Patient Access Review & Consulting

The Challenge

If your facility is like most, it has become an ongoing struggle to establish and maintain adequate Patient Access procedures due to constant government/third-party insurance changes, staff turnover, training and system limitations. This common situation often results in registration errors, little or no pre-verification of insurance coverage, and the absence of an effective collection policy for insurance deductibles and co-pays. But how do you implement the critical changes necessary for lasting improvement?

Our Service

Revenue Cycle Solution's experienced Patient Access Consultants will analyze all aspects of your current Patient Access operations and focus on ways to improve use of scheduling, pre-registration and capture of pertinent account information.

Patient Access problems typically stem from multiple sources. They are most often the result of deficiencies in a number of areas including education, training, staffing levels, workflow, and/or poorly implemented computer software. Each deficiency must be addressed as part of a coordinated solution necessary to obtain long-term improvement.

Our Patient Access Review begins with the establishment of baseline measurements of a provider's Patient Access performance, including the development of applicable indices and benchmarks.

We'll send experienced Patient Access Consultants onsite to gather information necessary to assess department staffing, skills, processes and system usage. Our consultants work closely with your organization's existing multi-disciplinary teams with minimal disruptions to your daily operations.

We review the following areas and provide you with specific findings and recommendations:

  • Patient Scheduling
  • Insurance Verification
  • Pre-registration
  • Emergency Registration
  • Outpatient Registration
  • Admissions

We then complete a detailed operational assessment of the Patient Access process to identify deficiencies and opportunities for operational and financial improvements.

As a final step, we provide a written assessment report and supporting work plan of your overall Patient Access operations and recommendations for the creation, implementation and monitoring of workable solutions.

Our Approach

  • In-depth discussions with senior management to understand concerns and establish the program objectives
  • Customized review of operations, including interviews of key management personnel responsible for the day-to-day oversight of various Patient Access processes
  • Hands-on participation by senior RCS staff
  • Validation of key information by appropriate hospital personnel
  • Creation of applicable indices and benchmarks including:
    • Overall scheduling rate for all non-urgent patients
    • Overall insurance verification rate of scheduled patients
    • Overall pre-registration rate of verified patients
    • Insurance verification rate of unscheduled high-dollar outpatients within one business day
    • Payment request rate for insurance co-pays/deductibles
    • Real-time collection rate of insurance co-pays/deductibles
  • Detailed analysis and documentation of all significant Patient Access processes, including identification of issues relating to compliance with HIPAA privacy regulations
  • Timely completion of work. Our entire assessment is typically completed within four to six weeks after obtaining all pertinent information.
  • Detailed management report containing all significant findings and opportunities

Benefits

  • Written work plan provides an easy and effective process to create, implement and track suggested changes for improvement.
  • Typical improvements include:
    • Increased scheduling of all non-urgent patients
    • Increased pre-verification of insurance
    • Adoption of pre-registration process for all non-urgent patients
    • Increased cash flow through significant increase in the real-time collection of insurance co-pays and deductibles
    • Greater accuracy and completeness of account information
    • Reduction of associated claim edits and denials
    • Improved patient convenience and satisfaction