What is Patient-Centric RCM?
Healthcare providers have traditionally spent their RCM focus on the health insurance claim including authorization, accurate coding, claim submission, denial management, and so forth. Little time and energy were spent on the 5% to 10% of revenue that came directly from patients in the form of co-pays and balances after insurance. Fast forward to today, high deductible health plans have shifted the first $3,000 or more in healthcare expenses to the patient in out-of-pocket costs. Now, providers are recognizing patient payments as 20% to 40% of their revenue and growing—a shift that requires new thinking and new tools to become more “patient-centric” in RCM efforts.
At Relatient we see 3 opportunities to make the shift to a patient-centric RCM process:
- Make improvements to the patient registration and intake process. Patients want the opportunity to complete the registration process in advance of arriving at the office for their scheduled appointments. Enabling patients to complete registration forms online via a mobile device and verifying their contact information will improve patient communications when you are ready to collect payment. Asking the patient to upload photos of their insurance cards with their mobile phone camera and automatically initiating the insurance eligibility and authorization process reduces the administrative burden at the front desk while providing an opportunity for co-pay determination in advance of the patient’s arrival. Informing a patient of the co-pay amount prior to arrival can ease patient anxiety by eliminating surprise expenses during the visit.
- Improve balance communication with patients. Patients are looking for convenient ways to make payments and to be informed of their balances. As they shoulder a growing financial responsibility, thanks to high deductible health plans and co-pays, they now expect an experience that mirrors that of other industries, wherein payments can be made easily from a mobile device. Portal adoption never gained the traction once hoped for, so relying on these strategies to drive higher collections and lower A/R days will yield disappointing results. However, utilizing an even simpler solution in SMS communication can drive the desired effect. Some research suggests that healthcare organizations can increase collections by 25% when they communicate with patients using a preferred channel—and we know patients prefer to communicate via text. Patients appreciate great customer service and technology can help you provide a great customer experience.
- Provide answers quickly and easily. Patients are expecting healthcare to be more like a retail customer experience. If a patient has a question about their bill, they want to quickly and easily get an answer. Most patients would prefer to text someone with their question instead of making a phone call and being routed through the maze of contacts within a healthcare organization in order to speak with someone about a bill. Again, technology may be the answer. Can you provide two-way messaging in a mobile environment? Can you easily switch to a secure chat environment that meets HIPAA privacy requirements? Relatient can help.
At Relatient, we’re working with customers every day to make the RCM process more patient-centric in their organizations. Our patient communication engine enables SMS text messages to be sent at predetermined points within the RCM workflow. Our customers are seeing improved cash flow and increased patient satisfaction with their shift to patient-centric RCM processes, we can help you do this same.
This post was written by Relatient’s RCM Director, Ed Kenney. Ed offers 25 years of healthcare IT and RCM marketing, channel development, partner strategy, and proven sales expertise to healthcare organizations and third-party billers. An active participant in helping solve critical problems in the U.S. healthcare system, Ed leads the strategy for Relatient’s RCM portfolio, addressing ongoing challenges like patient balances, A/R days, online payments, security, bad debt, and consumer-friendly options.