The Critical Role of Patient Access

 

Before a claim is billed and the provider receives reimbursement, before the charges are entered and coding complete, and even before the physician treats a patients’ ailment, patient access has already begun the revenue cycle process.

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Each encounter begins at the same point—with the patient access registrar. This interaction can send the claim on a smooth sail to resolution, or a roller coaster ride to revenue lost. Registration staff are often entry level employees, making an hourly wage in the mid-teens, and are underestimated in their impact on the revenue cycle. According to Becker’s Hospital Review, a hospital and health systems business and news publication, 23.9% of all denials in the U.S. are due to registration. Some of the most common registration errors resulting in denials include: incorrect or missing patient identifiers, ineligible or missing insurance information and missing authorizations or late notifications. All of these oversights cause rework and in turn cost providers money. At best, payment is delayed. At worst, services go unpaid altogether.

Investing in the patient access role of a provider’s services can streamline all of the processes that follow. Providing proper training and continued education through quality measures are the first steps to improving the efficiency and accuracy of patient access. In addition to training and quality standards, providing tools that allow registrars to verify information at the first interaction with the patient will also present opportunities to increase upfront collections, further shortening that encounter’s claim lifecycle. For example, many EDIs offer 270/271 eligibility and benefit file options to verify this information prior to billing.

 

Follow the cycle back to the origin and repair the source of the problem—your finances will thank you!

 

The Author

Savannah Ward, CRCP-I   HRG CBO Revenue Cycle Director

Savannah Ward, CRCP-I

HRG CBO Revenue Cycle Director

 

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