages automation brings to the revenue cycle is operational efficiency. Many practices still take a manual approach to the revenue cycle, managing patient information through outdated forms and esoteric spreadsheets. With automation technology, complex revenue cycle tasks can be modeled into digital workflows, executed seamlessly and quickly. A simple example is the claim editing and submission process. Automation tools can segment claim holds and edits, evaluate their deficiencies, correct them, and submit clean claims-all tasks that would have previously required staff time and attention. By utilizing automation, practices can simplify work, eliminate costly errors, and accelerate processes that are critical to cash collection. Ultimately, this means more hours of practice staff’s precious time are able to be focused on patient care.

Teaching your practice to work in this standardized manner and adjust workflows when needed to increase efficiency is just as critical as implementing the technology. Relieving your practice of repetitive tasks and removing activities that cause points of friction, failure, and inefficiency will enhance overall operational performance and allow your current staff to focus on more customer-oriented tasks that require a higher level of service. 

Being Transparent Has Never Been So Important 

With 57 percent of Americans having been surprised by a medical bill

, there’s a clear need for both hospitals and physician practices to educate patients on their financial responsibility. As hospitals begin to disclose pricing and estimates, patients will expect the same from physician practices. 

Given the growing complexities of healthcare, maintaining an accurate and up-to-date inventory of costs for services will be challenging for many practices. With a digitized, automated revenue cycle, practices can leverage their data for accurate cost estimation, and can provide pricing information to patients in a clear and concise way. By integrating these tools within your revenue cycle, estimates can easily be generated, and accurate pricing information can continually be made available to patients whether they are researching services on your practice’s website or receiving an estimate at the time of service. 

Being able to provide real-time financial information and counseling to patients allows them to make better financial decisions which ultimately ends up benefiting your practice in the long run. An analysis by R1 RCM found that patient collection yield increased by over twenty percentage points when potential out-of-pocket costs were clearly articulated prior to service.

To keep up with consumer demands, practices need to capitalize on the opportunity to digitize their revenue cycle processes self-service technology and automation. For successful long-term results, consider how a revenue cycle partner might enable a comprehensive approach to digitally transform the revenue cycle. If your practice can utilize automation to deliver the best possible experience from scheduling all the way to paying the final bill, your organization is bound to see an uptick in revenue, as well as a delighted customer base much more likely to visit your practice again. In short, digital transformation of the revenue cycle offers a competitive advantage that you may not want to wait any longer to achieve.

Joe Polaris, MBA, is senior vice president of product and technology for R1 RCM.

2019 Commonwealth Fund Health Insurance in America Survey, https://www.commonwealthfund.org/publications/issue-briefs/2019/sep/what-do-americans-think-health-coverage-2020-election

To keep up with consumer demands, practices need to capitalize on the opportunity to digitize their revenue cycle processes self-service technology and automation.