Verify insurance without costly delays

Make it simple for staff

Registrars at UK HealthCare in Lexington, KY, have had great success using a real-time insurance verification tool, reports Courtney M. Higdon, director of enterprise patient access services.

"Over the past year, we have distributed this tool to all locations where appointment scheduling and check-in or registration occurs," she says. "100% of our accounts have real-time eligibility checks performed as patients are registered."

The tool will better equip the patient access department for the future, according to Higdon. "Insurance plan coverage and accessibility will change dramatically over the coming years with the implementation of healthcare reform," she says.

The tool gives staff the ability to access the requirements of all payers, whereas previously they relied on individual payer web sites or failed to do verifications at all, she explains. "Additionally, this tool has improved our ability to know what the copay collections opportunity is for each patient as they arrive," says Higdon. "Previously we were able to measure our actual collections, but were not always certain what the full opportunity was." This change allows patient access leaders to measure the opportunity for collections, as opposed to just the actual collections.

Collections at the organization's two hospitals' admitting offices and EDs have increased more than 100% from 2010 to 2011 because of the tool and other initiatives aimed at improving upfront collections, she reports. Collections in these areas increased from $313,000 in 2010 to $663,000 in 2011. "We are expecting to see a positive impact on eligibility denials as a result of real-time insurance verification," adds Higdon.

The biggest challenge was educating more than 100 staff operating in a decentralized model who hadn't previously performed eligibility verification about what it is and why it is important, says Higdon. "We are planning to assess each area in the upcoming year to measure the adoption rate of this tool across the organization," she says. "As we find areas that have been slow to adopt the tool, we will work to support their training needs more aggressively."


For more information on insurance verification processes, contact:

• Courtney M. Higdon, Director, Enterprise Patient Access Services, UK HealthCare, Lexington, KY. Phone: (859) 257-6780. Fax: (859) 257-8727. E-mail: