Innovative Approaches to Improving Patient Access in an Evolving RCM Landscape

As the starting point for all healthcare procedures, patient access has a substantial impact on revenue cycle management. A high-quality patient access process can help grow revenue and patient experience.

Many healthcare providers accelerated their IT investments and worked with outside vendors to develop solutions like medical coding and claims administration in response to the pandemic and its effects on the labour force. However, a recent Kyruus investigation revealed that many health systems still lag in terms of digital patient access.

Patients are choosing their healthcare providers more carefully as out-of-pocket expenses rise and healthcare expenditures rise. Considering the increasing focus on the patient experience and the mounting need for higher reimbursement rates, providers need to make patient access a top priority within the revenue cycle.

Patient Access is Critical to Healthy Revenue Cycle Management

With a successful patient access solution, physicians can reliably capture virtual medical records and claim data on the first interaction.

For example, getting demographic and insurance information at the time of registration is critical as the patient pursues treatment and the claims process develops. Even though it may not be needed right away, healthcare practices should ensure to capture this information to optimize patient access.

It’s also an opportune time to financially clear patients and collect payment for shared economic responsibility.

Every revenue cycle stage — from benefits verification and medical code input to billing and claims administration — benefits from the early capture of clean and accurate data. It also enables practices to automate processes later.

Furthermore, a seamless patient access process will leave a positive first impression on patients. When patients don’t need to repeatedly provide their insurance information or medical history, they have a much better patient experience.

Patient Access and Revenue Cycle Management Challenges

One chance to create an impression is all you have. Seldom do healthcare providers have another chance to resolve issues with payers and patients before they have a detrimental effect on the revenue cycle. Inaccurate or neglected data entry during patient access can cause delays in the claims procedure and result in denials.

High claim denial rates can result from the result issues in the patient-access process. 25% of denials are the result of errors made during the registration or eligibility verification process, according to a recent analysis of hospital claim denials. It also found that 25% of denials could have been avoided.

Avoidable errors are often caused by manual patient access techniques. This is still relatively common, with 30% of health institutions only using manual patient access procedures, according to RevCycle intelligence. So, it would be highly beneficial for practices to enable patients to manage pre-appointment duties such as insurance validation and registration, for avoiding patient access issues and claim denials.

How Revenue Cycle Management Can Improve Patient Access

Increasing number of healthcare has provided are addressing patient access issues with all-inclusive RCM platforms. Ideal RCM solutions improve patient access services by:

1. Facilitating patient registration

2. Improving scheduling efficiency

3. Improving medical record and claims data accuracy

4. Amplifying claim approvals

5. Accelerating reimbursement

6. Reducing the length of the patient’s journey

Hospitals can save as much as $20 million by implementing a new technology-focused front-end patient access strategy, according to a recent Health Leader article. RCM platforms have advanced to the point where they are built for interoperability, patient access, and the safe extraction and sharing of payer and patient data among key stakeholders.

RCMs have a suite of solutions covering the whole revenue cycle—from initial contact to payment resolution. They streamline workflows, remove data silos, and produce insightful analytics.

Integrating patient access and other revenue-cycle functions under a single platform can help providers maximize reimbursement from patients and payers. It can also engage patients more fully in their healthcare journey.