Patient-centered technology is key to transforming the prior authorization, appointment-setting and revenue cycle processes from tedious tasks to frictionless experiences.
During a Becker's Digital Innovation + Patient Experience + Marketing Virtual Event featured session sponsored by RevSpring, a panel of patient access and engagement experts discussed tools and technologies that can help healthcare organizations accomplish their access and engagement goals.
Panelists were:
- Howard Bright, chief technology officer, patient engagement, RevSpring
- Jaime Mathews, vice president, patient access and experience, Chicago-based Dignity Health (part of CommonSpirit)
- Tesha Montgomery, senior vice president, system patient access, Houston Methodist
- Tanya Powell, director, patient access, Ochsner Health System in New Orleans
- Matt Rohrer, director, patient access, UW Health (Wisconsin)
Three key takeaways were:
1.) High prior authorization denial rates affect health systems' operations, finances and patients. Top factors contributing to high denial rates include not having the right patient insurance information upfront, payer and contract complexity, inadequate staff training, high turnover and eligibility hurdles related to coordination of benefits and expenses incurred after determination.
At Ochsner, the sheer number of errors bogging down the eligibility process was such that "we couldn't even initiate the start of the revenue cycle," Ms. Powell said. A convoluted prior authorization process also creates frustration for patients, Ms. Montgomery said.
2.) Ample, accurate data collection at the outset of the patient journey minimizes denial rates downstream. Collecting as much patient information as early as possible and connecting it across organizations' EHR systems, patient portals and back-end revenue cycle workflows is key for authorization approval, seamless pre-registration and effective intake.
"Whatever technology is in place, it has to be simple and seamless from a patient experience standpoint, but also on the back end," Ms. Montgomery said.
3.) Leveraging technology can drive better clinical, administrative and financial outcomes. One effective way to do so is by enabling self-service check-in, where patients can use either a patient portal through an app or an on-site kiosk to pre-register for a visit. Both modalities reduce labor costs by cutting down or reassigning staff to higher value-added tasks.
Pre-registration tools such as these ask users to verify their demographic information and allow them to obtain auto-generated cost estimates, view outstanding balances, make payments and sign documents. "This makes sure we have the right information upfront, saves time when the patient comes in and [improves] payment collections," Mr. Rohrer noted.
Technology can further alert staff when a patient's insurance information needs to be reviewed or updated. "That helps us be proactive by reaching out to the patient and ensuring there are no surprises when that patient shows up. The worst thing that can happen is for someone to show up, bringing in their worry or concern, only to hear that there's a friction point and maybe they have to wait or maybe they have a surprise bill," Ms. Mathews observed.
If there is one overarching goal to keep in mind as healthcare organizations implement patient-centered processes, it is to ensure that the tools and technologies that are used amplify the patient experience in a positive direction. "You have to make sure that you're putting tools in there that are patient-first and patient-centered," Mr. Bright said.