At nThrive, we recognize that our hospital and health care provider clients are experiencing a fundamental shift in how they get paid, largely due to health care reform, the rising cost of care and an ever changing regulatory market. Although patients are now expected to cover more of their cost for care due to a dramatic rise in deductibles, many can’t – or won’t, depending on whether they are insured, underinsured or uninsured, resulting in rising patient bad debt. Ultimately affecting cash flow and threatening financial health, this is further compounded by claim denials resulting from registration errors on the front end, which inaccurately document or omit benefits that insured patients are entitled to.
“To better serve clients in today’s new age of Patient Access requires understanding the changing role of the front office, which now includes use of the latest technologies to improve accuracy. This begins with informing patients about their obligations upfront and working with them on payment options to mitigate patient bad debt, and extends to billing, ensuring patient information is accurate and complete,” said Kelley Blair, senior vice president, Service Solutions.
Linking front office dependencies across the revenue cycle—from Patient-to-Payment℠—is critical, with solutions including Eligibility and Enrollment, Patient Advocacy, Patient Access Operations Outsourcing, Patient Access Technology and Patient Education.
Eligibility Enrollment and Patient Advocacy
In the realm of Eligibility Enrollment and Patient Advocacy, nThrive capabilities have been enhanced with the recent acquisition of Adreima, which offers services to help both uninsured and insured populations meet their obligations. For the uninsured, Adreima provides counseling and assistance to obtain payment through Medicaid and other charity programs. For the insured, they offer a Concierge service, assisting patients in managing invoices resulting from complex cases with multiple providers.
Regardless of status, “We are not just touching patients, we are trying to create a meaningful experience,” said Kathy Turner-Motley, Adreima vice president, Southeast Operations, adding that “it improves patient satisfaction to get patients into the right program.”
Patient Access Operations Outsourcing and Technology
To dramatically accelerate collection of out-of-pocket dollars and circumvent claim errors, clients can turn to nThrive’s Patient Access Operations Outsourcing. Through a Patient Access outsourcing engagement, nThrive helped East Jefferson General Hospital in Metairie, La., increase collections by 80 percent within the first month.
Jit Sivalogan, director, product management, noted that integration of Patient Access Technology is integral to achieving a high level of success. He highlighted CarePricer® as an essential tool to improve estimate accuracy, enabling hospital organizations to provide estimates within 98 percent of the final bill. Accurate estimates are integral to patient satisfaction, helping health care consumers make better educated choices on care, as well as alleviating the stress of unanticipated charges following discharge.
Ambulatory and Education
nThrive Ambulatory helps clients extend Patient Access improvements into the non-acute setting and integrate importance enhancements such as one-call resolution to address patient problems. Patientco, an nThrive partner, also offers automated payment capabilities to make it faster and less stressful to pay, either in full or through payments using online technology.
Across the board, education is a critical component of success, ensuring that Patient Access resources understand changes confronting the front end of the revenue cycle, as well as the impact down the line. Adequate training is a growing imperative with expanding roles, both to utilize the latest technology and to ask for payment upfront. Currently, nThrive Education offers a suite of Patient Access courses to address client needs, said Darcelle Johnson, manager, Revenue Cycle Education Development.
Aligning business solutions to address key issues
Ultimately, the new age of Patient Access requires better alignment to address key issues facing organizations and the community, said Erica Franko, principal director, Business Health. “Our teams help clients by identifying issues and developing strategies with actionable plans that support leading practice outcomes,” she explained, adding that “optimal processes and governance enhance the successful adoption and integration of our solutions—including outsourced services and technologies—through implementation into adoption.”
Better alignment is needed between advisory, education, implementation and training to achieve the highest results, Franko stressed, adding “education needs to be a part of everything, with more involvement by Advocacy to better guide patients upfront.”
“Our goal is to holistically integrate Patient Access within the revenue cycle for optimal performance,” said Blair, focusing efforts around people, process and technology to better address client needs. She noted that achieving the highest impact requires strategies that address the patient as an individual consumer, adopting them at the center of the process.
“This includes incorporating HR and education solutions, as well as meaningful integration of ambulatory and acute scheduling with billing and collections, creating customized workflows for individual patients,” she added.
For more information on how nThrive can help you meet your patient access challenges – from delivering an accurate patient estimate to streamlining POS collections and preventing denials – visit us here.