5 Key Components of an Effective Patient Access Strategy
When we think of the term “patient access,” we think about all of the administrative processes in the early part of the revenue cycle, like patient registration, appointment scheduling, prior authorization, etc. And while those are all a part of the PA process, the real focus of patient access is to access to care for your patients. That means clearing the way of any barriers that could inhibit that care and cause a poor patient experience.
This blog explores five key components of an effective patient access strategy that focuses on improving access to care and the patient experience.
Hospital registrars typically conduct registration over the phone. Since calls aren’t scheduled in advance, catching patients when they’re home can be hit or miss. When they do answer, patients have to stop what they are doing and search for information like insurance cards, medication lists, provider information, and medical history.
A more patient-centric approach is to send a registration link via email or text that goes to a mobile registration application or an online registration portal. This allows patients to register when convenient for them, allowing them the time to gather all the information they need beforehand. And because these digital apps can integrate with the provider’s electronic health record, registration data is transferred automatically without time-consuming, error-prone manual data entry. This type of digital process also ensures advanced data security and compliance with privacy regulations.
Consumers appreciate the convenience of online self-scheduling for dinner reservations, car repair, and other professional services.1 Now, they want the same convenience for scheduling their healthcare appointments. Surveys show that 80% of consumers would choose a provider that offers online scheduling over one that does not, while 35% say online scheduling is a “major deciding factor” when determining between competing providers.2 Online scheduling can also reduce no-shows by 17%.3
Online, self-service scheduling reduces patient calls and mitigates the impact of long on-hold wait times on the patient experience.
Online, self-service scheduling should include appointment reminders as well. Besides helping cut down on empty appointment slots, it can also help improve the patient experience and reduce the risk of patients getting frustrated and not rescheduling. Another benefit of digital reminders is that providers can include a link to online check-in and an option to pay in advance. It also gives providers the opportunity to remind patients what they need to bring to their appointment, like their insurance card and medications.
The effectiveness of verifying insurance and attaining prior authorization is critical to timely access to care. Ninety-three percent of physicians surveyed said the prior authorization process causes delays in care, and 88% described the burden of prior authorizations as “high” or “extremely high.”4 When patients have to wait weeks or months for insurance verification or prior authorization before having a service, or when they’re told a service is not covered when it actually is, it can cause patients to put off or cancel procedures that they should have had much sooner. This can negatively impact outcomes and the patient experience.
One of the most effective actions providers can take is to automate insurance verification and prior authorization processes. Automation technology can reduce manual processes like calling payers or searching payer websites for coverage information, giving overburdened staff more time to focus on patients or other strategic tasks. Automation technology can also streamline prior authorizations by proactively identifying requirements for prior authorizations and the need for additional documentation. This can reduce delays in care and delayed reimbursement, in addition to reducing denied claims.
Healthcare is highly complex and difficult for patients to navigate, especially with regard to insurance coverage and their financial responsibility. Since both are foundational to the patient access process, providers must educate patients about both early on. Providing patient responsibility estimations allows providers to educate patients about their insurance co-pays, deductibles, and financial responsibility in advance of their service. Having this information helps alleviate patient stress and gives them the information they need to make more informed decisions about their care.
Providers should also consider helping patients who may be eligible for financial assistance or charity to find and apply for those resources. This enables providers to position themselves as advocates for the patient. It is vital that staff communicating with patients about their financial responsibility be trained in soft skills such as active listening and compassion as this can help reduce stress while creating a positive patient financial experience. In one survey 61% of respondents said the patient financial experience is a determining factor in choosing whether to continue with a provider.5
Providers should also consider offering multiple communication options and allow patients to choose the methods they prefer, such as phone, text, email, or snail mail. In a recent healthcare consumerism survey, 48% of participants said they prefer to be reached digitally instead of over the phone: 22% preferred email, 14% preferred text, and 12% preferred communications over a patient portal.6
Creating an optimally performing, patient-centric patient access process requires data analytics to help proactively identify problematic trends. When combined with patient survey feedback, data analytics gives providers greater insight into both operational performance and patient engagement.
A great example is key performance indicators (KPIs). Data analytics can be used to measure and track KPIs for multiple patient access processes like the use of online registration, self-scheduling, and digital payment apps. No-shows, on-hold wait times, and appointment cancellations can also be tracked. This information can help providers implement corrective actions or increase their patient communication efforts.
Partnering for Success
Implementing patient access tools, process updates, and technology can be challenging for providers already dealing with staffing shortages, a lack of internal expertise, and financial constraints. Partnering with patient access experts like Conifer Health can help.
Conifer Health’s Patient Access and Experience solutions streamline access to care from appointment scheduling to pre-registration to patient financial counseling. Leveraging investment in its omni-channel patient engagement technology, analytics, and automation, Conifer’s experienced patient-facing team provides a simplified patient experience while keeping the provider’s mission top of mind.
Innovation and Automation
- Advanced rules and prior authorization automation reduce claim denials with real-time error detection
- Automated eligibility verification eliminates checking payer websites
- Helps meet pricing transparency compliance requirements
- Touchless patient estimates and one-step scheduling
Workflow Optimization
- Alleviate delays related to incomplete patient documentation
- Simplified desktop and automated eligibility eliminate having to access payer websites
- Standardized workflows provide clients with work with customizable options
- Single sign-on reduces administrative burdens by managing logins for more than 250 websites
Actionable Insights
- Real-time dashboards display the current status of all accounts
- Secure rate status reports allow leadership to identify specific risks
- Drives high-cash collection rates by leveraging payer analytics
- Enables scaling and specializing the workforce by claim type
- Unified tracking across multiple systems
Conifer Health Results
98%
financial clearance rate
70%
of prior authorizations automated
75%
decrease in patient wait times
98%
decrease in denials*
>2000
quality rules**
Putting it All Together
The patient access process sets the stage for the entire patient experience, even before the clinical encounter, and lay the foundation for optimal reimbursement. By leveraging these five critical components of an effective, patient-centric patient access program, providers can simultaneously improve operational efficiencies, increase reimbursement, and enhance the patient experience. Partnering with Conifer Health can help providers achieve their strategic patient access goals faster and more effectively.
References
- https://www.physicianspractice.com/view/online-appointment-scheduling-a-missed-chance-to-boost-patient-satisfaction
- https://www.healthleadersmedia.com/innovation/assessing-online-scheduling-emerging-trend-scheduling-physician-appointments
- https://financesonline.com/appointment-scheduling-software-statistics/
- https://www.ama-assn.org/system/files/prior-authorization-survey.pdf
- https://patientengagementhit.com/news/90-of-patients-say-loyalty-relies-on-patient-financial-experience