Patient Access

Patients today expect digital capabilities from their provider and will increasingly choose those who offer digital capabilities. Knowing this, many providers have been working to shift more of the patient journey online, through telehealth and virtual care. Not all care needs to be delivered face to face, and technological advances allow patients to access more services from the comfort of their own homes, at a time that suits them. This trend has been visible for a few years now, as consumers sought out more smartphone-friendly digital healthcare experiences. But change in the healthcare industry often comes at a lumbering pace, so when the coronavirus pandemic hit and accelerated the transition to remote care, many organizations found themselves on the back foot. Now, it’s a case of catch-up, keep up or get left behind. As demand for telehealth services grows, so too does the regulatory framework around it. A big part of staying competitive will be the ability to keep track of new telehealth regulations and changing payer rules. Those that don’t will find their collections straining under the added pressure of missed reimbursement opportunities. How can providers stay on top of the changes and maximize reimbursement? Keeping track of telehealth reimbursement regulations Since early March 2020, the federal government has moved to make telehealth more accessible to patients with Medicare coverage. Limitations on the types of clinicians that can provide telehealth services under Medicare have been waived, while Medicare beneficiaries in rural areas and those with audio-only phones can now access care remotely. New telehealth services will be added to the reimbursable list under a quicker process, which is a huge benefit to both patients and providers, but will mean the rules around reimbursement could change more frequently. Speaking in March, CMS Administrator Seema Verma said: “These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus. Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries.” Flexibility is always welcome – but what do looser rules mean for reimbursement workflows? Three challenges stand out: Payer variation. Telehealth and telemedicine data can be presented differently by different payers, causing a headache for providers during eligibility verification. Coding variation. Each type of telehealth visit is coded and billed differently. Regardless of where appointments are carried out, clinicians must still follow the same billing workflow, so keeping track of the differences is essential. Geographical variation. Providers now have to track billing and coding changes for telehealth services from different payers across multiple states. What can providers do to bill telehealth services as accurately as possible? Billing for telehealth services more frequently calls for a solution that’s flexible enough to keep pace with changing payer rules, and sufficiently scalable to provide real-time reimbursement information when it’s needed. Automation can help achieve both of these goals. Two use cases for automation: Quicker Medicare checks: Run quick and accurate checks to confirm patients are eligible for Medicare coverage for the services in question. A tool such as Coverage Discovery can comb for available coverage, even as patients are switching plans or payer rules are changing. In addition, eligibility verification automations can sweep for coverage information on telehealth services, using reliable and secure third-party data and analytics to check for updates. Cleaner claims submissions: Tighten up billing workflows so that claims can be submitted as soon as possible. Claims management software can run automatic checks so that every claim is submitted clean and error-free. Any missing or incorrect codes can be flagged up, eliminating costly and time-consuming rework. Telehealth alerts can be included as customized edits to confirm whether virtual care is a benefit included in the patient’s current plan. While these actions can help protect your bottom line during the immediate crisis, they’ll also help you build a solid foundation as your telehealth offering inevitably continues to grow. Whether you’re looking to verify coverage, check eligibility or protect patient identities as they log in and use telehealth services, reliable data is key. Schedule a free consultation to discover how Experian Health can help you leverage accurate and real-time data insights to optimize your billing workflow and maximize telehealth reimbursements.

From airlines to cafés to car manufacturers, businesses across America are scrambling to respond to the challenge of COVID-19. In healthcare, services are being put on pause to protect staff and patients on the pandemic’s front line, leaving health systems to contend with gaps in reimbursements and exhausted cash flows. The problem lies in the sheer number of human touchpoints involved in the typical patient experience: scheduling, paperwork, waiting rooms, treatment, payment…all that in-person interaction just isn’t realistic in the current climate. Digital and mobile technology could be the answer. While digital communication platforms have been growing steadily over the last decade, they’re now a life raft for many providers as COVID-19 forces much of the patient journey online. Megan Zweig, director of research and marketing at Rock Health, says investments in virtual care have already exceeded $3 billion this year: "Without COVID, the story would have continued from last year as this was a healthy, growing space with a lot of momentum behind it. That momentum has turned into incredible urgency and demand for communication, testing, monitoring, care – all of those things done at a distance." This trajectory will likely continue beyond the immediate crisis, as providers prepare for a possible second wave later in the year and patients become accustomed to remote and mobile options. Providers that take advantage of these digital solutions now will be better positioned to optimize the patient journey in a post-COVID world. What could the digital patient journey look like beyond COVID-19? A digital healthcare experience can offer patients more convenience and flexibility while protecting revenue for providers, in the following ways: Scheduling appointments when it suits The first bump in the road for many patients is scheduling their appointment. With many in lockdown juggling home-schooling and home-working, it’s not always convenient to call during office hours. A patient scheduling platform lets the patient book their appointment whenever suits, using the channel they prefer. Before the pandemic, Benefis Health System found 50% of patients chose to book after hours, including for urgent care. We can expect this to increase as even more patients are nudged online. As the threat of COVID subsides, a massive influx of patients will also want to reschedule postponed visits. Automated patient scheduling will reduce the pressure on call centers and offer a more efficient consumer experience. Reducing registration gridlock with automation Patient access is often rife with avoidable stress – queues, unnecessary forms and manual data entry, resulting in costly errors and repeated work. Instead, providers can streamline the process by allowing pre-registration tasks to be completed online, and automating patient access with a mobile intake experience. Completing as many tasks as possible outside of the provider’s office will help minimize face-to-face contact, keeping everyone safe. Opening up access to telehealth There’s no getting around the fact that most care needs to be delivered in person. Telemedicine offers an effective way for patients to seek care from the safety of their own home. Video calls can be used for general consultations, remote monitoring of patients with respiratory conditions, and even supporting patients with chronic conditions to adhere to care plans. As the government allocates $20 million to support access to telemedicine in response to COVID-19, up to 54% of patient encounters are expected to take place remotely in the near future. Many of these patients will choose to stick with telemedicine, even when in-person options return. [Remember to check out our free COVID-19 Resource Center, where you can get free access to telehealth payer policy alerts to help avoid payment denials and delays.] Making contactless payment the easy option Contactless payment through apps such as Apple Pay and Venmo are gaining popularity as consumers try to avoid exchanging cash and cards. But can it be used in hospitals? In short, yes. Not only does Experian Health’s Patient Financial Advisor offer patients a way to make secure – and socially distanced – payments, it allows providers to give a breakdown of estimated costs using real-time information. Patients get updates on their mobile or through their patient portal. These digital alternatives not only offer a more convenient patient experience, they can also allow providers to collect payments faster and in full. Contact us to find out how digital health solutions can help your organization adapt to the new normal, and provide a better patient experience now and beyond COVID-19.

The term “digital front door” is one of the biggest buzz words in healthcare, and thanks to COVID-19, we can expect to see it even more. Already, according to an Accenture survey, 77 percent of patients believe the ability to book, cancel, or change an appointment online is important. Now, with social distancing and stay at home orders in place, offering digital tools for engagement is more important than ever. But what exactly makes a strong “digital front door” and what does it take to create one? What precisely does a digital strategy need in order to better engage and retain patients? There are a lot of thoughts about what the digital front door looks like, from pricing transparency to ratings and reviews, reputation management, patient registration, and more. We know patients today are seeking greater transparency from their entire healthcare experience. Yet each of the qualities above reflect more of a digital billboard than an actual front door. After all, the front door needs to be a pathway to see a physician or access care; it must actually “open.” A true digital front door will do the following: Enable omni-channel access. Improving access begins with offering more channels for patients to find the care they need – a necessity today in the midst of COVID-19. Digital scheduling drives patient access, plain and simple, whether it be through call centers, automated outreach, or online self-scheduling. Omni-channel access not only opens the door for patients experiencing COVID-19 symptoms, giving them a fast and easy way to connect with a provider, but will be key for the post-COVID world when patients begin to reschedule those appointments that have been cancelled or deferred. Engage patients. Patients want convenience when it comes to accessing care. Now, more than ever, patients look online for information and expect to find what they need easily and quickly. Making service information available online, such as COVID testing, is an obvious first step. Allowing consumers to simply and efficiently book the care they need online will lead to increased engagement, as well. Improve productivity. More than half of all patients prefer to schedule outside of business hours. Digital scheduling can enable that, increasing appointments while improving provider workflow, freeing up staff to focus on other activities. This will prove critical as providers brace for an influx of patients seeking to reschedule appointments that have since been cancelled or deferred due to COVID-19. Additionally, automated reminders help improve patient show rates while data-driven practices help refine scheduling logistics.  Increase revenue. Providing better, more efficient access, increases the number of patients coming into a practice – which means more revenue. And today, as a result of heroic efforts to serve communities impacted by COVID-19, providers are more strapped for revenue than ever before. With access to digital and mobile solutions, providers can attack revenue loss from two sides –attracting new patients and retaining current ones. Drive higher patient satisfaction. Faster, easier access to healthcare equals better satisfaction with the process of accessing healthcare, with the provider organization, and with the provider. And, if you really want a crowd pleaser that can also generate revenue, automated business rules and scheduling protocols are a must have.It’s the combination of convenience and effectiveness that keeps them coming back for future care needs – coming back, of course, through the digital front door. Learn more about how Patient Scheduling can help to unlock your organization’s digital front door.

The novel coronavirus pandemic crisis of 2020 has plunged the healthcare system, and frankly the whole economy, into a dark place. It will take time, and likely a lot of time, to overcome what may end up being several months of a national shut down. Eventually people will re-emerge from isolation, business will resume a new normal, and healthcare providers will turn their attention to the revenue generating services that they temporarily halted, as well as the patients who delayed care for a myriad of conditions. The Centers for Medicare and Medicaid Services (CMS) recently published “phase one” re-opening recommendations that recognized in some areas the possibility of non-COVID-19 care is already being considered. There will be an overflow of pent-up demand and provider organizations need to position themselves now to be ready. One consideration, with many health systems now feeling the squeeze and not being able to re-deploy staff to serve in the crisis, is to use some of those resources and prepare for the next phase.  Here are few strategies to get ahead of the curve, if you will, as it flattens: Reschedule appointments – Literally hundreds of appointments– for some providers, thousands – that had been cancelled or delayed will require rescheduling. Deploying an omni-channel scheduling platform now can relieve the pressure of that future volume in several ways: Online scheduling can guide patients to the right care with rules automation, allowing patients to accurately self-book and reducing call center volume.Enable patient scheduling via automated outreach messages sent via text message or IVR. (For example, you can target all those who need to reschedule, reaching them via text campaigns and reducing call center workload).Reduce training time with a call center scheduling solution. Agents (such as temps hired to handle the influx of appointments) can be trained in a matter of hours to schedule and book appointments accurately.Harden your telehealth offering – This crisis has shown the necessity for virtual visit technology during a pandemic; however, its value won’t disappear as the crisis fades. Telehealth is destined to become a staple of healthcare delivery. Restrictions have been lifted and the technology has proven practical, convenient and efficient, paving the way for broad acceptance. But what are the digital complements that can be paired with telehealth to harden the solution and make the offering a robust tool into the future? While many providers are now able to offer this type of virtual care, scheduling across a variety of specialties has become a challenge. A  tool that guides patients and call center agents to the right provider across all services, including telehealth, is going to be critical in the months ahead to maintaining scheduling efficiency and delivering an optimal patient experience.Establish your digital front door – Patients aren’t going to want only clinical telehealth options; the whole spectrum of patient-provider interaction is shifting. Scheduling, registration, payments - all these are going to see increased demand for digital self-service. This gets patients out of the waiting room and removes the need to swipe or insert a credit card or use a POS kiosk. Patients, who are consumers, want to use their mobile devices and they will form lasting opinions of those services enabling – or restricting – their ability to do that.Collections optimization – Right now the focus is on caring for patients, as it should be; however, in order to continue operating, providers must collect for the services rendered. Putting in systems that automate collections processes and reduce the human resources necessary to bring in revenue will to be key to capitalizing on the rush of non-COVID-19 care that will soon be required. These are just a few of the ways that healthcare providers can deploy digital technology to prepare and turn this looming challenge into opportunity. The reality is that managing patient engagement and collections through this next phase is critical to the U.S. healthcare ecosystem’s recovery. Organizations that emerge stronger will be those that prepare now and are ready when the time comes. Find out more about patient engagement solutions that can help you respond now and prepare for the future.

Data-driven technology and automation can help drive improvements you meet changing consumer expectations in the world of patient access.

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With health system expenses rising, Martin Luther King, Jr. Community Hospital focused on improving patient registration with automated software.