Walk-in volumes are surging, according to Laura Marston, a principal in the Chicago office of ECG Management Consultants.

This is especially true in primary care and pediatrics. It also is happening for any services that people can shop around for, especially imaging. For the revenue cycle, these are the two biggest challenges, according to Marston, who specializes in revenue cycle and access operations:

It is difficult to staff properly with unpredictable volumes. The best approach is to trend typical walk-in volumes by day and time. “These data can then be used to build appropriate capacity into physician schedules,” Marston explains. If walk-in volume is very high, additional registrars might be needed. “Registration kiosks can also expedite this process,” Marston adds.

There is a chance the payer will deny the claim. Insurance verification can be conducted in seconds, right when the patient presents. If authorization is not required, the process is straightforward. As long as the insurance checks out and copays are paid, the patient is seen right away. However, if an authorization is needed, things become far more complicated. Clinical information is needed, and the referring provider has to handle his or her part.

“Coordinating with the payer can take some time,” Marston says. To reduce financial risk, “there are a few critical factors,” Marston notes. Registrars need good training on how to verify insurance, collect from the patient, and choose the correct plan in the system.

“As many payers as possible should be integrated into a real-time eligibility tool,” Marston offers.