As rising healthcare costs push more Americans into high deductible plans, patient access professionals are tasked with navigating these patients through an unfamiliar landscape: the actual cost of healthcare service delivery. Patients need insight into which services are crucial for care, where to obtain them, what’s covered in their plans and what’s not. And they need this information now.
Many old ways of gathering these answers for patients are just that-- outdated approaches that are quickly becoming obsolete in the face of new patient needs. As it happens, the market is responding with automated and online tools that practices can leverage in every area of patient access, from verifying insurance coverage upfront to enabling online bill pay.
Automated eligibility verification
Collecting from patients must become a core competency for practices, as the insurance payment alone is unlikely to cover the full cost. This of course involves making sure a patient’s insurance coverage is active before performing services. The complication: this coverage can change from visit to visit. Further, checking eligibility through payor websites is cumbersome and very time-consuming. It can also be expensive for practices that pay for each transaction through a traditional practice management system or clearinghouse.
By contrast, practices can use automated eligibility verification to enable automated 270/271 responses, access real-time verification, and even create flags and alerts to identify demographic capture errors in the scheduling process. Automated identification of patient responsibilities varies from payor to payor, but typically communicates in network co-pay, out of network responsibility, and deductibles used to data. This information is critical in estimating costs for services and a patient’s outstanding balance.
Patients with more financial responsibility for their care tend to shop around—and getting a voice recording may be as far as they’ll ever attempt to communicate with a potential new provider. If they call during business hours, they may be put on hold (even multiple times); should they reach a live voice, it can take more back and forth to find an open spot.
With online 24/7 scheduling, patients can set their own appointments, while practices can capture patient emails and phone numbers. Both can be used at later dates to communicate with patients about follow up visits, vaccines and other health needs. Another benefit—it drives patients to the provider’s website, where they can learn about the provider’s available services, experience and credentials. This is information “shoppers” will take close note of.
Online scheduling should also include interactive features that make sure patients don’t cancel. When the patient schedules the appointment online, for example, they can click on a link to update their personal calendars with the appointment information. In addition, practices can establish automated reminder messages through automated phone calls, emails and text messages. These do cut down on missed appointments, and are a benefit to both patients and providers.
Online Bill Payment
Consumers today are regularly encouraged to pay their bills electronically. It’s a convenience for patients, too, and much more cost-effective for the practice since paper checks and trips to the bank are reduced. From a service perspective, making it easy for patients to pay is vital in creating a positive patient experience and collecting the ever-growing amount owed by them.
Practices can introduce this feature into their own patient access workflows by setting up an online payment portal that enables automated withdrawals and payment plans. It’s fast, reduces payment procrastination, and eliminates manual processing of deposits, late fees and overdrafts.
Adopting these and other patient access tools coming online makes it easy and intuitive for patients to understand the value of services delivered, and the terms and timing of payment.
As for where to find these tools, the best option for many practices may be to engage with a revenue cycle partner that offers a full suite of patient access automation solutions. The right one will be able to help practices of all sizes and specialties streamline workflow, eliminate payment confusion and improve patient payment outcomes.
Indeed, by automating the entire billing process--from eligibility to patient payment--practices can significantly increase timely, accurate collection on the patient portion owed for services, while at the same time reducing any uncertainty for the patient about the terms of his or her responsibility.