Stacie Fults, Senior Vice President of Client Services at National Medical Billing Services – Tuesday, September 13th, 2022 on Beckers ASC Review
In today’s competitive healthcare environment, building a successful ASC begins with creating a patient experience that differentiates your surgery center from the competition. Establishing a process to address patient expectations and improve patient satisfaction increases the likelihood of new patient consultations converting into booked appointments. Since your front desk staff and front end procedures are the initial touchpoint for patients — be it over the phone, online, or when they walk through your door — here are three best practices to ensure your facility makes a positive first impression to increase the likelihood of a patient booking a surgery.
1. Hire Knowledgeable and Dedicated Front Desk Staff
A go-to strategy for improving front desk procedures is to thoroughly train front desk staff on all aspects of scheduling, including gathering relevant patient and payer information, providing proper documentation to patients, verifying insurance, and scheduling surgeries for multiple surgeons.
However, expert knowledge of ASC industry trends and updates is also necessary to address the nuances that accompany the ASC revenue cycle. A dedicated team with a deep understanding of revenue cycle management will recognize the importance of staying current on the latest regulatory changes to remain compliant. Knowing which procedures require preauthorization as well as best practices for capturing patient information will also foster a competent, professional relationship between your staff and your patients. Your customer service improves when staff members are knowledgeable, prepared, and ready to answer patient questions.
2. Invest in Front End Technology & Processes
Incorrect patient demographic capture and eligibility can result in rejected or denied claims. This has an immediate impact on cash flow and can also result in misquoting the patient’s responsibility, thus negative
Incorrect patient demographic capture and eligibility can result in rejected or denied claims. This has an immediate impact on cash flow and can also result in misquoting the patient’s responsibility, thus negatively impacting the patient’s experience. Implementing the right front end technology and processes is one way to help eliminate claim rejections and denials, which in turn improves clean claim rates and increases cash flow. To improve efficiency and accuracy, leveraging a combination of well-developed processes, training, and technology will streamline scheduling, registration, insurance verification, pre-authorization, and other front-end processes.
- Patient registration – Providing self-service registration through an online portal allows patients to skip the front desk visit altogether. Patients appreciate the convenience while ASCs save on labor costs. When your staff can authenticate data in real time, they’re able to discuss copayments and deductible amounts upon request. This further strengthens the revenue cycle while providing price transparency and peace of mind for your patients. Software platforms feature self-service check-in, estimated wait times, and real-time patient status updates for family members.
- Insurance verification and pre-authorization – Insurance verification and pre-authorization should be addressed as early in the patient process as possible. By confirming what is covered by the insurer, you can communicate the responsibilities of costs to your patient and simultaneously gain early access to billing data at time-of-service. Consider purchasing a real-time eligibility verification tool to allow access to patient benefit configurations and patient out-of-pocket expenses.
Patients have become one of the primary payers in healthcare today due to the rise of high-deductible health plans. Once the insurance estimation tools have confirmed patient benefits and eligibility, you can discuss patient obligations well in advance of the surgery and provide effective financial counseling, including customized payment options.
3. Provide Patients with Price Estimates, Financial Counseling, and Online Bill Pay
The growth of consumerism and the need for healthcare cost containment has resulted in federal action such as the No Surprises Act that require providers to produce good faith estimates when asked. In addition, many states are passing legislation to require healthcare providers to make costs available online with the goal of supporting patients’ rights to informed healthcare decisions. While it may be time consuming and complex to offer accurate estimates of care prior to a procedure, the more knowledgeable a patient is about out-of-pocket expenses, the more likely the patient will pay their portion of the bill when it is due.
According to the U.S. Bureau of Labor Statistics, healthcare costs are a large component of the average household budget in the United States, and those costs are on the rise. About 155 million Americans rely on employer-sponsored health insurance coverage, and as of 2018, almost half of Americans (45 percent) have high-deductible private health insurance plans with deductibles ranging from $2,000 to $6,000. More recent data collected from the 2021 Kaiser Family Foundation’s Employer Health Benefits Survey confirms the average single deductible in 2021 was $1,669 and family premiums have been rising faster than workers’ wages and inflation since 2011. Over the past decade, when the growing share of employees with deductibles and the rising average deductibles are combined, the burden of deductibles has increased by 92 percent across all covered workers. Therefore, paying for a surgical procedure can be a significant source of financial stress for many Americans, especially since few have budgeted emergency savings for medical expenses. Patients want to know what their procedures will cost in advance and ASCs can provide this information through financial counseling.
According to a July 2021 JAMA article, data compiled from 2009 to 2020 indicated that the total amount of medical debt in collections now exceeds the amount of nonmedical debt. Financial counseling reduces the odds of uncollected patient debt. Upfront discussions on payment options, including payment plans and loans through outside financing organizations, ensure patients can meet their financial responsibility as early in the process as possible. We also advise surgery centers to collect some portion of the payment up front prior to the procedure.
When financial counselors educate patients on multiple ways they can pay, and review how to pay, such as how to access an online patient portal, there’s greater likelihood that patients will fulfill their financial obligations. A user-friendly online bill pay option can also improve the rate of collections, especially if there is an option to enroll in an automated payment plan. Automating patient financial responsibility can help eliminate or at least minimize the burden on your staff to collect payments, especially if online billing incorporates re-occurring payment reminders via email or text or allows for automatic monthly withdrawals to meet pre-set payment plan obligations. In comparison, a paper and manual bill collections process places the responsibility on your staff to manage patient collections, including: printing each billing statement, mailing them, following up with patients by phone, keeping track of paper checks as they trickle in, deducting each payment from a patient’s total outstanding balance, mailing additional statements, and depositing checks in a timely fashion. The longer it takes to collect each payment, the longer a claim can linger in A/R. Ultimately, you can improve the patient experience and the efficiency of your revenue cycle by providing price transparency, financial counseling, and electronic bill pay options.
Everyone involved in front end processes shares the goal of delivering the best service for patients. Streamlining front end processes minimizes errors that could turn into expensive billing headaches. Whether you partner with a revenue cycle management company or hire and train an exceptional front desk team, implementing the right technology will improve revenue cycle efficiency and increase overall patient satisfaction. Every time patients interact with your staff, your technology, and your surgeons is an opportunity to put your surgery center ahead of the competition.
This post was first published September 19, 2022 and was updated September 21, 2022.