Transforming Patient Access

(PYA Alert dated April 17, 2007)

The healthcare revenue cycle can be a vehicle for implementing vast performance improvements. As you look to enhance the revenue cycle, addressing issues in the first component of the cycle–patient access–can lead to dramatic and sustainable returns. Some of the most common patient access challenges today are accurate information capture and quality assurance tracking.

Quality assurance can be primarily tracked through the use of software or through routine sample account reviews. Although a manual process, sample account reviews provide advantages over software because errors can be identified that may otherwise be overlooked, including incorrect insurance card and pre-certification numbers or incorrect patient and guarantor names and addresses, among many other essential data elements.

A patient access quality assurance program can lead to a variety of benefits including:

• Increased accuracy and completeness of registration and scheduling data
• Standardization of tracking and control over all points of access
• Ability to revise data faster for utilization by downstream processes, and for proactive denials prevention
• Comparison of quality among staff within each point of access and across all access points
• Improved communication between patient access and other revenue cycle departments
• Reduction in the amount of returned mail and the time associated with resolution efforts
• Enhanced cash flow and reductions in accounts receivable days and bad debt due to better information accuracy
• Improved satisfaction among patients and personnel downstream of patient access

In conducting these sample account reviews, information system fields are compared to documentation compiled during patient access processes. Results can then be tabulated for each registrar and summarized by area, allowing comparison between points of access. This process vastly aids management in identifying opportunities for improvement at both the staff and department levels.

PYA’s revenue cycle professionals can assist your organization with improvement in patient access and other revenue cycle functions. If you would like further information on these or other services provided by PYA, please contact Mark Cameron or Vijay Madyastha at (800) 270-9629.

The information provided via PYA Alert, Tax Planning Alert, or Audit and Accounting Alert should not be construed as accounting, auditing, consulting, or legal advice on any specific facts or circumstances. The contents are intended for general information purposes only.  Please contact us at (800) 270-9629 to discuss your specific situation or to discuss any specific questions you may have.

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