Do you remember ten years ago, when electronic insurance verification was taking off but wasn’t quite as efficient as we would have hoped for? Many times insurance providers’ sites were down, and there was no consistency between the layout of a government-sponsored site for Medicare and the confusing layouts unique to each- and every- major insurance company. Sites required a unique login and password per employee, and it was difficult for employees to wrap their head around the specificity of the work, including the idea that it was “Best Practice” to have employees split by payer in order to work accounts. This was one of the only ways to exercise efficiency rather than cross-functional working.
On the road as a consultant for over twenty years, I remember going to hospitals and physician organizations of all sizes throughout the country. We would develop crosswalks for employees to understand the electronic insurance verification code. I developed a training manual for the Henry Ford Health System in Detroit that had pictures of the insurance providers’ responses and what it actually meant. I have to say, I FELT for the front-line! What a mess!!! Getting on the phone and waiting 15-20 minutes per response was almost the only way to guarantee you understood that patient’s benefits!!
Luckily, today's electronic insurance verification has come around by leaps and bounds. With the integration of the 270/271 payer response, real-time integration is not only possible, it is mainstream. Granted, there are still flaws, but the data integrity is hands down 90% better than the days of old.
Patient Liability Estimation
Patient liability estimation seems to be riding a similar wave. Just 2-3 years ago, many hospitals, clinics and physician offices doubted the sophistication of estimate tools and also the sophistication of the patient. Administrators nationwide still believed that providing estimates or asking for up-front payment might negatively impact patient satisfaction.
Healthcare providers of all classification – acute care, clinic, physician organization – are realizing that providing patients estimates prior to service or at the time of discharge in some Outpatient and Emergency Department settings, is not only what patients want … but they expect it. Furthermore, this is a sure way to INCREASE PATIENT SATISFACTION!
Catch the wave!!! Listen to how we helped a multi-health system provide patient estimates and in turn gain an estimated $28-million dollar income statement improvement!
~ Pattie Kloehn
