Increase Patient Satisfaction by Automating Eligibility Verification Processes

Author: Chris Fisher, maxRTE Business Development Director

 

Whether you are on the leadership team making high level business decisions, or on the front lines as the first point of contact for patients, you play an important role in the effectiveness of your organization. Each department adds to the organization’s value chain by finding efficiencies to help you work smarter and ultimately, increase patient satisfaction.

 

Revenue Cycle Management is no different. Consider the following excerpts from a recent HealthIT Analytics article, “Leveraging Business Intelligence for Healthcare Management:”

Patient satisfaction

A high satisfaction score is an indication that healthcare organizations have gotten it right with the patient experience from start to finish. Communication, transparency, empathy, and respect are key competencies for providers who wish to instill loyalty in their patients.

Key Performance Indicators (KPI) measuring patient registration times, insurance verification rates, and service pre-authorization factors can also give providers some insight into how efficiently they get patients into the system with the minimum amount of disruption, paperwork, and delay.

Claims management, denials, and A/R days

Successful revenue cycle management depends on a high degree of efficiency, short wait times between billing and reimbursement, and reducing the amount of uncompensated care delivered to patients. KPIs can be particularly helpful for financial officers, since numbers don’t lie, and a variety of pre-developed revenue cycle measurement metrics are available from organizations like the Healthcare Financial Management Association (HFMA).

Indicators such as did not final bill (DNFB), final bill not submitted (FBNS), did not submit to payer (DNSP), and clean claim rate can help ensure that claims are being generated efficiently.

Monitoring duplicate and repeat claims submissions, denial rates, and time from service delivery to final reimbursement can aid organizations as they gauge their available revenue streams and processing activities.

Providers may also wish to add clinical documentation improvement initiatives to their claims monitoring programs.  Clean, complete, and accurate clinical documentation can prevent billing queries and denials for lack of specificity while ensuring that coders can attach the best possible ICD-10 code to claims to speed the reimbursement process.

 

As you develop your own KPIs to add to your organization’s value chain, look for ways to increase efficiencies in your eligibility verification process. By automating your process through a web interface or integration with your EHR that is linked to your payers, you can quickly and easily validate plan-specific benefits, capture accurate payment data at the front end of the revenue cycle, and avoiding costly back-end collection.