During each step of patient registration and scheduling, it is important to access patient information regarding insurance eligibility and verification of benefits. The process should be repeated routinely for effective revenue cycle management, but it is crucial at time of Patient Access for improved cash collection of co-pays and deductibles.
Leading healthcare organizations have found that when the key personnel in the registration and scheduling functions can access patient insurance information early in the workflow process, point of service cash collections increase and bad debt decreases.
From the first encounter with patients, whether it is in person at registration or scheduling, or perhaps through a centralized patient access service center, checking insurance eligibility and confirming benefits not only helps your hospital ensure payment for services, but it helps educate patients understand their financial obligations. Studies show that patient satisfaction increases when patients know what to expect prior to receiving their first bill.
Here are some useful tips on where and when you should access patient information to ensure maximized cash flow, while at the same time, increase patient satisfaction.
A centralized scheduling department may your first encounter with a patient, so it will not seem unusual or uncomfortable to ask the patient for their insurance information. It also provides an opportunity for discussion if you must access patient financial information in the event patients do not have health insurance. At this point you can also check eligibility for Charity Care as well as provide assistance to access patient advocacy programs and government programs such as Medicaid.
During the registration process, you will access patient insurance coverage, prior to their schedule visit.
In addition to gathering the patient’s demographic information, updates to insurance coverage should be checked. For most hospitals, a direct connection to most payers will speed the process of checking benefits.
Many registration systems integrate with the hospitals financial services systems to help find insurance coverage for those lacking insurance or to provide assistance to enroll in federal and state programs. It is also common to check and apply the hospitals charity care program at this time, if the patients have no coverage and are not eligible for state or federal programs.
When deposits or large deductibles are required prior to admission, many hospitals have added Financial Counselors to their Patient Access staff. Having the ability to access patient financial and credit history gives you the flexibility to set up a payment plan or provide access to credit if necessary.
Service providers such as NCO Healthcare Services provide Pre-registration and Scheduling expertise to help ensure your hospital gather insurance and benefit information at first point of service.
Our team of dedicated customer care representatives reminds your patients of their appointments, educates them about their financial responsibility through the use of a price estimator, verifies demographic and insurance information, obtains pre-authorization for services and pre-collect payments prior to their scheduled appointment. We can also provide real-time updates to your admission system, ensuring your records include the most up-to-date information.
NCO uses up to date payer data and sophisticated call center technology to provide all levels of support for insurance verification.
Payment Plan Development and Up-front Collections
We educate patients with understanding their financial responsibility and help them to resolve their obligations in a manner that is in line with your standards.
Eligibility / Charity Screening / Emergency Department
NCO offers robust onsite and offsite solutions to assist patients in qualifying for any available programs. We identify charity accounts in a timely manner to allow you to fortify the main entry point of bad debt.
Onsite Financial Counseling Support
We counsel patients that do not qualify for either Medicaid or charity care, resulting in increased up-front cash collections and a reduction in bad debt. Our customer service staff is highly-trained in contacting patients, explaining account details and securing payment arrangements that are in line with your policies.
NCO provides support and management of all your scheduling and registration functions. Our comprehensive solution ensures trained professionals are available to perform real-time insurance verification, benefits screening, financial counseling and up-front cash collections. Your ability to complete these vital steps depends on your ability to access patient insurance and financial information.