Amid evolving patient access preferences, the ongoing healthcare workforce shortage, and the drive for compliance with electronic medical record (EMR) and interoperability standards, an optimal pairing of technology and human resources is crucial to a provider’s patient engagement strategy and financial well-being.
A technology-based platform backed by skilled healthcare customer-service professionals can lead patients from scheduling and prior authorization through the care process to reimbursement. An end-to-end patient contact solution can accelerate authorization requests, improve eligibility approval rates, reduce time to payment, increase overall collections and decrease bad debt placement.
Even more important, a comprehensive patient contact solution should also enhance the patient journey. It should improve patient satisfaction by boosting patient-contact resolutions and decreasing patient-call abandonment rates.
Consumers have broadly embraced digital services, and the healthcare sector is no exception. Demand for digital patient services skyrocketed during the pandemic and continues to rise.
Most healthcare consumers desire their providers to have an online presence focusing on self-service options. In particular, patients seek appointment scheduling, eligibility verification and payment processing capabilities.
Yet many providers lag in addressing consumers’ patient-engagement preferences. A 2021 patient digital-access study found that only 40 percent of top health systems offered online scheduling for new patients, and barely a quarter of those providers had a live virtual assistant to address patient queries.
Yes, some demographic groups remain less likely to use patient portals and other digital engagement services than others. But part of this challenge — as observed in a recent study about disparities in the use of patient portals — is an access issue, particularly for underserved communities, older adults and rural residents.
For many patients, online and remote access to health services isn’t just about convenience. It’s also about having greater insight into and control of their health and medical treatments.
As the industry transitions to value-based care and patients take on a greater financial role in their healthcare, digital services like patient portals and remote patient-contact solutions like call centers promote smart healthcare consumerism and patient literacy. They accomplish this by providing patients instant access to tools that help them manage their health. This access puts lab results, prescriptions and medical records at patients’ fingertips and offers immediate access to customer service professionals about their treatment journey and billing.
An inclusive patient engagement solution should leverage advanced technology and a knowledgeable, customer-focused workforce to deliver a seamless patient experience. It can also help providers augment their revenue by improving reimbursement outcomes, reducing claim processing times and lowering the costs associated with managing patient contact through multiple platforms and overburdened internal personnel.
An end-to-end patient engagement solution offers key benefits in the following areas:
The ability to schedule appointments online is among the top demands of healthcare consumers, and the availability of digital intake technology can elevate the patient experience and improve loyalty.
Scheduling technology supported by skilled staff can improve performance relative to patient volume, late cancellations and no-shows. A digital dashboard should allow the real-time tracking of scheduled patient visits, cancellations and no-shows and feature a patient-visit history.
The pre-authorization processes necessitated by commercial and government payers are drains on many providers with limited resources. Provider and patient displeasure has grown so extreme that the U.S. House of Representatives recently advanced a bipartisan bill that would reform prior authorization for Medicare Advantage and other plans and establish an electronic pre-authorization process.
A technology-enabled patient engagement solution can put providers ahead of the curve. A team of registered nurses should reinforce that technology and other clinical specialists who understand the pre-authorization requirements and billing procedures across the payer spectrum, including Medicare and Medicaid, managed care plans, commercial providers and other programs.
The pre-authorization and eligibility verification processes are inextricably linked. Still, it’s crucial to distinguish eligibility services, in part, to identify the patient’s financial responsibility up-front and in accordance with healthcare cost transparency rules.
Accurate eligibility and benefits verification at the initial stages of patient contact prevents later problems, including denied claims, delayed payments and diminished patient experience. A patient engagement solution should improve eligibility approval rates, reimbursement rates and customer service quality and offer automation capabilities for patient follow-ups and collections.
A healthcare provider’s revenue cycle is increasingly bound to the patient experience. A patient engagement solution must provide the patient with a simple and smooth journey, from the first call through the care process to reimbursement.
Call center representatives should be customer-focused professionals specializing in healthcare and understand the nuances of payer procedures and compliance with state and federal regulations. A call center team should be able to answer calls promptly, offer ample hours of coverage, improve the first-call resolution rate and reduce the call abandonment rate — all of which should add up to elevated patient satisfaction and a per-call savings cost for providers.
Self-pay collections offer convenience to patients, and self-pay prices are often more economical for healthcare consumers than insurance prices.
Though bad debts remain an issue, a patient engagement platform that gives patients easy payment options and provides targeted patient reminders can help. A premier patient engagement service should provide turnkey self-pay options that reduce time to reimbursement and employ analytics to create patient-centric payment campaigns that lead to increased collections and decreased bad-debt placement.
Most healthcare providers are falling short of patient expectations regarding the implementation of patient engagement technology, according to a recent healthcare consumer survey.
The survey found that nearly 70 percent of patients desire the ability to schedule and reschedule appointments online, although, as noted earlier, only about 40 percent of providers offer this. The survey also found that patients between 18 and 34 are twice as likely to select a healthcare facility that provides digital access tools like online scheduling and appointment check-in over a provider that doesn’t offer digital services.
The preference for digital services isn’t limited to younger patients, however. About 60 percent of elderly healthcare consumers said they want the ability to self-schedule medical appointments online or through an app.
Patients and patient engagement shouldn’t be afterthoughts when it comes to healthcare information technology. Healthcare consumers are increasingly sophisticated and demand actionable digital services and personalized customer service that help them manage their care journeys.
GeBBS Healthcare Solutions is a leader in healthcare IT and patient contact services.
GeBBS is committed to helping its partners achieve measurable cost-reduction, productivity and patient-satisfaction improvements through scalable solutions that unite AI-enabled technology and expert human resources.
GeBBS is proud to be recognized as a Leader by Everest Group’s Revenue Cycle Management Operations, one of Black Book Market Research’s Top 20 RCM Outstanding Services, one of Inc. 5000’s Fastest-Growing Private Companies in the United States, one of Market Research’s Top 20 RCM Outstanding Services and one of Modern Healthcare’s Top 10 Largest Revenue Cycle Management Firms. Connect with GeBBS Healthcare Solutions today at gebbs.com to request a consultation and learn how we can help you meet today’s patient contact challenges and prepare for those on the horizon.