Efficient pre-registration is a must for efficient revenue cycle management. However, ensuring this can be a big challenge, because most patients do not come with a pre-scheduled appointment. The problem tends to get compounded at large health systems such as hospitals. In most big practices, inefficient pre-registration makes it difficult for them to connect patient credentials to the correct medical record.
Today, most practices have established pre-registration and rcm process. Yet they are struggling to streamline their pre-registration process. This is because they are unable to find where the rot lies. The pre-registration process can go wrong for many reasons. And most the times a wrong process manifest itself with telltale signs. In this blog we will discuss about those signs that indicate that your process is going wrong.
Improper Demographic Verification
Errors during the demographic verification stage is common. But if it becomes too common then there is something grossly wrong with your process. Such repeated errors may include mistakes in noting the social security number, gender, marital status, occupation, age etc. Errors of this sort may make it hard to match the information with existing account records and establish the legitimacy of the patient.
Besides these mistakes, practices often fall prey to medical identity theft. This mostly happens due to improper demographic verifications and is common during economic slowdowns. Fraudsters avail health care benefits by faking identity and the provider has to bear the expenses incurred.
An increase of either of the two means it’s high time to outsource your pre-registration process. A third-party partner specializing in pre-registering has several robust checks and balances in place to avoid such mistakes from happening.
| According to a Federal Trade Commission (FTC) survey, 5% of all identity theft victims have faced medical identity theft. The annual figure of such thefts stands at around 450,000. |
Improper Insurance Verification
Insurance verification is a critical pre-registration activity. Errors in verifying patient coverage properly can lead to delays and even denials. During cross-reference of patient information providers may go wrong on the following counts:
- Errors in establishing that the patient is indeed enrolled with the payer and plan
- Errors in determining benefits such as deductibles, co-pays, and co-insurance.
- Failure to note any required referrals and/or pre-authorizations
- Failure to find out about secondary coverage
These errors may happen too often leading to a host of payment issues. In such cases it is indicative of a deep-rooted procedural error that can be overcome only with the help of a third-party agency.
| In House Insurance Verification Challenges – Too Much to Do with Too Little a Staff Carry out insurance verification for scheduled patients as well as pre-registered patients Verify insurance of unscheduled inpatients within one business day Carry out insurance verification of unscheduled high-dollar outpatients within one business day Maintain data quality as established by provider guidelines and industry standards |
A report by America’s Health Insurance Plans (AHIP) has found that 24% of pending or delayed claims are primarily due to improper insurance verification issues and create an additional lag time of 10 days.
Fall In Up-Front Collections
One primary reason for carrying out pre-registration effectively is to understand which patients need financial counselling or may need follow ups. This is done after getting a correct idea of deductibles and co-pays. Therefore, the financial importance of pre-registration goes well beyond establishing patient identity and insurance eligibility.
If your pre-registration and rcm process is not able to determine patients who may require financial counselling, your revenue cycle process will take a hit. This is mostly seen in the form of slowdown of cash inflow. In such cases a third-party partner can be of great help. They have great expertise in identifying patients who require counselling and therefore can get in touch with them to counsel them about their financial responsibilities.
Denial Reasons Due to Pre-Registration Errors
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Benefits of Outsourcing Pre-Registration Services
There are several reasons for outsourcing pre-registration and rcm services to a third-party partner. These include:
Correct Patient Information Collection
A third-party vendor confirms 100% of demographics each time a patient is registered. This is because they bank on digitized data collection process. Further, they use customized data collection forms to meet the exact needs of the provider. They have a well-developed process to take care of data collection in a thorough manner. Another big plus is that their process is transparent and fully HIPAA compliant.
Clear Communication with Patients
Third-party partners have well-developed process to communicate with patients. They speak to patients on your behalf to make them aware of their financial responsibilities. A specialized vendor banks on tools such as automated dialers, email, online registration portals, and text messages to get in touch with patients and explain their responsibilities in details. They ensure a appointment is scheduled only after all these basic formalities are met.
Increased Upfront Collections
Upfront collections spare providers of many troubles. Third-party partners facilitate the process of upfront collections. This is because they make patients aware of the money that needs to be paid upfront for availing the services. In most cases patients come ready with the money to pay upfront or meet their financial obligations online before walking in for the appointment. This spares the front office desk of the trouble of explaining things out to patients.
Better Earnings and Greater Cost Savings
Outsourcing pre-registration services help providers gain through savings. Firstly, providers can do away with the need to employ a greater number of employees. This translates into huge costs savings. Secondly, as patients come prepared for upfront payments, providers can collect all dues even before start of the treatment. This leads to a steady inflow of revenue. Studies have shown that providers have been able to make cash inflow consistent by outsourcing pre-registration services.
Increased Patient Satisfaction
This is a factor which has no direct bearing on revenues but has an impact on provider reputation and patient retention. The efficient handling of pre-registration needs helps patients have a hassle-free experience. Patients will prefer coming back to the provider in future and will provide positive reviews. Therefore, by outsourcing pre-registration services, providers get access to specialized professionals dedicated exclusively to the task of patient outreach. This way they separate clinical experience from financial experience and ensure complete patient satisfaction.
| A study reveals that 35% of people are unlikely to return to a facility if the experience is negative. |
Who We Are and What makes Us an Authority?
This article is brought to you by MedBilling Experts. We are an expert medical back-office support provider with over 10 years of experience in catering to US healthcare practices. We specialize in revenue cycle management back-office services. Pre-registration is one aspect of rcm healthcare that we excel in. Our clients bank on us to overcome pre-registration challenges such as registration desk turnover, demographic quality check, end-to-end insurance verification, upfront collections etc. Our process is driven by experts with years of industry experience.
If you are looking for the best pre-registration services get in touch with us now.
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