Senior Vice President, Office-Based Physicians at

Richard Lopez

Healthcare consumerism has been a trend on the rise for many years, but has never been more relevant than in the COVID-19 “new normal.” Since millions of patients are dealing with financial struggles, loss of insurance, and an overall sense of apprehension when it comes to resuming care treatments, they are extremely particular around where and how they receive care.

Right now, it’s imperative for practices to make patients feel like they have control over their healthcare, which means having the right tools in place to deliver a streamlined financial experience, convenient and efficient self-service options, and transparency around pricing and financial support. To meet these demands, physician practices should leverage the expertise of a proven revenue cycle partner that has the knowledge, technology investments, and process improvement experience needed to drive next-level revenue cycle performance and exceed patient expectations.

This article will cover three key advantages of a revenue cycle partnership and how these relationships allow practices to achieve patient satisfaction goals amid the market’s consumer-driven environment.

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Obtaining Specialized Talent and Technology

Many practices try to handle all revenue cycle work internally, typically through a central billing office with manual processes and limited resources, which can often result in significant backlog when it comes to charge capture and payment posting. With a revenue cycle partner, practices can rely on advanced technology and a larger staff who specialize in key areas, such as billing and coding, to determine where gaps and opportunities exist to enhance internal operations and maximize reimbursement.

A qualified partner knows how to apply automation technology to key revenue cycle processes that affect a practice’s bottom line, such as claims and correspondence management, to remove errors and decrease overall expenses. While automation can certainly create efficiencies, due to the complexity of the revenue cycle, a large amount of work still needs to be handled by human staff members, (e.g., payer contracting), adhering to value-based programs and coding updates. A revenue cycle partner who offers a model that allows digital and human staff to work in tandem is the best way to generate widespread efficacy and ensure all processes are handled efficiently.

A technology-driven revenue cycle also eliminates patient frustrations since they spend less time circumventing administrative roadblocks, such as denials, inaccurate bills or misplaced information that can prolong the care process. With the right people and technology in place, patients can also receive more personalized service from staff members who no longer have to spend countless hours managing all aspects of the revenue cycle and can focus more time on the patient. 

Establishing a Digital Front Door Strategy

COVID-19 introduced patients to a new kind of financial experience – one that allowed them to manage appointments electronically and receive care much more quickly when they arrived for an appointment. With patients becoming more accustomed to this convenience, practices need solutions that will help them further build out their digital front door strategy. A revenue cycle partner that offers a patient experience platform provides practices the ability to connect with patients in a safe, contactless way from wherever they are located.

Through integrated technology, patient experience platforms allow patients to easily self-schedule appointments, complete pre-registration and make payments, all from their preferred digital devices. In addition to this user-friendly functionality, patients can also receive pre-service out-of-pocket estimates, so payment responsibility is clearly communicated upfront, allowing patients to appropriately plan for the financial side of their care. Practices can also strategically use the platform to send valuable on-demand messaging, such as appointment reminders with links to self-schedule, as well as memos about safety procedures or telehealth offerings. With the right partner, providers can meet the demands of consumerism head on and make the administrative side of healthcare more manageable.

Creating Resiliency through Financial Clearance

With many Americans still facing unemployment, more and more patients either need to secure supplemental funding or establish alternate plans to pay for the care they need. A revenue cycle partner can help practices create end-to-end financial clearance processes to determine what financial assistance is needed upfront prior to service taking place. By combining best practices with the right automated workflows and training for staff members, the right partner can help practices: 

Capture patient eligibility information and screen patients with necessary financial questions at the point of scheduling to ensure patients who need additional funding are appropriately flagged. By conducting eligibility checks upfront, practices can also provide price estimates based on the typical cost of service and how much insurance will cover.

Identify which funding sources patients may qualify for and provide patients with counseling to fill out necessary forms to obtain funding. 

Secure any required prior authorizations quickly, avoiding front-end denials and patient care delays. With so many changes being made to patients’ insurance plans, providers need technology that can capture all required information up front and allow patients to be cleared for services within minutes.

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Having the right financial clearance program in place is a key strategic advantage because it further engages patients in their care and increases overall loyalty since practices are providing crucial financial assistance when it’s needed most. Financial clearance programs also give practices the most accurate financial information for every care encounter and help them secure payment for those services, creating a win-win situation for both patients and providers.

With concerns around the safety of receiving care and the subsequent financial implications continually increasing, practices need to make immediate and lasting changes so they can provide reliable, convenient and compassionate services to patients. Instead of taking all of this on internally, practices should establish a revenue cycle partnership that gives them access to the right people, technology and best practices – enabling differentiation amongst consumers and allowing them to focus on their core competency of providing superior patient care. 

Articles

Three key advantages of a revenue cycle partnership. 

How the right revenue cycle partnership can address consumerism challenges

While COVID-19 has presented challenges to every healthcare industry sector, physician practices have taken some of the most significant financial hits over the past few months. A recent Medical Group Management Association (MGMA) survey found that 97 percent of practices have experienced a negative financial impact 

directly or indirectly related to COVID-19

To recoup lost revenue, practices now face the challenge of re-engaging with patients and convincing them to schedule appointments and come back to the office. But when patients do decide to return, they’ll expect the same easy, contactless consumer experience they’ve been receiving during quarantine from companies such as Amazon, Netflix and Zoom.

During these uncertain times, it’s important to think strategically; many physician practices should consider working with partners who can help them identify solutions to ensure business continuity, while also addressing safety concerns and consumer needs. This article will specifically look at how an EHR-agnostic revenue cycle platform can drive substantial improvements to the patient financial experience and help physician practices operate effectively in the post COVID-19 world. 

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An EHR system is a critical component of any healthcare organization’s infrastructure. In addition to digitally recording patient data—including medical history, treatment plans, and insurance information—it easily transfers this information between various providers versus relying on front desk staff to fax or email paper records. Similarly, it’s important to have digital alignment between a practice’s EHR system and an RCM platform to easily transfer patient data across the continuum of care, and ensure claims are billed correctly and collected efficiently on the back end.

Instead of trying to connect disjointed solutions across a patient’s care continuum, an EHR-agnostic revenue cycle platform has the technology, automation, and performance analytics needed to create standardized workflows that ensure full data transparency and a seamless exchange of information. This ensures timely reimbursement, lower denial rates and increased cash flow, while reducing operating costs since much of the traditional back and forth manual work is eliminated.

Interoperability between an EHR system and the revenue cycle offers major benefits to both physician practices and their patients, especially in our current environment. Embedding automated RCM workflows into a practice’s EHR system allows for faster hand-offs of patient information throughout the revenue cycle process. This reduces cost to collect, speeds up and ensures accuracy for patient payments, and allows practice staff to focus on more strategic tasks such as proactive patient outreach.

To increase volume and revenue in the coming months, practices need to get patients to schedule wellness checkups and appointments for elective procedures. Given that many practices will most likely be working with smaller teams, staff members need to focus on bringing business back into the practice versus keeping up with administrative work and billing procedures. Because EHR-agnostic revenue cycle platforms also offer digital patient experience solutions, it enables practices to send on-demand messaging via email or text. Practices can use these communication tools to remind patients to schedule appointments, utilize telehealth services, and notify patients of safety procedures implemented in response to COVID-19.

From a patient perspective, EHR-revenue cycle alignment delivers the optimal financial experience. It eliminates the need to fill out clipboards of information during each visit, and for patients to work with practice staff to receive medical records, fax them to different providers and then complete all new paperwork when referred to another specialist. Having a digital patient record that can be easily transferred through the revenue cycle process on the back end makes the financial and administrative aspect of receiving care much easier, which in turn encourages patients to schedule future appointments.

The digital patient experience solutions that are part of EHR-agnostic revenue cycle platforms also offer many patient-preferred capabilities. Tools like online/mobile self-scheduling and registration, self-service check-in, and online bill pay/automated payment plans help facilitate the convenient, user-friendly, and contactless experiences today’s consumers are looking for and expect—especially when factoring in COVID-19. If a patient knows they can easily schedule an appointment with little to no in-person interaction during the actual care experience, they will be much more likely to engage.

It’s no secret that we’re operating in a different world as a result of COVID-19. To thrive in this new environment will require adopting new technology that allows consumers to receive services the way they want them. Being that it’s expensive to build, manage and maintain an effective revenue cycle platform in-house, the best approach is to work with an end-to-end revenue cycle partner that has experience integrating with existing EHR systems and knows how to effectively automate internal workflows to see the best results.

As practices work to determine where to go from here, they need to consider how revenue cycle transformation can help reduce administrative burdens, create better experiences for patients and most importantly improve financial health during this difficult time. Practices are already facing enough challenges coming out of COVID-19–don’t let an inefficient revenue cycle continue to be something that holds you back. Instead, take the first step toward being the cohesive, convenient provider patients want and need right now.

Align with consumer demands for optimal patient experiences and operational efficiencies.