August 30, 2016

3 Patient-Centric Benefits of Unifying Clinical Operations with Back-Office Processes

Value-based healthcare demands transformation beyond patient care; coding and billing processes also need to be efficient, accurate, connected and easy to use. Embracing an integrated solutions platform lets you minimize the unnecessarily cumbersome, inefficient and costly nature of many of today’s medical back-office systems. When clinical operations are linked together with back-office processes and technologies, patients benefit in three key ways.

Benefit 1: Time and efficiency for patients

The coding and billing office cannot — and, hopefully, does not — work in isolation. For back-office staff to succeed by generating accurate codes that appropriately maximize revenue, extra effort and care must be taken to thoroughly document the patient encounter. But ensuring complete and accurate documentation diverts the physician’s attention from care of the patient. Furthermore, physicians have to review claims before submission, and they can be slowed when there are questions from the back office, particularly those that require going back to check the medical record. Real-time, point-of-service coding that links the patient, physician, scribe and medical coder ensures that documentation clearly supports coding, and that accurate codes are generated.

These process efficiencies save doctors from spending time on administrative work, freeing them up to focus on patient-engagement and high-quality care. Patients receive more provider time and attention when back-office and other clerical tasks are handled through supporting stakeholders who are well-aligned — including medical scribes, medical coders, billing staff. In addition, the flexibility created in the physician’s schedule means patients can receive more timely care through well-orchestrated processes in place throughout the practice or organization.

Benefit 2: Transparency that helps patients understand the costs of care

When you’re able to begin coding in the room, it opens up the capability to trigger meaningful actions such as patient financial education and options available through identified and context-based awareness of patient and financial status. The codes can be matched to both billing costs and the patient’s co-pay or deductible responsibility, allowing discussion of what’s realistic for the patient in terms of payments and anticipated treatment costs.

If patients are confused by their bills, they may set them aside until there’s “a good time” to sit down and understand what’s included. Or they may feel the need to call your practice, thus taking up valuable time in a busy day to answer questions. Both scenarios lead to delays for you, and result in lower levels of patient satisfaction. The worst-case scenario is that a patient is unpleasantly surprised by costs or feels the bill is an attempt to mislead them, and refuses to pay — a scenario in which no one wins. Therefore, it’s important to be transparent and up-front with patients when you have their attention, at the point of care.

Helping patients understand what care they received, what they owe, and why isn’t a waste of time. It’s transparency, a key way to improve patient satisfaction and decrease issues later. Steps to make financial policies clear and well-understood should not be limited to the staff in your organization, but should be accessible, in a timely manner, and to patients as well.

Benefit 3: Greater efficiency throughout the health system

Embracing the philosophy of patient-centric billing has broad benefits for all patients, not just the individual being treated. Every day that a claim sits in a payor’s system is a day that your practice, physicians or facility goes unpaid. These claims in “accounts receivable” cost your facility in terms of net revenue beyond just the amount of the bill, due to the accumulated costs of inflation, depreciation and administrative time. Tighten up the timeline by even one day on every claim, and it adds up to a lot more free capital — which can be invested into the financial health of the practice or organization.

To get bills out the door quickly and efficiently, you should begin generating them at the point of care. Using a certified medical scribe ensures that the documentation of the patient encounter satisfies all billing requirements. With the addition of live coding, the medical scribe is able to relay this information directly to billing personnel via live chat, where real-time interaction between the scribe and billing personnel ensures that coding done on the spot accurately reflects what is currently happening in the room or at the bedside.

Claims can then be reviewed by physicians more quickly, and can be submitted to payors within 1 to 2 days, rather than the more customary 6 to 10 days. By quickly submitting well-supported claims, you’ll be able to improve accuracy of billing, shorten bill-drop times, and maximize reimbursement by avoiding delays due to documentation deficiencies. The resulting cost reductions lead to greater efficiency throughout key operational processes that translate to lower cost structures within the health system, and can be passed on to patients.