Revamp access with these 10 technologies

"A number of exciting collection technologies have evolved over the last few years. They are already lowering costs and improving services," says John Thompson, senior consulting manager at Chadds Ford, PA-based IMA Consulting. Here, he gives his "top 10 list" of patient access technologies:

1. Contact verification.

In addition to improving billing and statement delivery, this can also increase staff productivity. "Optional batch features are often offered," says Thompson.

2. Eligibility verification.

Coverage benefits can be verified prior to service delivery by submitting patient information and receiving a real-time response. "Rejections and denials are reduced, and upfront collections are increased," says Thompson. While old approaches for web site and telephone verification weren't integrated, key features to look for now include normalized benefit formats with the ability to design "standard" and "detailed" benefit screens, and ADT/practice management system integration.

3. Patient payment estimation.

These systems can reduce bad debt, accelerate payments, and cut collection costs. Previously, staff collected only copayments and self-pay deposits, and these were based on "guesstimates rather than estimates," says Thompson. New systems have charge master/eligibility system integration, with the ability to apply benefits to real charges, and charge master/contract management integration, with the ability to apply contractual allowances before developing estimates.

4. Communication management.

Having electronic records of payer communications can increase productivity, reduce denials, and increase successful appeals. Thompson says that features to look for include the ability to automate and monitor calls, and manage inbound and outbound faxed documents and e-mails.

5. Propensity-to-pay scoring.

This streamlines self-pay approvals while proactively identifying the need for financial assistance, instead of subjective approvals done by financial counseling staff. "This resulted in understated charity care on financial sources," says Thompson. New systems are able to factor in self-pay funding sources, such as available credit on credit cards, lines of credit and home equity, and external finance solutions offered by banks and other lenders.

Thompson says two good features are segmentation analysis, which customizes scoring profiles to community characteristics, and workflow management, which electronically forwards accounts to the financial counseling process.

6. Electronic cashiering.

This can accelerate collections by increasing the speed of payment capture, save time by automating manual payment posting, and increase efficiency by enabling more employees to accept payments. "It also provides dashboard reporting of payment activity, with the ability to track, audit, and control all customer payments," says Thompson. Instead of collecting payments only at the time of service, these can be accepted real-time from any location, including web portals. Thompson says to look for a system that accepts all forms of electronic payment and does cash posting and management so that payments can be audited, tracked, and controlled.

7. Financial assistance automation.

A patient's eligibility for entitlement programs is proactively identified, which reduces unnecessary outsourcing to self-pay vendors and cumbersome manual processes. Systems can pre-populate applications for Medicaid with information from your ADT system. "Look for integration with propensity-to-pay systems and e-pay systems, and presumptive eligibility and approvals," says Thompson.

8. Rule-based document imaging.

These systems can reduce time-consuming copying and scanning, and there are fewer denials related to missing referral or authorization forms. "Optical character recognition mapping compares insurance card information to ADT system fields and corrects data entry errors," says Thompson.

9. Patient self-service kiosks.

These can reduce wait times and decrease errors due to inconsistent collection compliance. Thompson says to look for a system with date/time stamping of arrival, automated printing of armbands, and real-time payment processing and eligibility verification.

10. Rule-based process automation.

"Efficiency can be vastly increased, cash flow and collections improved, and whole categories of errors eliminated," says Thompson. "Look for full integration between all applications."