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Many Americans have become accustomed to self-service options for online shopping, booking airline tickets, making hotel reservations, and even paying phone and utility bills. In sharp contrast, patient access processes are starting to seem terribly outdated.
“Patients desire similar experiences with their healthcare payment needs,” says Gordon Jaye, vice president of hospital operations at Patient Matters.
Other self-service experiences are known and loved for their simplicity and consistency. Understandably, patients want the same when it comes to registration, physician referrals, scheduling, and bill payment.
“Patients are beginning to wonder why they need to interact with anybody as they perform a full registration and financial clearance,” Jaye says.
Healthcare is notoriously slow to react to change, and self-service is certainly no exception.
“It can take hospitals time to come around. Self-service is very much in the early stages,” says Jason Considine, senior vice president of patient collections and engagement for Experian Health.
One barrier to self-service is surprisingly simple: Many patient access departments lack permission to communicate with patients via cellphones.
“When we interact with self-service tools elsewhere in our lives, there’s an opt-in process we go through as a consumer,” Considine explains. “Hospitals lack that entry point.”
Most patient access departments are not communicating in any way with patients through phone apps for this very reason.
“Many [apps] have very low use rates, even on their patient payment portals,” Considine notes.
Obtaining consent to communicate through a website or mobile device is an important first step.
“It is a gate that people have to get through,” Considine says. “It’s an investment in building an electronic relationship with the patient.”
Changes in consent policies and the paperwork that patients sign are needed. “Many hospitals, believe it or not, we find, aren’t collecting email addresses or cellphone numbers from patients,” Considine notes. This is because outdated registration systems don’t contain those fields. Therefore, there isn’t any reason for patient access to enter this contact information.
“If you don’t have the data, it’s starting from scratch to build the ability to do this,” Considine says. Unlike retail shopping, healthcare reimbursement is complex, private, and highly personalized.
“There are impediments to the widespread use of technologies in the healthcare revenue cycle that support this level of consumerism,” Jaye explains.
Hospital systems don’t support the data validation that online shopping merchants use to conduct business. “This causes issues on the back end with claim processing,” Jaye says. Problems also occur on the front end. Sometimes, insurance information is not validated, or authorizations are missed.
“The gap here is that there are lags in the system and data integration between HIS legacy systems and many of the traditional front-end systems,” Jaye notes.
This is going to take some time to overcome, but change is underway.
“We’re beginning to see patient-friendly price estimations, where patients can go on to provider websites and run estimations for themselves,” Jaye says.
Future patients will handle more of the registration work themselves.
“Staff will check out those who are the exception,” Considine offers.
This will allow patient access staff to perform higher-level activities.
“They can redeploy staff to tackle some things that were going unnoticed,” says Jason Wallis, senior vice president of patient access for Experian Health. Staff can turn their attention to accounts at high risk of going uncollected, claims denials, or upfront collections. All these activities emphasize creating a positive experience for the patient. The rise in healthcare consumerism is the driving factor behind all these changes, according to Wallis.
“Before, the patient would just show up at the hospital that was closest to them.”
Once self-service is commonplace, patient access will take on more of a customer service role. Wallis expects registration areas to be redesigned as a result of this shifting role. These areas might seem more like hotel lobbies than waiting rooms.
“Access is moving from ‘Let’s get the data we need, and you go sit in the waiting room,’ to looking at the level of greeting, to making sure you have a good experience,” Wallis says.
Even with self-service, there still will be a need for face-to-face interactions with patient access staff.
“We have yet to see a successful deployment of a registration process that is completely automated without any interaction on the hospital side,” Jaye notes.
This would be potentially dangerous, since multiple registrations could be created for the same patient.
“The ideal situation would be a more, but not completely, automated registration process,” Jaye says.
Checks and balances always will be needed to prevent errors and identity fraud. In this regard, the patient access version of self-service has something in common with the self-checkout line at the grocery store.
Even though the customer has all the tools to complete his or her transaction, says Jaye, “there is a high percentage of time that a human must intervene and correct a human user error.”