5 Best Practices for Centralizing Patient Access
For years, health systems have spent large amounts of capital on initiatives inside the walls of their hospitals, such as large-scaled EMR implementations. This has helped address important quality issues as well as meet regulatory requirements, but the stark reality is that these large investments have done little to help health systems — who are already operating with slim profit margins — generate much-needed revenue. This shouldn’t come as a big surprise. All of a hospital’s net patient services revenue originates from outside its walls. Therefore, it’s critical for health system executives to look outward, where the revenue stream actually begins, and collaborate more effectively with referring providers, making it easier for patients to access the care they need.
It all begins at the front door of care – At a health system’s front door today are patients who are increasingly becoming retail consumers, and they expect the ease and expediency they’re used to from other services, such as buying a plane ticket online or scheduling a ride on a smartphone. These same desires apply to referring physicians, who want to seamlessly guide their patients to the right and most convenient locations for care. Health systems can capture more business and gain competitive advantage by offering convenient, retail-like experiences. Centralizing the patient access experience is a big first step toward improving patient and provider satisfaction.
Here are 5 best practices for centralizing patient access:
- Real-Time Integrated Orders – It’s common for faxed referrals and orders to fall through the cracks – 46 percent of such referrals never result in a scheduled appointment or patient visit. The problem compounds itself in a large health system. To ensure seamless access across multiple disparate locations and facilities, scheduling and order management workflows need to be as tightly integrated as possible, even with multiple EHRs. Embed electronic orders and automatically match orders with scheduled appointments to eliminate delays and frustration from phone tag, lost orders, and faxing.
- Front-End Revenue Cycle – To ensure timely payment for services provided, health systems should incorporate revenue cycle management tasks at the front-end of the patient access workflow, well before care is rendered. With the use of an embedded rules engine that triggers revenue cycle checks at the time of referral or scheduling, you can ensure medical necessity is met, insurance eligibility is verified and authorizations and orders are obtained prior to the scheduled appointment, leading to higher reimbursement and fewer denials.
- Consumer Self-Service – Enabling patients – at their convenience from any device – to self-schedule appointments at all locations across the network is key to remaining competitive. With the help of embedded rules, health systems can control which procedures or visits can be self-scheduled, rescheduled, or cancelled. Using automated rules, health systems can create customized questions to guide patients through the process step-by-step to assure readiness, slot availability, insurance, and other factors as part of the scheduling process.
- Provider Self-Service – Offer providers convenient self-service/correspondence tools to reduce inbound call volume, improve productivity and reduce network leakage. Health systems receive higher outpatient referral volumes when provider offices can quickly and easily book patients into the earliest appointment anywhere in the health system.
- Appointment Reminders – To limit the rate of no-show appointments, which is as high as 30 percent nationwide, health systems must integrate automated patient communications directly into the patient experience. A large, centralized call center must support appointment reminders for all types of available procedures and locations. Patient preferences for how they want to receive reminders (voice, mail, email, or text) should also be taken into account.
For more tips on centralizing patient access, please review our checklist infographic.