Patient Financial Clearance

Less Denials, More Payments: Thanks to Automated Patient Financial Clearance

Patient financial clearance helps provide a smooth patient experience while ensuring a better revenue cycle for the providers. However, this process can often feel like a burden, and, at times, can even create obstacles during care delivery.

South County Urological in Missouri was facing similar issues before the workflow automation process changed the scenario. With the help of patient financial clearance automation, their COB denials have dropped by almost 75 percent, while patient payments have increased by 15 percent. Patient satisfaction comes as a bonus.

Several specialist offices, like the above one have witnessed a similar problem. Most of them say that there have been several occasions when patients have to sit at the front desk because a referral, which was supposed to come, never arrived. Even the follow-up was not up to the mark.

Patient Financial Clearance

Manual vs. Automation

These practices were using a process that was mostly manual, and less automatic. As a result, problems like longer patient waiting times, potentially avoidable denials took place. All these meant more work on the back end of the revenue cycle.

With automated patient financial clearance, most clinics can outline patient information and the tasks to be completed even before a patient enters the office, including updated insurance information and referrals. Before that, most of the work was being done while the patient was waiting at the front desk, which created barriers in delivering optimized patient care. Now, with most of the things automated, the waiting time for a patient is almost none, and the providers can immediately focus on the health concerns.

Benefits of Automation

1. Automation in the workflow has several other perks. It ensures that the staff is verifying insurance and demographic information, any need for prior authorization, and the financial responsibility of the patients a few days before they arrive at the clinic. The last benefit has brought about a vast improvement in the revenue cycle management.

2. Patient financial responsibility has been on a steady rise for the last decade. The most recent increase was around 12 percent in 2018. This implements a slower revenue cycle for the providers as patient collections take almost over a month every time the bill is over $1,000.

3. Claim denials, as we are aware of, are also on a rise. It is the hard truth that most of these denials are avoidable with slight improvement at the front-end revenue cycle. Almost 86 percent of the denials are avoidable, and every one in four denials arises due to registration and eligibility.

4. Workflow automation eliminates unnecessary paperwork and helps a practice go through the financial clearance of patients’ days before they arrive at the clinic. Besides, now being the era of telehealth, workflow automation can act as the perfect solution to check the patients in without letting them leave their house.

The Alternative (& Better) Option

There are several people who are underinsured or not insured at all. Health Beyond Insurance (HBI) have made healthcare easily available to all. They charge the patients a minimal fee on a monthly or yearly basis and do not take insurance as a mode of payment. Where there is no insurance, the overall process is much smoother than the rest, and the specialists can solely focus on the care they deliver.