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


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.

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 $67,774 per physician in 2020.

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.

Be boldly transparent about costs

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.

Make self-service a clear option

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.

Close the loop on care next steps

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.

About the Author
Joe Polaris, SVP of Product & Technology, R1 RCM
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