As the number of high-deductible health plans increases, alongside the deductibles themselves growing, co-insurance ratios and the cost of care escalates, co-payments rise, and care exclusions surge, the resulting environment is one of considerable difficulty for both patients and providers. Patients facing tremendous costs for much needed care are often unable to cope with burgeoning bills, particularly in scenarios where long-term, chronic illnesses have caused hardship, loss of employer-supported insurance and in many cases, the ability to work. Providers also face new challenges in communicating the cost of care to patients, caregivers, and families, and balancing the aims of providing access to high quality care while at the same time balancing an increasingly precarious financial position.
In this evolving environment, the Patient Financial Services team plays an integral role across the revenue cycle, supporting patients from in-take to final bill, providing guidance on everything from coverage and eligibility, to explanation of benefits, decoding or translating highly technical medical bills, to assisting patients and families with financing opportunities. A conduit between hospitals and patients, patient finance teams must be well versed in an incredible range of issues transcending the revenue cycle in order to effectively and efficiently ensure bills are generated swiftly and accurately, and that payments are remitted as quickly as possible.
With teams working in alignment across the revenue cycle, in order to reach the highest level of efficiency, achieving an unparalleled level of collaboration with numerous departments is essential. The most skillful of patient finance teams will bring registration teams, coding groups, finance executives, as well as providers to the table in order to create a cross-functional group focused on ensuring access to care alongside maximized reimbursement from payers and payments from patients.
Industry analysis has continued to point toward registration and pre-registration errors as a primary driver of first-pass denials from payers, underscoring the need to increase attention in this area. While front-door technology has assisted to some extent in automating and collecting correct data, patient errors in data submission are rife, highlighting the need for collaboration between patient finance teams, registration teams, and the patients themselves, to ensure benefits and insurance data as well as personal data is correctly captured.
Revenue Integrity & Identifying Leakage
For many hospital and health system teams, retrospective analysis of denials is helping to create new priorities for identifying leakage and capturing additional revenue that might have otherwise been lost. Critical to this effort is the combined work across patient finance and revenue cycle teams, who must come together with goals aligned in order to improve processes and reduce denials.
Optimizing Team Training & Onboarding
Across the revenue cycle, executives report a high level of vacancies, with patient finance teams also facing staffing shortages, causing additional strain on already constrained resources. Given the considerable amount of training required to bring new team members up to speed, creating mentorship programs with existing staff, and increasing resources for training and onboarding will help bring teams together in the most effective way possible.
Collaborating in a Remote Work Environment
The COVID-19 public health emergency resulted in an incredible shift across many sectors, with more staff working outside of the traditional office environment than ever before; a trend unlikely to reverse at this time. While many efficiencies result from this format of work and benefit both employees and employers, greater effort must be expended to create collaborative teams, where face-to-face interaction is limited. Leadership from not only patient financial services teams, but across the revenue cycle must consider new and unique ways of creating highly collaborative relationships with their teams.
Throughout the Patient Financial Services program being hosted live online this October 11 & 13, executives will share how they have brought together teams of executives from across their organizations in order to more effectively support both patient and hospital goals. Our opening keynote leadership panel will focus on ways to collaborate with teams across the revenue cycle but with a focus on the front-end optimization, featuring perspectives from the VP of Revenue Management from Paradigm Treatment, the Chief Revenue Cycle Officer from the Medical University of South Carolina, and the VP of Patient Access from Rush University Medical Center. Join us now, Live Online.