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CMS Compliance Requires Identifying Patients Correctly – Are you Ensuring it? 

From the title, it is quite clear what this is about. The changes made to the Medicare CoPs (conditions of participation) have attracted attention within the US healthcare system, especially after the introduction of mandatory e-notifications during every ADT (admission, discharge, or transfer) of a patient. While providers are more focused on e-notifications, most of them forget about one very important prerequisite: identifying patients correctly. While we have already touched upon the topic regarding CMS (Centers for Medicare and Medicaid Services) Interoperability & Patient Access Final Rule, this time, we will focus more on the practical aspects and how patient identification is a crucial component that is absolutely necessary for e-notifications to work properly as well as CMS compliance. Without further ado, let’s dive deeper into the topic at hand.

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A brief refresher

A few changes have been made regarding the CMS Interoperability & Patient Access Final Rule. As the name suggests, it has been done to boost interoperability efforts within the caregivers of the patients. Let us look at why it is required within the healthcare system.

There are many cases where a patient is not restricted to a single healthcare provider;  especially if they have complications, multiple ailments and so on. Such patients need to visit and consult with multiple healthcare providers in order to receive the best patient care. For this to be effective, caregivers need to have access to the patient’s medical record, history, medications, vitals and other necessary information. In order to make the caregiving process seamless and boost interoperability, the Final Rule was introduced.

The “companion final rule” states that e-notifications must be sent out by healthcare providers (such as acute care, psychiatric, critical access providers, etc.) during every ADT to the appropriate recipients, i.e., the other caregivers (post-acute providers & suppliers, established primary care practitioners, or any other entity primarily responsible for the patient’s care). This rule applies to inpatient admissions as well as ED admissions. 

Who needs to ensure it?

Applicable healthcare providers are those who use digital medical records like EMR or EHR systems. They need to ensure compliance and have proper systems set up by May 1, 2021 so that they can send out e-notifications during ADTs. 

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While that’s a succinct summary of the most recent change in the CoPs, every healthcare provider needs to ensure that they are sending out e-notifications. Otherwise, they can face undesirable consequences such as receiving penalties for non-compliance, or worse, jeopardizing their CMS provider agreements. But how is identifying patients correctly related to CMS compliance regarding e-notifications?

Identifying patients correctly is required for CMS compliance

As previously mentioned, the CMS rule requires healthcare providers to send out notifications during ADTs. But there’s a catch.

Identifying patients correctly is quite important for e-notifications to work. Think about it: if a patient is not accurately recognized or is misidentified as a different patient, the healthcare provider risks sending alerts to the wrong caregivers. Worst of all, the provider risks that they won’t be able to answer alerts other caregivers are requesting.

Without a reliable way to identify patients, things can escalate quickly. If a provider cannot fulfill alert requests or sends too many incorrect alerts, care coordination teams will start to lose faith and miss opportunities to improve patient outcomes. Noncompliance will also incur CMS penalties, which can result in hefty fines. After COVID-19, nobody can afford such costs.

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While healthcare providers are busying themselves by deciding how to best implement e-notifications, they should also assess the effectiveness of their patient identity matching systems. Clearly, the former is dependent on the latter. Those who are struggling with patient identification need to upgrade their systems to futureproof, easy-to-use and hygienic ones. 

RightPatient helps identify patients correctly

We ensure that patients are always identified correctly with our industry-leading touchless biometric patient identification platform.

How it works

After making an appointment, patients receive an SMS or email to validate their identity. During this process, the patient takes a photo of their driver’s license and a selfie. RightPatient automatically matches the selfie photo with the photo on the driver’s license to ensure a proper identity match. If the patient is not already in the system, RightPatient assigns biometric credentials to the new patient.

This is how we prevent patients from registering under a different identity or medical record mix-ups. There’s no need to worry about name changes, mistakes when entering a patient’s name or other common issues. Patients are recognized with their selfies.

We have been helping prominent health systems like TGMC, CMC and CHSLI fight the battle against patient misidentification for years. With RightPatient, responsible healthcare providers can send e-notifications and comply with CMS without worrying about faulty alerts.

If we haven’t convinced you by now, why don’t you try our free trial? No gimmicks – it’s really free!

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A Futureproof Patient Identification Protocol Can Help Mitigate Providers’ Losses

COVID-19 has been one of the biggest catastrophes to hit the world in modern times. There is literally no aspect of our lives it didn’t affect. Unfortunately, it will continue to affect us – experts are saying that the second wave is already here in the US. However, healthcare providers are still reeling from the ongoing surge of COVID-19 patients as well as the unprecedented losses faced due to the pandemic. With hospitals and health systems having to make hard choices like laying off employees, introducing pay cuts, and furloughing employees, is there any way to mitigate the losses? Yes, there are many, but the most sensible choice for providers would be to adopt a futureproof patient identification protocol like RightPatient. Let’s explore further.

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Hospitals expected to lose $323 billion in 2020!

And that is apparently an understatement. Losses might even exceed $323 billion, depending on the inevitable surges during the rest of the year as well as the increasing number of cases in some specific states.

The breakdown

During the final half of the year 2020, hospitals are set to lose at least $120.5 billion, especially due to lower inpatient visits, whereas an estimated $202.6 billion has been lost between March and June, according to AHA.

COVID-19 has affected all industries in the US, but its healthcare system is clearly the one it hit the worst – $323 billion is no small number. Since the pandemic started, hospitals had to reprioritize to deal with the surge of COVID-19 patients. Healthcare providers canceled elective procedures and non-COVID-19 patients were advised to use telehealth, reducing inpatient visits and leading to most of the financial losses.

Moreover, COVID-19 is causing hospitals to face higher expenses. PPE and ventilators, for instance, were not used as extensively prior to the pandemic. As previously mentioned, providers had to lay off employees, furlough them, or reduce their salaries, while others were even forced to close down due to the financial strain. Let’s look at some of the recent victims.

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Some recent victims

BRMC (Bluefield Regional Medical Center) will be permanently closing down by July 30th, 2020. Financial damages due to the pandemic, lower patient volumes, and reimbursement rates were contributing factors that forced the officials to make this tough decision.

Saint Luke’s Health System will permanently close the doors of its Cushing Hospital in Kansas on October 1st, after closing down its inpatient unit on July 17th – another victim of COVID-19.

HealthPartners will shut down seven clinics and has stated that it will lay off 200 employees at two of those seven facilities. This, too, is because of the financial pressure brought by the pandemic. 

Suffering from financial challenges tied to the pandemic, UW Medicine will lay off 100 employees. This comes after it has already furloughed 4000 unionized employees and 1500 non-union ones. It has also received around $180 million in provider relief funding, but sadly, it looks like that will not be enough to offset the damages caused by COVID-19.

These are just some of the numerous cases that show the effects of the coronavirus pandemic on healthcare providers and how the pandemic is forcing them to make tough choices. Sadly, we are only halfway through this pandemic-driven year – we do not know what’s in store for us. 

Healthcare providers need to reduce costs significantly in order to survive this challenging phase – perhaps the most challenging one they have ever faced. So, is there anything that can help them mitigate their costs? 

An effective patient identification protocol can help

While healthcare providers are searching desperately for ways to reduce their costs, they can do so by preventing medical identity theft, avoiding duplicate medical records, and preventing patient identification errors. All they need to do is upgrade their patient identification protocol.

Before doing that, healthcare providers need to evaluate their current patient identification protocols.

  • Is it ensuring accurate patient identification across the care continuum?

  • Is it preventing medical identity theft?

  • Is it preventing duplicate record creation?

  • Is it ensuring a hygienic environment for patients and employees?

  • Does it have a high acceptance rate among patients?

  • Is it futureproof?

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If even one of the answers to the questions listed above is no, then providers seriously need to upgrade their patient identity matching systems within their facilities. This is where RightPatient can help hospitals and health systems to reduce their losses and improve patient identification.

Achieve accurate patient identification with RightPatient

RightPatient is a photo-based patient identification platform that checks all the boxes for being an effective patient identifier. During registration, the platform locks the medical records of the patients with their photos. Returning patients simply look at the camera and are identified by the platform within seconds – providing the EHR user with accurate medical records. It also prevents medical identity theft, as fraudsters are red-flagged when they face the robust verification process. 

RightPatient prevents duplicate record creation, reduces denied claims, and prevents avoidable medical errors in the process to enhance patient safety.

Even before the pandemic, responsible healthcare leaders chose RightPatient because its touchless platform eliminated any chances of infection control issues during its usage – something that other conventional patient identifiers do not possess. RightPatient has over 99% patient acceptance rate – it provides a seamless, hygienic, and easy way for ensuring proper identification, improving patient safety and quality of care

The pandemic requires providers to switch to a touchless patient identifier and reduce healthcare costs significantly – try RightPatient now and experience the difference it makes.

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Patient Identification Policy Impacts Data Integrity and Patient Safety Issues

Let’s face it – patient identification errors are nothing new and it is a much-discussed topic among healthcare leaders. For instance, just a month ago, a new coalition was formed to urge Congress to develop a UPI (unique patient identifier) to be used nationwide. Sadly, such formations are quite common – groups, competitions, and alliances have formed for years for the same reason. The result is that no UPI exists yet and patient identification errors are still wreaking havoc. However, many healthcare providers are reaping the benefits of accurate patient identification – it boils down to the patient identification policy used by the caregiver. Let’s take a closer look at how patient identification errors can cause a multitude of problems, why accurate patient identification is so crucial, and how platforms like RightPatient can help ensure just that.

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Patient misidentification

It is quite self-explanatory. Patient identification errors occur whenever a healthcare facility fails to accurately match the patient with their appropriate medical record present within the EHR system.

It happens for a number of reasons. As already mentioned, it is nothing new and has been the result of years of human errors and improper patient data maintenance like duplicate medical records, overlays, and missing, incorrect, and/or incomplete information, leading to low patient match rates.

To put it into perspective, AHIMA stated that health systems can house up to 20% duplicate records within their EHR systems. The financial impact? It can go as high as $40 million for any given healthcare facility. 

Effects of patient misidentification

Low patient match rates is just the tip of the iceberg! Patient misidentification leads to several problems. Let’s look at the more prominent effects of patient misidentification.

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Whenever you incorrectly identify a patient, it means that one patient’s data will get written into someone else’s medical record – creating patient data integrity issues. This leads to a lot of problems – incorrect medications, repeated lab tests, incorrect medical procedures, inaccurate patient history – the list just goes on. Both the patients will receive inaccurate care by the caregiver as a direct consequence of patient misidentification, hampering patient outcomes.

Naturally, patient misidentification leads to patient safety issues – these are bound to happen if your treatment is based on the wrong medical record. Consequences can be delays in treatment, worse patient outcomes, irreparable damages, and sometimes, patient misidentification can even result in deaths. According to a report by John Hopkins University, medical errors can cause up to 250,000 avoidable deaths per year, many of which happen due to patient identification errors. 

Thus, the million-dollar question is how can healthcare providers ensure accurate patient identification across their facilities?

It depends on a provider’s patient identification system

The accuracy of patient identification is as good as the patient identification policy used by the hospital in question, and there are many options hospitals can choose from. Responsible leaders, in any case, must choose the patient identification system that ensures accurate patient identification, provides a seamless experience, and provides a safe and hygienic environment for all involved.

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There are a plethora of options available that hospitals can use as their primary patient identification policy. Sadly, many are still choosing the most obsolete one – inundating patients with questions. Whenever a patient arrives, officials ask them questions to find the correct medical record. This policy is slow, outdated, and extremely insecure – anyone can pass themselves off as the patient. In fact, this leads to medical identity theft – fraudsters buy stolen medical records from the black market and have all the information to pose successfully as the victim.

One other policy is to use patient ID wristbands. While this is a tad more secure than asking questions, it can still be taken off a patient and used for fraudulent purposes. Moreover, it is a contact-based solution, and that’s not something hospitals would want after the COVID-19 crisis – everyone is extremely aware of infection control issues now.

The most secure solution is using an identification policy where the identifier cannot be transferred or stolen – biometric modalities come to mind. There is a caveat though – patients would be quite reluctant to accept touch-based solutions such as fingerprint or palm-vein scanning.

Implement a touchless patient identification policy

The best option has been left for last – touchless patient identification platforms. RightPatient is the leading photo-based biometric patient identification system used by progressive healthcare providers.

Locking the medical records of patients with their photos upon registration, returning patients only need to look at the camera and the platform matches the photo with the one saved alongside their medical record, ensuring accurate patient identity verification.

There are many patient identification platforms available – be the responsible leader by choosing the one that shares the common goal of improving patient safety and quality of care at your facility.

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Patient Data Protection is Ensured by Responsible Healthcare Leaders

Healthcare providers in the US have a lot on their plates. Even before the coronavirus pandemic, they had their hands full with issues like patient identification errors, cybersecurity threats, HIPAA compliance issues, an abundance of duplicate medical records, medical identity theft, a distinct lack of patient safety, and more. Whatever the case may be, progressive healthcare leaders need to ensure patient data protection at all costs. In fact, many of the aforementioned problems can be mitigated by protecting patient data – leading providers have been doing that constantly. But why is it so important? How can providers safeguard patient data? Let’s dive in.

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Patient data protection

Safeguard-electronic-health-records-with-RightPatientPatient data protection has been one of the oldest and most important requirements for healthcare providers, and rightfully so – a patient shares critical and sensitive information with their caregivers. Names, Social Security numbers, dates of birth, contact information, addresses, facial photographs, medical history, and ailments are just some examples of the information stored within patient records. If these get compromised and land in the wrong hands, such cases can have disastrous consequences – healthcare insurance fraud, litigation costs for providers, and hampered patient safety are some common results. Thus, protecting patient data is crucial for any caregiver. Let’s take a look at a few more reasons why protecting patient data is necessary for hospitals and health systems.

Reasons to protect patient data

Ensuring Compliance

Concerns regarding data privacy are more common than ever – even more so when it comes to patient data. The frequency of healthcare data breaches proves that. However, providers, along with other healthcare organizations that deal with patient data, need to have safeguards in place to protect sensitive information.

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HIPAA, also known as the Health Insurance Portability and Accountability Act, was introduced back in 1996 and is primarily used for patient data protection. It mandates that all healthcare organizations who deal with PHI (protected health information) must ensure that the data is protected at all times. If an organization fails to do so or violates HIPAA in any other way, they will face heavy scrutiny and hefty fines – up to $1.5 million per year. On top of that, the person committing the violation may face criminal penalties – fines and even jail time. Data breaches can cost up to $ 6 billion for the healthcare industry, and the US also tops the list of most expensive data breaches, besides Germany.

HITECH, or the Health Information Technology for Economic and Clinical Health Act, compliments HIPAA. It was created to make sure that healthcare information technology is adopted and utilized appropriately. Privacy and security concerns are addressed by HITECH as well.

Thus, patient data protection is a must to ensure compliance with the laws and regulations that are in place. While HIPAA compliance can be cumbersome and challenging, healthcare organizations can simplify compliance management and reduce HIPAA-related administrative burdens. There are solutions available to ensure HIPAA compliance – organizations should choose one that is simple but powerful and gets the job done effectively. HIPAAReady is such a solution. A robust HIPAA compliance software, HIPAAReady ensures training management and scheduling, reduces administrative burden, and keeps all HIPAA compliance documents in a centralized location. Organizations can even detect security gaps by conducting internal audits with HIPAAReady.

Preventing medical identity theft

One of the more crucial reasons why protecting patient data is so important is because failure to do so leads to medical identity theft. Let’s see how that happens.

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Cybercriminals are always trying to breach the security of healthcare providers, and when they finally do so, they steal sensitive patient information and sell it on the black market for high prices. Fraudsters buy the data and assume the identity of the affected patients – committing medical identity theft, pushing off the expenses on the victims, and fraudulently obtaining healthcare services. 

Medical identity theft can lead to lawsuits, demand significant time and costs from patients and/or providers to rectify the issues, and compromise patient data integrity. That leads us to the next reason for protecting patient data.

Enhancing patient safety

Failure to maintain patient data integrity means that the data is not accurate anymore. When a provider fails to protect patient data, it leads to medical identity theft. When the fraudster uses the victim’s healthcare services, he/she contaminates the patient data – the fraudster’s data gets written onto the victim’s patient record, rendering it inaccurate. If such cases remain undetected or unfixed, they can severely hamper patient outcomes. Medical errors, delays in treatment, incorrect procedures, and even deaths – these are just some of the numerous consequences of compromised patient data. Thus, patient data protection is critical for enhancing patient safety.

Protect patient data now

Protect-patient-data-now-with-RightPatientProtecting patient data is a huge challenge, but it is achievable. One of the first and foremost things providers can do to protect patient data is to ensure positive patient identification at each encounter. That’s where we can help.

RightPatient is the leading patient identification solution chosen by progressive providers. It is a photo-based and touchless biometric patient identification platform with common goals shared by caregivers – to enhance patient safety, to ensure accurate patient identification, and to prevent medical identity theft

It locks the medical records of patients upon registration with their photos. Returning patients look at the camera and the platform matches the photos and provides accurate records within seconds. Even with healthcare data breaches, RightPatient protects your patients and their data as the platform will red-flag fraudsters during patient identity verification.

Protect patient data, prevent medical identity theft, ensure positive patient identification, and more – with RightPatient.

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Patient Identification Errors in Hospitals Should be Eliminated Now Instead of Waiting for a UPI

Patient identification errors have been haunting the US healthcare system for decades now. In fact, the lack of effective patient identity management within the majority of hospitals and health systems is quite well-known as it is prevalent. Otherwise, groups would not have formed every year to appeal to Congress to finally approve a state-funded unique patient identifier (UPI). However, the coronavirus pandemic has been wreaking havoc across the US, which is why accurate patient identification is needed more than ever. But should they still wait for Congress for a UPI, or is there a way to eliminate patient identification errors in hospitals now? The short answer to the latter is yes – RightPatient. Let’s dive deep into the issues caused by patient misidentification, what the healthcare industry is doing about it, and how leading providers are solving it.

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Issues caused by patient misidentification

Patient misidentification has always caused a plethora of problems – for patients, healthcare providers, insurance companies – basically anyone involved with patient care. However, the pandemic has deemed the elimination of patient identification errors in hospitals more necessary than ever, so that patients can get faster, more accurate care, leading to improved health outcomes. So, what are the issues caused by patient identification errors?

The lack of accurate patient identification can create duplicate records or overlays (merged medical records of the same or different patients), causing a ripple effect and hampering patient safety by generating inaccurate patient information. For example, a patient with a common name comes into a provider’s facility, and without a robust patient identification platform, it will be quite difficult for the EHR user to determine the correct medical record for the patient. Thus, the healthcare official will either painstakingly search for the correct record, which is quite time-consuming, or else an entirely new record will be created, leading to just another duplicate record among the several existing ones. Duplicate records create patient safety issues – patients will be treated based on an incomplete or inaccurate medical history. For providers, the financial cost of duplicates can be up to $40 million, according to AHIMA.

Patient misidentification can also cause denied claims, which have a severe impact on the financials of hospitals and health systems. Suppose a patient is misidentified by the provider using an obsolete patient identification system. While the patient at the facility will be receiving the care, someone else will be charged inadvertently for the services as a result of patient identification errors. However, the medical record holder can simply let the authorities know that someone else had used the healthcare services, and thus, he/she will not be charged – leading to a case of claim denial. Denied claims can cost up to $4.9 million on average for any given healthcare provider.

Even during this ongoing and unprecedented health crisis, patient misidentification is quite common. It occurs because there is no proper way to match patients to their electronic health records (EHRs) within those providers’ facilities, and it leads to patient safety issues as well as reduced quality of care. Other issues patient misidentification causes are incorrect treatments, medications, and lab test results – hampering patient outcomes significantly. Given the current scenario of the healthcare system, these issues should be minimized as much as possible – something that RightPatient can help hospitals with.

What is the healthcare industry doing about it?

During a virtual briefing, the CEO of AHIMA, Wylecia Wiggs Harris, stated that COVID-19 shows how important accurate data is and why patient misidentification issues must be solved as soon as possible. 

Leading-healthcare-providers-use-RightPatient-for-positive-patient-identificationLikewise, other experts have been making similar statements. For instance, even COVID-19 test results were affected by patient identification errors. After the results came in, it was quite difficult to identify and search for the patients, as no accurate patient identity management system existed within the facilities.

Thus, healthcare leaders across the states are coming together to once again to ask Congress to lift the archaic ban on a state-funded UPI. However, if the past has anything to teach, it is the fact that the ban has been in effect for decades now. Lawmakers and officials placed the ban citing privacy concerns regarding a UPI, and it is quite unlikely that they will budge now.

Instead, many leading providers have taken it upon themselves to eliminate patient identification issues within their premises themselves. How are they doing that?  

Eliminate patient identification errors in hospitals now

Forward-thinking providers did not rely on Congress to remove the ban, which might not happen anytime soon, admittedly. Instead, they deployed RightPatient – the leading photo-based biometric patient identification platform.

It locks the medical records of the patients with their photos – a returning patient looks at the camera, allowing the platform to identify the correct medical record within seconds. It is completely hygienic and ideal for the current crisis. 

Our platform has been successfully reducing patient identification errors in hospitals and health systems. RightPatient ensures accurate patient identification, reduces claim denials, avoids duplicate medical records, and even prevents medical identity theft – improving patient safety and quality of care in the process.

Contact us now and ensure accurate patient identification at your facilities to stay ahead of the curve.

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Identifying Patients Accurately is Critical for Ensuring CMS Compliance

The US healthcare system has been going through a very challenging phase due to the coronavirus pandemic. However, it looks like healthcare providers are going to have their hands full – they have another rule to comply with and must plan accordingly to ensure compliance by May 1, 2021. The fact that there have been additional changes to the Medicare Conditions of Participation (CoPs) is already well known among healthcare leaders. However, while many providers are already thinking about how they can ensure compliance, they might leave out one significant factor that can make or break the entire effort – are they identifying patients accurately? Why is this important? How does patient identification fit in with the new changes? How can providers ensure accurate patient identification? Let’s explore in detail.

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CMS Interoperability & Patient Access Final Rule

While the entire healthcare system has been suffering from the lack of interoperability, the Centers for Medicare and Medicaid Services (CMS) have made some changes to the CoPs to ensure that there is some degree of interoperability, believing that it will have positive effects on care coordination as well.

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The “companion final rule”, as per CMS, mandates that healthcare providers like acute care, psychiatric, and critical access hospitals send out e-notifications during every patient admission, discharge, or transfer (ADT) to the designated recipients (read: providers and other entities primarily responsible for patient’s care). This is applicable for both inpatient admissions and patients registered in the emergency departments (EDs).

Moreover, the providers obligated to follow the ADT requirements must make enough effort to ensure that they have sent out the notifications to the applicable parties (suppliers, entities, practitioners, etc.) in real-time.

Any given healthcare provider that uses digital medical records like EMRs or EHRs needs to ensure compliance with the updated CoPs for e-notifications. COVID-19 has extended the deadline – healthcare providers now have until May 1, 2021 to ensure compliance with the recent changes. 

Why are the CoPs important?

What is the biggest reason to ensure CMS compliance? Financial factors like CMS reimbursements and avoiding non-compliance penalties are more than ample motivators. Healthcare providers need to be compliant in order to safeguard their CMS provider agreement – it determines whether the providers are able to receive reimbursements or not, which can be quite significant in some cases. If providers do not ensure compliance, not only will their agreements be in jeopardy, restricting them from receiving reimbursements, but they might also face penalties. Given the current healthcare crisis that has crippled almost every caregiver, more financial woes are something any provider would want to avoid. 

What the healthcare providers are doing

Since the deadline has been extended to May 1, 2021, leading figures of healthcare providers are brainstorming about how to comply with the change – should they build an in-house e-notification system themselves, or should they buy from experienced vendors? Whatever option providers go with, they are not addressing the elephant in the room – are they identifying patients accurately?

How identifying patients accurately is related to e-notifications

Think of it this way – patient identification in hospitals is already inaccurate. In fact, many healthcare providers face patient identification errors due to duplicate medical records, medical record overlays, and patient mix-ups, among other problems. These lead to issues like compromised patient safety, unwanted patient outcomes, avoidable medical errors, and even deaths.

So, it has already been established that if a hospital does not have an accurate patient identity management system, then it causes a lot of problems for the facility. Can you imagine what will happen if the hospital goes for an e-notification platform without identifying patients correctly first?

Issues like common names and characteristics shared by patients are already quite prevalent and cause patient mix-ups. If such a case occurs while sending out e-notifications, then the wrong patient’s data will be provided to the subsequent caregiver. Thus, patient mix-ups and incorrect patient identification cases during ADT notifications will wreak havoc – delays in treatments, medical errors, and lawsuits are just some of the consequences of such scenarios. It will be a nightmare for any given provider. Hospitals and health systems that are not identifying patients accurately at their facilities need to eliminate these errors to ensure CMS compliance and avoid any unwanted consequences. They need to ensure patient data integrity by ensuring positive patient identification every time a patient comes in. That’s where we can help.

Identifying patients accurately with RightPatient

CMS-compliance-requires-proper-patient-identification-for-e-notificationsRightPatient is the healthcare industry’s leading photo-based biometric patient identification platform. It seamlessly integrates with the major EHR systems and becomes part of the workflow. Patients are registered by locking their medical records with their photos. After enrollment, incoming patients only need to look at the camera and the platform matches the photos and provides accurate medical records within seconds. This ensures a safe, easy, touchless, and hygienic patient identification experience for everyone.

RightPatient ensures that the correct patient is identified every time across the care continuum, helping you maintain patient data integrity. With RightPatient, you can send out the correct patient’s notification every time, ensuring CMS compliance and safeguarding your patients and, in turn, your business.

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Verifying Patient Identity – Top 3 Benefits

The failure to accurately identify patients throughout the healthcare industry continues to result in medication and diagnosis errors, procedures on the wrong person, duplicate medical records, and health insurance fraud. Therefore, healthcare providers should properly collect and manage information for verifying patient identity to prevent medical identity theft, improve medical record accuracy, and comply with HIPAA.

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The amount of information flow in healthcare is greater than any other industry, but it all means nothing if a patient’s identity is compromised, or cannot be matched with their records. Verifying patient identity before starting a medical treatment or service is vital for ensuring a positive patient experience. The inability of healthcare providers to accurately identify their patients during the COVID-19 pandemic has resulted in slow procedures, incorrect treatments, and even encouraged insurance fraudsters to take advantage of this chaotic situation. 

That being said, RightPatient has been helping healthcare providers keep accurate records connected with the correct identity for years now, ensuring effective health treatment and recovery. The coronavirus pandemic has also been a prime catalyst for the consideration of futureproof biometric identity management solutions, such as RightPatient, for verifying patient identity. The reason for this is that our solution helps providers maintain a hygienic environment and limit the spread of contagious diseases. Here’s what else RightPatient can do for your organization:

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Verifying patient identity to prevent medical identity theft

Even during this pandemic, security experts warn that the threat of medical identity theft is far from over, because attackers know they can take advantage of this situation. Healthcare providers, as well as patients, suffer from medical identity theft: the illegal access of a patient’s personally identifiable information and using this information to fraudulently obtain medical treatment, goods, or services. 

The cost of proper medical treatment is exorbitant, especially if not covered by health insurance. It results in claim denials and negatively affects a health system’s bottom line. That is why verifying an individual identity is crucial before providing any kind of service. Health care providers, such as Terrebonne General Medical Center (TGMC) and the University Health Care System have successfully prevented many potential medical identity theft occurrences since using RightPatient. 

Reduces information discrepancies in medical records

Arguably, the most damaging concern for healthcare providers is incorrect and potentially life-altering information being put on someone’s medical record. Inaccurate records have been the root cause of incorrect treatments, delays in procedures, and even the creation of duplicate records and overlays. Medical records are very difficult to change as they are meant to be a permanent and comprehensive account of an individual’s healthcare history. Thus, verifying a patient’s identity and accurately matching their information with their medical records can help providers to avoid financial losses due to fraudulent claims and improve data integrity.

Verifying patient identity for compliance

In the U.S., various state, federal, and industry-specific compliance regulations such as HIPAA and HITECH have been established for verifying patient identity. Not complying with these Acts can lead to hefty financial penalties being issued, and in worst-case scenarios, criminal charges being filed. 

HIPAA, which stands for the Health Insurance Portability and Accountability Act of 1996, is a federal law that provides security provisions and data privacy, to protect a patient’s medical information. It enables smooth transitions of electronic records and requires appropriate controls over the use and disclosure of medical records.

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Any organization that deals with protected health information (PHI) is required to comply with HIPAA’s rules and regulations. The law consists of several standard verification requirements for the disclosure of PHI. Under this subpart:

(i) Except with respect to disclosures under §164.510, verify the identity of a person requesting protected health information and the authority of any such person to have access to protected health information under this subpart, if the identity of any such authority of such person is not known to the covered entity;

Numerous stipulations suggest that it is lawful for organizations to take reasonable steps, such as using HIPAA compliance software and using platforms like RightPatient for verifying patient identity, to ensure compliance. HIPAA compliance also ensures that there are appropriate safeguards in place to protect PHI from unauthorized disclosure or breaches. 

RightPatient – touchless biometric patient identity management platform

RightPatient is the healthcare industry leader in biometric patient identification. RightPatient also offers remote identity validation and appointment scheduling solutions for telehealth practitioners to ensure positive clinical outcomes during this pandemic. The platform verifies patient identities by comparing their selfie photos and ID (e.g. driver’s license). It helps healthcare providers save money on more costly identity-proofing solutions through credit agencies.

Even without this pandemic, exercising due diligence is vital. With the threat of medical identity theft looming even greater than before, healthcare providers need to have the most risk-conscious and thorough procedures in place to mitigate fraud. With RightPatient, healthcare providers can confidently stand under the near-perpetual spotlight of public scrutiny.

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Optimizing Revenue Cycle Management in Healthcare is More Important Than Ever

While the US is still suffering from the effects of the highly contagious COVID-19, it has arguably hit its healthcare system worse than anything else. Around 1.4 million people working in healthcare have lost their jobs. The number itself is quite shocking, however, what makes it worse is that the pandemic has changed everything. For instance, the US healthcare system used to be unaffected by any recessions, but COVID-19 has shown otherwise. This is because numerous hospitals have declared layoffs, furloughs, or are even shutting down due to unimaginable financial pressure. With that in mind, as hospitals are opening up, they need to reduce their losses right off the bat, otherwise, it will be hard for anyone to survive. Thus, revenue cycle management in healthcare is more crucial than ever now.

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The numbers are drastic

It has already been mentioned that over 1.4 million healthcare professionals lost their jobs. That’s not where it stops, though. Since hospitals made the difficult but necessary choice to prepare for the overwhelming amount of COVID-19 patients by shutting down non-emergency care at their premises, they became financially crippled. The American Hospital Association stated that hospitals are losing a mindboggling $50 billion a month, due to the fact that they are seeing an extremely low number of patients – as low as 70%. Revenue cycle management in healthcare has always been a much-discussed topic, however, as the numbers show, it is of utmost importance now to optimize revenue cycles by reducing costs and mitigating losses – something that RightPatient can help healthcare providers with. But how does optimized revenue cycle management help hospitals deal with the financial crisis?

Benefits of optimized revenue cycle management in healthcare

Reduced denied claims

A streamlined revenue cycle depends on the level of accurate data present within the system. If there is a high level of accuracy, it reduces the chances of denied claims. Usually, denied claims occur when there are mistakes in payment claims. One example is when patients are mistakenly charged for services they have not used. RightPatient ensures that the patient is accurately identified from the beginning to the end of the process – substantially reducing denied claims. 

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Enhanced patient experience

An optimized revenue cycle means that the FTEs will spend less time on redundant tasks such as rechecking coding and billing for errors and focus more on providing better care to the patients – enhancing the patient experience. 

Higher and faster collections 

It is quite simple – if the revenue cycle is optimized, there will be higher collections with a lower number of errors. FTEs, thus, do not have their hands full of coding and billing errors – giving them the time to focus on the remaining collections, improving efficiency in the process. 

Accurate patient information 

An optimized revenue cycle means that you are ensuring patient data integrity; that is, from the beginning of caregiving to collections, the correct patient has been identified. This can be easily achieved using an accurate patient identification platform like RightPatient.

Better financial returns

One of the most vital parts of a healthcare provider that everyone scrutinizes, other than treating patients, is its financial performance. After all, these are the indicators as to how well a provider is doing. An optimized revenue cycle means that there are increased clean claims, faster collections, lower lost claims, and accurate patient data – all leading to improved revenue of the provider.

Since COVID-19 is still affecting the financial performance of providers, they need to ensure that their revenue cycle is as optimized as possible. 

Optimize revenue cycle with RightPatient

Optimized revenue cycle management in healthcare means that you need to have the correct data for the patient and you are ensuring that he/she is being billed accurately throughout the whole process. Thus, for a better revenue cycle, you need to ensure accurate patient identification. This is where RightPatient can help you.

It is a touchless biometric patient identification platform and is used by leading healthcare providers for a number of reasons. It prevents medical identity theft, optimizes the revenue cycle, reduces denied claims, prevents duplicate record creation, enhances patient safety, and more – leading to improved financials, boosting the bottom lines in the process. 

Upon registration, RightPatient locks the medical records of the patients with their photos. Whenever an enrolled patient comes in, all he/she needs to do is look at the camera and it identifies them within seconds, providing the correct patient record to the EHR user and ensuring accurate patient identification. This ensures that the correct patient is identified right from the start – reducing billing errors and denied claims and optimizing revenue cycle in the process. This is something that every provider needs to ensure to survive during this unprecedented situation.

RightPatient has years of experience and has been helping protect over 10 million patient records. Duke Health and Community Medical Centers, among others, are using RightPatient to ensure safe, hygienic, and accurate patient identification. Are you optimizing your revenue cycle sensibly? 

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Patient Identity Matching – Solving an unsolved crisis with RightPatient

Accurate patient identity matching holds paramount significance across the U.S. healthcare system. Delivering the best possible patient experience, including safety and outcome, hinges on the ability of the healthcare providers to keep and maintain accurate medical records. Healthcare providers continue to struggle to accurately match their patients’ identities to their health records, and blame it on inaccurate and incomplete patient data, says the Government Accountability Office (GAO). Physicians should be able to retrieve accurate records on each patient’s medical history, including lab results, diagnoses, medications, imaging, surgeries, etc. to deliver the best patient care. Needless to say, accurate patient identity matching during the COVID-19 crisis is vital for ensuring a positive patient experience.

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Can healthcare providers solve the patient identity matching crisis? Yes, and the solution is RightPatient – a leading touchless biometric patient identity management platform that has been successfully helping many leading hospitals address this specific issue.

Accurate patient identity matching ensures that the right patient is associated with the right medical records within a healthcare system. It means knowing with certainty that a piece of medical information belongs to the correct individual. There are many consequences if records are mismatched, such as incorrect treatment, improper data entries which can lead to the creation of duplicate records, and medical identity theft. Effective patient identity matching is not just about patient safety, it also helps healthcare providers avoid financial losses associated with duplicate records and claim denials from medical identity theft. 

How costly are patient identity matching errors?

Let us look at this example. A patient’s kidney was surgically removed by the time physicians realized that there was no tumor. This blunder in the operating room of Saint Vincent Hospital in Worcester, Mass., occurred when the patient’s CT scan was accidentally mixed up with the record of another patient who had the same name. The incident was widely reported in July 2016 when regulators came to investigate what exactly happened. Most people who read the accounts thought it was a rare blunder. But this type of blunder is not rare at all. 

Every day in medical clinics and hospitals, physicians assume they have an accurate picture of a patient’s medical history, diagnoses, lab results, and other information when they click into an electronic medical record (EMR). But this assumption can lead to fatal consequences, like the example mentioned above.

The problem is called patient identity matching error, a crisis that RightPatient has been addressing for years. One of the most severe match errors is when two patients’ medical records, with a similar or same name, get merged, leading to an erroneous organ removal or other nightmares. More common than this is the creation of duplicate medical records. For instance, Christina Elizabeth Smith, Cristina E. Smith, and C. E. Smith refers to the same individual, but her medical information is filed under three separate records. Neither the physician nor the patient will be aware of missing data points when they are discussing treatment decisions or procedures. 

The problem with common identifiers

Duplicate medical records can be created in many ways. One of the most common sources of duplicate records is making errors during the patient registration process. Other variations can be associated with identifying an unconscious patient when they are in the ER. Many times, duplicate records are also created due to demographic changes for the patient. Registrars face difficulties when patients change their last name or move to another place, so they create a new record for that individual. 

Patient identity matching errors can also occur when there is a variation in using common identifiers during the registration or identification process. A simple typo or mishearing the correct word can result in a mismatch in records. 

Common identifiers are also used to commit medical identity theft, an issue that healthcare providers have been trying to avoid for the past several years. A fraudster can easily get access to this type of information and fraudulently imitate someone else’s identity to get medication/benefits for their own use. 

These kinds of problems can be mitigated if common identifiers such as names, DOB, SSNs, or other demographic data used during the initial registration and identification process are replaced with the unique identifiers that RightPatient uses. For instance, identifying and authenticating an individual by using their iris pattern or a photo of their face. 

Accurate Patient Identity Matching with RightPatient

RightPatient is a touchless biometric patient identity management platform. Problems pertaining to duplicate records, medical identity theft, and record mismatch have been successfully mitigated by using RightPatient. Leading healthcare providers such as Terrebonne General Medical Center and The University Health Care System have successfully eliminated these sorts of problems and are continuously delivering the best experience for their patients with utmost clinical efficiency. 

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During the initial patient enrollment process, RightPatient will lock an individual’s medical records using their iris pattern or a photo of their face. Each time a patient arrives at the continuum of care, RightPatient will verify and authenticate their identity through an iris scanner, camera, or a webcam and retrieve their accurate medical records.

As a leader in the patient identity matching process, RightPatient helps healthcare providers to keep and maintain accurate medical records of their patients. Patient identity matching problems related to aggregating patient data via Health Information Exchanges (HIE) can be eliminated if all the healthcare providers adopt RightPatient, ensuring the best clinical outcome and data integrity across the healthcare system.

Due to the COVID-19 pandemic outbreak, touchless biometric technologies will play a key role in the next few years. RightPatient ensures safety and hygiene in a health facility by limiting physical contact between people and frequently touched high-risk surfaces, such as fingerprint scanners. Adopt RightPatient and make sure that one patient does not have multiple records in the master patient index (MPI) and that each piece of health information ends up in the correct patient record.

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5 Strategies to Ensure Revenue Integrity in Healthcare

Many healthcare providers were struggling financially before the pandemic. But now, the U.S healthcare industry is on the verge of financial disaster. According to the American Hospital Association, hospitals are bleeding approximately $50 billion per month due to canceled elective procedures and costs associated with treating COVID-19 patients. Many non-COVID patients have also stopped seeking primary care visits, including patients with life-threatening conditions, because they are worried about exposures. In addition, claim errors, denials, and payment delays that result from inaccurate patient identification, duplicate medical records, and medical identity theft still persist, all of which affects revenue integrity. 

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Adopting Value-Based Reimbursement (VBR) models has shown to have economic advantages but poses a real challenge for healthcare providers alongside ever-changing healthcare compliance regulations. Siloed workflows, data proliferation, and disparate systems make it difficult to achieve the collaboration that is needed for VBR to yield optimal results. However, intelligent revenue cycle management can be the key to achieving financial stability and revenue integrity. 

Identify the problem

Today’s environment requires automating workflows and considering the whole revenue cycle process to ensure revenue integrity. Healthcare providers want an easy, seamless way to manage revenue cycle without errors, such as those caused by patient identification issues. Considering the lack of electronic medical record (EMR) system capabilities to adequately address the critical need for accurate patient identification, it is vital to leverage complementary technologies with core-specific competencies that can improve the overall revenue cycle. For example, improving patient identification and matching processes at the front-end of the revenue cycle process can significantly reduce costs. 

As an industry-leader in touchless patient authentication, RightPatient has been helping many healthcare organizations reduce claim errors and denied claims by ensuring accurate patient identification. By eliminating denied claims linked to identification errors, healthcare providers can reduce the burden of back-end activities in the revenue cycle and simplify the reimbursement process to ensure revenue integrity.

Rely on technology

Adopting technology is also essential to ensure that clinical teams across the healthcare ecosystem are accessing high quality shared data to produce the best outcomes. Augmenting the organization’s core systems with complementary technologies on a single, integrated platform enhances internal collaboration with other teams or departments. For instance, RightPatient crosses departmental silos and brings transparency to patient healthcare data across disparate domains. Transparency across teams is critical. RightPatient will ensure that a holistic and accurate medical record of each patient can be accessed by clinical and operational staff members no matter where the patient is authenticated. By automating the patient identification and authentication process, RightPatient improves clinical outcomes and enables staff to proactively focus on other areas where their expertise has the most impact.

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Ensure compliance

According to the National Association of Healthcare Revenue Integrity (NAHRI), the goal of revenue integrity is to prevent issues that lead to revenue leakage or compliance risks through effective, efficient, and internal controls across the care continuum, supported by strong documentation and sound financial practices that can withstand audits at any time. 

Violation of healthcare compliance is a major contributing factor to financial losses. For instance, HIPAA violations are becoming more common across the U.S healthcare system. HIPAA compliance software, on the other hand, can help address this issue. Such software allows healthcare providers to simplify their compliance efforts and manage training through an effective communication system. Ensuring HIPAA compliance prevents privacy issues that can impact proper revenue cycle management and helps to avoid costly financial losses.

Accurate documentation and coding

Unfortunately, as long as healthcare providers do not address the issue of front-end data validation, claim denials will continue to wreak havoc. Inaccurate patient identification and medical identity theft still remain a major contributing factor to denied claims and payment delays. However, through accurate patient identification, RightPatient enables healthcare providers to bill and code each patients’ information accurately. By ensuring accurate and clinical documentation, this platform significantly reduces inefficiencies of denials and rework, thereby strengthening revenue integrity. 

Improve hygiene and foster patient trust with RightPatient

Healthcare providers are witnessing a reduction in non-infected patient activity due to the fear of COVID-19. Visits for general check-ups or other routine procedures have decreased to the obvious financial detriment of healthcare providers. These providers need to reassure their patients that they are taking all precautionary steps to maintain hygiene and control this contagious disease. Adopting RightPatient is a sensible part of this strategy. 

RightPatient is a completely touchless biometric patient identification platform that can accurately identify patients throughout the continuum of care. After capturing a photo from a smartphone, tablet, or webcam, RightPatient instantly identifies patients and retrieves their correct medical record. By securing unauthorized access to medical records, hospitals are able to prevent medical identity theft, reduce denied claims, and duplicate records – all of which are vital to a high-performing revenue cycle. 

RightPatient also offers remote patient authentication, which is becoming increasingly necessary as people are maintaining social distance by staying at home and getting treatment through telehealth practices. During this process, RightPatient validates patient identities by comparing their ID (e.g. driver’s license) and selfie photos. This process can also help healthcare providers to save money on more expensive identity proofing solutions through credit agencies. 

As patient care becomes more complex, so does the management of the revenue cycle. RightPatient can help to simplify and manage the complexity by ensuring safe, ubiquitous patient authentication from various patient encounter points. Full financial recovery from this pandemic may take years, but adopting RightPatient will ensure that you are on a faster path to success.