Integrated systems can solve many dilemmas for patient access by creating work lists for error management and allowing staff to determine eligibility in real time.
“But they are not a panacea,” says Katherine H. Murphy, CHAM, vice president of revenue cycle consulting in the Oakbrook Terrace, IL, office of Experian/Passport Health, a provider of technology for hospitals and healthcare providers.
Hospitals sometimes expect the integrated organization-wide system will solve all of their revenue cycle problems. “But many still need additional outside platforms to manage the revenue cycle process,” says Murphy.
Often, patient access leaders worry that they will have to work in two places: the integrated hospital information system (HIS) and the other platform. “However, when they see how easy this is, and the benefits and additional streamlining this creates, they quickly stop their worrying,” says Murphy.
Some hospitals are implementing, in addition to their integrated system, revenue cycle software programs that provide integrated platforms. These software programs allow a single sign-on for all revenue cycle applications. “They offer real-time integration intelligence that the big box systems do not,” says Murphy. Such platforms can automate the updating of insurance code errors and information flowing from one application to another, for example.
“The platforms can actually take the electronic order and have that information flow across to registration, medical necessity, eligibility and address checking, preauthorization, and estimates,” says Murphy.