Welcome back! As we covered in the first blog in the series, first impressions are critical in creating loyal patients. Loyal patients return and they tell their friends and family to go. But what about reducing denied claims? What’s the connection between first impressions and preventing denials?
First, let’s consider some perspective on denials. According to HealthcareFinance.com, 90% of denials are preventable. Additionally, HBI Academy Research concluded 30-40% of denials are due to issues with patient registration, whether it be eligibility issues or incomplete claim data. As you can see, a large portion of denied claims can be prevented by improving the accuracy and completeness of data.
So, you can probably see where this is going. Let’s play it out. What is the link between the first impressions and data accuracy? Registration. From the consumer perspective that link includes research, scheduling, pre-registration information sharing, financial clearance, and onsite registration. When you boil it all down, the first impression a patient experiences with your organization occurs in that link.
So how can we leverage this entry point of first impression to reduce denials? Here are 3 things to consider:
1) PARALLEL YOUR DENIAL MANAGEMENT WITH ‘FIRST IMPRESSION’ PREVENTION.
While nearly 2/3 of denials are recoverable, 90% are preventable. The old saying holds true, “an ounce of prevention is worth a pound of cure.” Invest in prevention as the end-game priority over reworking denied claims. Net revenue AND margin will increase, and cash will be accelerated. Additionally, patient experience will improve as they are no longer pulled down into the process, avoiding the negative experience that accompanies it. First impression prevention includes empowering your Patient Experience and Patient Access teams with the right integrated technology footprint. While EMRs have operational value in your organization, first impression patient engagement technology is unique. Consider platforms that do that well and integrate easily.
2) REAFFIRM YOUR COMMITMENT TO COMMUNICATION FROM THE PATIENT PERSPECTIVE.
According to the Healthcare Consumer Survey conducted by Katzenbach Partners, over 50% of patients choose a hospital or clinic based on the quality of communication. What does this mean in terms of first impressions and patient registration? Patients want convenient access (as noted in the first blog), they want to know exactly what information is required, what to expect in their visit, and how much it costs. When communicated effectively, your patients will be more likely to provide high-quality, accurate data.
3) VIEW ACHIEVING EFFICIENCY DIFFERENTLY.
Your patients feel like their time matters, but repeated surveying shows they don’t believe it matters to their healthcare providers. While workflow efficiencies may show improvement internally, measuring the impact to wait times and patient profile accuracy both feed into denial prevention. While this isn’t news to you, consider looking beyond traditional wait-time and accuracy metrics. Look at all transition points of the patient journey, from online research through post-discharge follow-up. Where are the bottlenecks that remain despite improvements already made? Also consider how your technology supports that journey…the technology patients use and the technology your Patient Access team uses. Does the configuration and experience ensure accuracy? Is your team empowered to achieve both accuracy and efficiency while the patient is sitting right in front of them? High performing healthcare systems do both well. And their denial management rates are considerably lower than average.
As we wrap up, what can we take away? By ensuring data accuracy is achieved during the first impression, the number of denied claims will be reduced, resulting in increased Cash Flow and Net Revenue. Additionally, achieving accuracy and efficiency reduces the collection of redundant data, thus saving the patient’s time. These results are good for financial performance and they are good for creating patient loyalty.
What stories of success or challenge have you experienced in your hospital? Feel free to share your comments, or email me at firstname.lastname@example.org. If you found value in this blog, share it with your peers. In the meantime, one final ‘first impressions’ blog is on its way. Stay tuned.