Diagnosing Pains in the Access Process
Healthcare's 5 Most Common Access Ailments—CURED!
Cindy Dullea, RN, MBA, BC, SCI Solutions
Where does it hurt? Are you experiencing Access distress? What are your pains in the Access area? Are you worried about the condition of your Patient Access processes? Read on to better understand the symptoms and remedies for the 5 most common ailments faced by Access Management professionals in healthcare facilities nationwide: Order Disorder, Schedule Mania, Revenue Deficiency, Dysfunctional Workflow and Portal Phobia
1. Order Disorder
ORDER DISORDER is the description given to physician offices and hospital departments
that experience pains due to poor order circulation. This discomfort is sometimes characterized
as overall CHAOS.
Some people describe the pains of ORDER DISORDER as frequent phone tag, and incomplete, illegible or missing orders. Sometimes this pain is very severe; often it is chronic—and many believe incurable!
Occasionally this pain radiates to patients who exhibit extreme agitation with long wait times or insufficient prep instructions, resulting in general dissatisfaction with their healthcare experience.
ORDER DISODER symptoms typically originate in the setting of busy physicians' offices and are transmitted to the hospitals and imaging centers to which they refer patients.
Note: ORDER DISORDER symptoms should never be ignored.
THE CURE: Implement the Online Order Communications Tool: ORDER FACILITATOR®—healthcare's pre-eminent web solution for automating outpatient orders from community physicians to increase provider satisfaction and reduce operational delays.
2. Schedule Mania
SCHEDULE MANIA is the description given to the painful, laborious and time-consuming
patient and resource scheduling process. Some people describe the pains of SCHEDULE MANIA as
disorganization and confusion due to the complexities of coordinating appointments, resources,
equipment, providers, locations, patients, prep instructions and travel schedules. This syndrome
generally erupts in a manual scheduling environment where pencils and paper appointment books
are prevalent and workflow is non-existent. SCHEDULE MANIA also presents in decentralized departments.
It can be contagious and spread to the patients who neglect to show-up for a scheduled appointment
because they did not receive an Appointment Reminder.
Symptoms of SCHEDULE MANIA are reaching epidemic proportions in hospitals nationwide.
Note: SCHEDULE MANIA symptoms should never be ignored.
THE CURE: Implement online Enterprise Scheduling: SCHEDULE MAXIMIZER®—healthcare's most intelligent scheduling application that streamlines access, maximizes scarce resources, performs advanced pre-registration and enables web self-scheduling.
3. Revenue Deficiency
REVENUE DEFICIENCY is a viral condition where hospitals lose significant amounts
of money due to poor pre-encounter claims/workflow processing. REVENUE DEFICIENCY is characterized
by excessive errors, absence of eligibility verification, malignancy of Medical Necessity functionality
and excessive amounts of missed appointments.
This systemic disorder is present in decentralized and/or disparate scheduling systems and is aggravated and compounded by the pre-registrations/pre-encounter challenges of knowing which procedures, payers and plans require pre-authorizations and referrals and/or Medical Necessity verifications.
REVENUE DEFICIENCY occurs as a consequence of scheduling systems
that are not inter-connected and do not provide real-time updates to the core hospital information
system. This causes pre-registrars to rely on paper schedules that often change the moment they
are received.
REVENUE DEFICIENCY is the chief complaint of hospitals threatening to shut their
doors and go out of business.
THE CURE: Implement REVENUE ACCELERATOR®--healthcare's newest pre-encounter workstation that incorporates revenue cycle tools to streamline pre-registration, prepare patients for arrival and expedite service delivery.
4. Dysfunctional Workflow
DYSFUNCTIONAL WORKFLOW is prevalent among stressed out hospital pre-registration,
scheduling and finance departments that are often disjointed, repetitive and overwhelmed
with paperwork. DYSFUNCTIONAL WORKFLOW results in communication breakdown, typically
precipitating a flurry of phone calls, faxes and emails. DYSFUNCTIONAL WORKFLOW leads to errors
from having to manually enter information from one source to another. "To-do" lists prevail (many
times as handwritten notes) with no central storage or search capabilities. This disorder presents
when there is no efficient way to assign, track and monitor items that need to be "worked" or
completed prior the patient's arrival.
THE CURE: Implement Worklist functionality—an extension of SCI's advanced scheduling solution (Schedule Maximizer). Worklist provides the ultimate means of communication among departments, while ensuring that all required tasks are completed prior to patient arrival on the day of service. Worklist is an integral tool for efficiently automating and managing workflow between an organization's front door (Access) and back office (Finance) departments. Rules, questions and manual actions post "To-do's" to online worklists that are integrated with SCI's Access Management components, which include Pre-Registration, Medical Necessity, Eligibility Verification, Account Management and Authorization and Referrals.
5.
Portal Phobia
PORTAL PHOBIA is the extreme fear (by both physicians and patients) to adopt 21st
century, internet-based technologies to improve the quality of their lives. PORTAL
PHOBIA is the inability to streamline and accept the efficiency and time-savings
offered by the self-scheduling capabilities of portal technologies. It is the unnatural need
to play phone tag and waste precious time by making callers wait on hold to schedule healthcare
appointments.
If left untreated, PORTAL PHOBIA can lead to increased agitation and dissatisfaction in both provider and patients, causing them to take their business to another healthcare organization that offers self-service technology.
THE CURE FOR Physicians: Implement the Provider Portal—which electronically connects physicians to hospitals.
THE CURE FOR Patients: Implement the Consumer Portal—which enables patients to view, pre-register and schedule appointments online and at their convenience.
client quote:
“With SCI we reduced our lab monthly denials from $23,000 to 0, and increased utilization from 400 average orders a month to 3,230, as well as improved patient, physician and staff satisfaction.”
Eisenhower Medical Center
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