When discussing digital transformation in healthcare there has been a strong emphasis on patient benefits, however providers can also gain many advantages from going digital. Providers are equally as frustrated with the administrative side of healthcare – completing and submitting referrals and orders by phone or fax, waiting for patients to be scheduled, and following up on prior authorizations. These manual processes are error-prone, frustrating and time consuming.
To ensure both employed and independent providers have more time to focus on providing care, health systems need technology that not only creates more internal efficiencies, but also makes life easier for providers. An EHR-agnostic patient experience (PX) platform that utilizes embedded best-practice workflows for better patient access, revenue cycle and care coordination across departments, facilities and locations, is a great resource for this. Below are five key ways, a patient experience platform can optimize the provider experience by allowing them to work in a more streamlined, digitally enhanced way.
Unfortunately, it’s extremely common for faxed referrals and orders to never be fulfilled – 46 percent of such referrals never result in a patient visit. To avoid this, digital referral and order management workflows that help physicians’ offices quickly enter compliant, electronically signed orders and manage them from a central repository need to be part of your patient experience platform.
The right PX platform will enable integration with HIS/EHR systems, which in turn allows the appropriate order information to be carried across multiple locations and facilities so patient access teams can convert these orders into scheduled appointments.
The R1 Patient Experience platform enables referring providers to generate and submit electronic orders – improving order conversion rates by up to 30% and eliminating lost orders, paperwork errors and the frequent phone tag and faxing that typically leads to care delays.
Data has shown that 90% of providers believe prior authorizations delay care and negatively impact the patient experience. In addition to being time-consuming, most denials and underpayments are attributed to prior authorizations. To improve this, providers need a patient experience platform that can trigger automated, pre-service clearance processes when an order is received and secure cleared authorizations so much-needed appointments can be scheduled more quickly.
With R1’s patient experience platform, orders and referrals are electronically ingested and run through the appropriate network and eligibility checks, member benefit determinations, and prior authorization requirements to ensure most patients can be cleared within minutes. By moving the prior authorization process up to when the order is initiated, rather than later on when the patient is pre-registering, it helps reduce appointment cancellations and reschedules, and reduces front-end denial rates since providers can ensure each order captures and conforms to all the guidelines set forth by a health plan. When using the platform, R1 clients have found that 67% of authorizations are cleared within minutes and 97% within three days.
Due to decentralized scheduling and an overall lack of standardization, scheduling can be a very complex task that requires highly trained staff, often with clinical backgrounds. To effectively guide patient access teams through the scheduling process, providers need a patient experience platform with scheduling workflows that incorporate clinical and operational rules.
With expert rules-based, cross-location technology, schedulers follow step-by-step prompts to ensure accuracy and adherence to guidelines for each facility, department or service, while eliminating reliance on memorizing these rules and reducing scheduling work by as much as 30%. A robust patient experience platform like R1’s requires less training, reduces call times and shortens wait times for patients, ensuring providers can trust that when a patient arrives, he or she has been directed to the right person, at the right location with the right resources to provide care.
Data indicates that 27% of providers are more likely to refer to a hospital that offers provider self-scheduling tools. In addition to being a major source of frustration, patient referrals also increase the likelihood of network leakage if their platform doesn’t easily identify providers that are in-network. To prevent revenue leakage and increase convenience for referring providers, health systems need access to self-service and messaging tools that make it easier to coordinate care for patients.
R1’s Patient Experience platform enables provider self-scheduling, so referring providers can book appointments directly on behalf of their patients before their departure. This facilitates appropriate patient follow up, and ensures that patients never leave a care setting without clearly defined next steps in hand Additionally, if the patient would like to schedule their own appointment later on, health systems can also use R1’s patient experience platform to reach out directly to patients via text and have them schedule their test or procedure using convenient self-service tools. For more information on how a patient experience platform can enhance consumer revenue cycle touchpoints, read our blog post: Five Ways to Create a Better Digital Consumer Experience in Healthcare.
Given the increasing number of uninsured Americans and continued economic uncertainty, it is becoming more and more difficult for providers to resolve outstanding balances, reduce bad debt and maximize reimbursement. Patient experience platforms can support pre-collection teams in resolving patient balances by leveraging technology to proactively reach out to patients – 80% want physicians to clearly communicate what they owe and what insurance covers. Through this outreach, health systems can obtain payments, payment commitments, insurance coverage details, and charity applications.
The platform can also apply advanced analytics to better gauge propensity to pay, identify potential risk and support presumptive charity and write off. If a patient is uninsured, the platform can also utilize technology to identify potential funding sources for each patient, so staff can then help them apply for assistance. Through a combination of technology and compassionate staff assistance, the patient experience platform helps health systems accelerate appropriate payment while offering patients financial resources that allow them to feel informed and respected.
A patient experience platform like R1’s empowers providers by giving back valuable time that was previously wasted on ineffective processes and helping them deliver better overall service to patients. With automated order/referral management, financial clearance and scheduling workflows, providers and their staff can improve clinical outcomes, maximize volume, and optimize capacity. What’s more, they will increase patient satisfaction, attract new consumers to their health system and gain the loyalty of referring providers.
Content written on behalf of R1 RCM.