When it comes to the biggest challenges facing revenue cycle professionals, the new role patients have in paying for the cost of care is one of the most pressing.
"Everyone's been focusing on that," said Patti Consolver, senior director of patient access for Texas Health Resources. "From clinical to housekeepers to finance to everyone ... it's a focus on what the patient truly wants."
Much of the difficulty is related to helping people navigate the confusing process of determining patient financial responsibility, Consolver said, not to mention helping patients make sense of their bills.
Kittie Smith, executive director of revenue cycle for Baptist Health Medical Group in Kentucky, said managing claims through the various payer channels is a struggle, especially when patients don't understand their coverage,
"Patients don't understand and registration clerks can hardly read the cards because there's no uniformity of what they mean. That's some of what challenges us every day," she said.
To help smooth the process, managers are turning to a mix of technology and process solutions.
Consolver said Texas Health Resources has used an estimator for several years. It's embedded into their registration system and allows the user to get an estimate, but they aren't always user-friendly. Recently, they've moved away from the word "estimate" to use words like "deposit" and a "range" of prices. They also have outstanding balances button which is embedded into their registration platform where they can view all the patients' outstanding balances and be able to collect on those at the time too.
"If they've got five patients waiting and there's a focus on wait times they may not go into that additional system to look at the outstanding balance that patient may have. Whereas, if it's embedded in the system it's easily obtained," said Consolver. "It does make an impact."
Consolver also pointed to their call center, which is responsible for insurance verification and pre-registration. She said this past year the system put a heavier focus on financially clearing patients and turned their registrar staff into true financial counselors. That required staff training so that they knew how to collect and how to offer patients options before they come in for service.
That has really made an impact, Consolver said.
For Smith, it's patient portals that have shown the best benefit for consumers since their bill and clinical information is available anytime patients want.
Smith, Consolver and Dan Ward, vice president of strategy for ZirMed, will address these challenges as well as how technology can help boost revenue cycle operations at the Revenue Cycle Solutions Summit in Orlando, Florida.