Patient Access Review & Consulting
The Challenge

If your facility is like most, it has become an ongoing struggle to establish and maintain adequate Patient Access procedures due to constant government/third-party insurance changes, staff turnover, training and system limitations. This common situation often results in registration errors, little or no pre-verification of insurance coverage, and the absence of an effective collection policy for insurance deductibles and co-pays. But how do you implement the critical changes necessary for lasting improvement?

Our Service

Revenue Cycle Solution's experienced Patient Access Consultants will analyze all aspects of your current Patient Access operations and focus on ways to improve use of scheduling, pre-registration and capture of pertinent account information.

Patient Access problems typically stem from multiple sources. They are most often the result of deficiencies in a number of areas including education, training, staffing levels, workflow, and/or poorly implemented computer software. Each deficiency must be addressed as part of a coordinated solution necessary to obtain long-term improvement.

Our Patient Access Review begins with the establishment of baseline measurements of a provider's Patient Access performance, including the development of applicable indices and benchmarks.

We'll send experienced Patient Access Consultants onsite to gather information necessary to assess department staffing, skills, processes and system usage. Our consultants work closely with your organization's existing multi-disciplinary teams with minimal disruptions to your daily operations.

We review the following areas and provide you with specific findings and recommendations:

  • Patient Scheduling
  • Insurance Verification
  • Pre-registration
  • Emergency Registration
  • Outpatient Registration
  • Admissions


We then complete a detailed operational assessment of the Patient Access process to identify deficiencies and opportunities for operational and financial improvements.

As a final step, we provide a written assessment report and supporting work plan of your overall Patient Access operations and recommendations for the creation, implementation and monitoring of workable solutions.

Our Approach

In-depth discussions with senior management to understand concerns and establish the program objectives
Customized review of operations, including interviews of key management personnel responsible for the day-to-day oversight of various Patient Access processes
Hands-on participation by senior RCS staff
Validation of key information by appropriate hospital personnel
Creation of applicable indices and benchmarks including:

Overall scheduling rate for all non-urgent patients
Overall insurance verification rate of scheduled patients
Overall pre-registration rate of verified patients
Insurance verification rate of unscheduled high-dollar outpatients within one business day
Payment request rate for insurance co-pays/deductibles
Real-time collection rate of insurance co-pays/deductibles

Detailed analysis and documentation of all significant Patient Access processes, including identification of issues relating to compliance with HIPAA privacy regulations
Timely completion of work. Our entire assessment is typically completed within four to six weeks after obtaining all pertinent information.
Detailed management report containing all significant findings and opportunities

Benefits

Written work plan provides an easy and effective process to create, implement and track suggested changes for improvement.
Typical improvements include:

Increased scheduling of all non-urgent patients
Increased pre-verification of insurance
Adoption of pre-registration process for all non-urgent patients
Increased cash flow through significant increase in the real-time collection of insurance co-pays and deductibles
Greater accuracy and completeness of account information
Reduction of associated claim edits and denials
Improved patient convenience and satisfaction.

Services

All Matters of Patient Access Consulting

SERVICES

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650-252-0306