June 10, 2009
Tough economic conditions and a rising number of self-pay patients are among the factors making a focus on the front end of the revenue cycle more important than ever for healthcare organizations.
A range of new resources from HFMA--featured in this issue of HWYTK--provides practical information and best practice solutions for optimizing patient access and emphasizing early and transparent financial communications.
And don’t forget to participate in our ongoing InstaPoll on revenue cycle issues. This week’s poll, which is sponsored by Craneware, asks whether you have the tools you need to evaluate pricing effectiveness and the impact of pricing strategies on your hospital.
Optimizing Patient Access
Many healthcare providers are discovering that the best chance to improve the revenue cycle is at the beginning of the process, when first capturing data while scheduling and registering patients. Optimizing Patient Access, a new HFMA educational report, emphasizes the need to take advantage of effective technology, design organizational structures for greater efficiencies, and focus on staff training and development to improve patient access.
The report, which is sponsored by GE Healthcare, offers case studies of several hospitals and health systems that have taken these lessons to heart. At Riverside Health System in Newport News, Va., for example, training involves use of a registration scrubber when developing for each registrar a score of how many data elements are wrong as a percentage of their total registrations. This score is then translated into a grade.
When the program was first instituted, all of the system’s registrars were failing. The healthcare system then took the next step, allowing registrars to fix their errors before they affected the registrars’ scores. The system has since gone to 96 percent accuracy and its billing clean rate has gone from about 60 percent clean to 85 percent clean.
Although improvements in patient access aren’t always easy, the report demonstrates that success does happen. “I’m doing much more with a lot fewer people,” says Richelle Fleischer, Riverside’s administrative director of revenue cycle management. “And I’m doing a much better job at it than I’ve ever done before.”
Early, Transparent Financial Communications
Patients want to know what they will be expected to pay for healthcare services before they incur the costs. Financial discussions that occur after services are delivered deprive patients of the ability to make informed choices about their treatment options.
When hospital and patient engage in transparent financial communications, “the billing and collection process becomes a verification of what the patient already expects,” say the practice guidelines. “Each patient’s personal payments will be related to what they can afford to pay, and providers are more likely to receive sufficient payment from all appropriate payment sources so that they can continue to provide quality healthcare services.”
HFMA’s Revenue Cycle Strategist newsletter is another excellent source of information on improving preservice communications with patients. This month’s issue features an article on “Tools and Techniques to Enhance Preservice Collections,” which is complemented by a web exclusive offering preservice collection scripts to assist staff in communicating financial responsibilities to patients. These scripts can be accessed free of charge for a limited time by HWYTK readers.
Members of HFMA’s Revenue Cycle Forum are also focusing on the revenue cycle’s front end. Current discussions include self-pay collection policies and procedures and barriers to a positive patient experience. The Forum is continuously updated with original material, peer-shared content, and an aggregation of the best resources on the web. Learn more about joining the Forum.