You may not realize it, but the revenue cycle – and the groundwork for successful account resolution – begins at the front desk, with patient scheduling. There are many important patient access functions that can and should occur before the patient encounter (and some even before the patient steps foot in the office).
One of the most important steps is to verify insurance eligibility, benefits, and service authorization prior to the appointment. Industry best practice is to verify 98 percent of patient eligibility and benefits prior to every visit, but few practices come close to that. Some practices verify after the appointment, while others do so infrequently or inconsistently, if at all. Make these pre-appointment checks part of your standard workflow, coupled with a liability estimator (available through a clearinghouse, practice management system and certain payers) so you know how much to collect from the patient up-front.
Some organizations, particularly hospitals, are going one step further with emerging solutions that forecast a patient’s likelihood to pay their medical bill, and customize payment policies accordingly.
These steps also collectively provide you with information necessary to educate patients about the availability of financial assistance programs, screen qualifying patients for coverage and walk them through the account resolution process – all before the appointment. Financial clearance steps ensure your services stand the best chance of being properly billed and paid.
Build a thorough financial clearance program into your office staff’s standard pre-appointment workflow and clearly define who is responsible for these tasks. Combined with a good payment estimation tool, you are not only armed with information you need to discuss a patient’s financial obligation with them, you can provide greater payment transparency, which leads to greater patient satisfaction.