Ensuring-safety-in-healthcare-facilities-is-possible-with-RightPatient

Ensuring Safety in Healthcare Is Crucial as COVID-19 Cases Rise

What a year this has been! While it’s almost the end of the unforgettable year of 2020, the effects of COVID-19 will be felt for many years to come, unfortunately. 2020 will be globally remembered as one of the worst years in recent times due to the pandemic and how it kept pushing everyone to their limits. Arguably, it hit the US healthcare system the worst – just take a look at the mindboggling statistics. COVID-19 has infected more than 15 million Americans while claiming just over 288,000 lives. That’s not all – cases are increasing rapidly every day, with healthcare providers being overwhelmed by the surge of COVID-19 patients. With all that’s going on, safety in healthcare providers’ facilities as well as accommodating patients is more important than ever.

Ensuring-safety-in-healthcare-facilities-is-possible-with-RightPatient

Let’s take a look at some of the recent moves taken in response to the pandemic, how they can improve healthcare outcomes and prevent hospital-acquired infections (HAIs), and how an effective patient identity management platform can help.

Recent moves to tackle COVID-19 challenges

Patients are being redirected to other facilities due to capacity limitations

Lifespan Health System of Providence, Rhode Island, is redirecting COVID-19 patients to a field hospital located at Rhode Island Convention Center, as the former reached its capacity and has no beds to spare. While it still has its ICU and ventilators available, its regular beds are full due to COVID-19 patients. Moreover, the field hospital, with a capacity for 600 patients, is accepting non-critical patients as well.

A similar case had occurred in Arizona’s Holy Cross Hospital. Instead of admitting the patient at a neighboring facility, the ambulance crew took the patient to the Nogales International Airport before transferring him to a different location (Flagstaff) due to capacity constraints.

COVID-19 surge forces Mayo Clinic to temporarily close clinics

The Mayo Clinic Health System closed one of its clinics temporarily and will do the same with its four other clinics. The affected clinics are its Mankato-Northridge, Belle Plaine, Le Sueur, Janesville, and Waterville clinics. The health system is doing so to reallocate its resources and prioritize critical care due to the COVID-19 surge. However, patients may still visit its other sites or use the online services they provide, such as virtual sessions, nurse line, etc.

A pediatric acute care hospital will accept adult cases

Cincinnati Children’s Hospital Medical Center will be accepting adults under 30, whenever possible, in order to help ease the pressure of COVID-19 on other hospitals. Many local healthcare providers that serve adult patients are almost nearing their capacities due to the overwhelming number of patients, which is why Cincinnati Children’s has made such a welcome decision.

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The existing practices aren’t enough to ensure safety in healthcare facilities

All of the healthcare providers have one priority right now – to ensure safety within their facilities. However, COVID-19 has been creating havoc in healthcare facilities for months now, leading to many of them shutting down, health systems suspending some of its facilities temporarily, or resorting to cost-cutting measures.

While a few might be benefitting from such measures, healthcare as a whole is suffering. Hospitals need to seek out ways to enhance patient safety, reduce HAIs, reduce response times, and improve patient outcomes to ensure survival during and after COVID-19. Thankfully, RightPatient can help.

RightPatient enhances safety in healthcare facilities

RightPatient is a touchless biometric patient identification platform that is extremely beneficial for healthcare providers, especially during the pandemic. Since it is touchless, it doesn’t have any infection control liabilities associated with it, leading to reduced hospital-acquired infections and improving safety in healthcare for everyone involved. Moreover, it maintains patient data integrity by associating correct medical records with the appropriate patients every time – it locks the medical records of the patients with their photos. Also, it is versatile enough to be used at any touchpoint in a healthcare facility, making it ideal for telehealth sessions.

After scheduling appointments, patients receive an SMS or email for verifying their identities. Patients are required to provide a selfie and a photo of their driver’s license or any other form of identification. RightPatient automatically compares the photos for a match, remotely authenticating patients. Biometric credentials are provided to the new patients. This helps ensure that the accurate patient is identified right from appointment scheduling.

At healthcare facilities, patients only need to look at the camera – the platform compares the photos for a match and provides accurate medical records within seconds, making it the most hygienic and feasible choice for patient identification. 

RightPatient improves safety in healthcare facilities not only by identifying patients accurately and ensuring patient data protection but by also reducing HAIs, something that is paramount right now. 

Be a responsible healthcare provider and use RightPatient now to improve healthcare outcomes, enhance patient safety, and protect patients.

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Improving Patient Outcomes Relies on Identifying Patients Even During COVID-19

Healthcare in the US has always had its fair share of troubles. Price transparency issues, medical identity theft, data breaches, denied claims, and interoperability issues are just some of the many issues plaguing it. However, it is having arguably one of the worst times it has ever faced due to COVID-19. To date, over 14 million American citizens have been infected with the infamous virus, whereas over 270,000 people have lost their lives battling it. Due to the spike, hospitals are shutting down, health systems are closing their emergency departments, elective surgeries are being canceled, and healthcare staff members are being pushed to their limits once again. It feels like a particularly bad déjà vu. While healthcare providers are doing whatever they can to help with improving patient outcomes, many are facing a critical issue that has been an impediment to quality healthcare for years – patient identification errors.

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Having said all that, let’s focus on: 

  • why patient identification errors are a big deal even during the pandemic
  • what healthcare providers are doing to address it
  • how a tried and tested solution ensures patient safety and quality healthcare, improving patient outcomes in the process

Patient misidentification is nothing new

Anyone who knows anything about the US healthcare system has heard at least one story about patient misidentification or something related to it, such as duplicate medical records, patient mix-ups, incorrect surgeries, medical errors, etc. It has been occurring for years, leading to delayed patient care, detrimental patient outcomes, repeated lab tests, among other consequences. While many caregivers have been facing all these challenges for quite some time, a large number of them didn’t pay much attention to the problems. Everything changed with the pandemic – let’s see how.

Improving patient outcomes is difficult due to existing issues

COVID-19 pushed everything to its limits, especially the healthcare providers, and they were forced to face the issues that significantly hamper patient outcomes. One of the more prevalent issues was, and still is, patient misidentification.

HIMSS VP of Government Relations, Tom Leary, said that public health response efforts can be significantly impacted by inaccurate patient data, and that’s exactly what happened during the first wave. Since patient identification was erroneous in most healthcare facilities, this led to improper data sharing, delayed test results, sending results to the wrong patients, and more. Nurses even tried to google patients so that they could send them the test results!

Improving-patient-outcomes-relies-on-patient-identification

COVID-19 is an unprecedented situation that requires prompt responses that can help save lives, and issues such as patient identification errors significantly hamper the efforts put forth by frontline teams. So, what are healthcare providers doing to address it?

Healthcare providers are urging for the UPI

The US healthcare system was supposed to get a unique patient identifier (UPI) years ago, but a bill had restricted state funding to create one. Since then, most healthcare providers have been struggling to identify their patients accurately. Each year, experts come together and urge the ban’s abolishment, but their requests get rejected every time – for almost two decades. Even if the mythical UPI is made, it won’t be enough to solve such a huge problem by itself.

However, not every hospital is struggling with patient identification errors – many forward-thinking ones are using RightPatient.

Improving patient outcomes is possible with RightPatient 

RightPatient is a touchless biometric patient identification platform that is the most feasible solution currently, given the pandemic. It uses the characteristic that cannot be stolen, lost, or transferred, patients’ faces, to verify identities. However, the part that makes RightPatient ideal for the pandemic is that it is entirely touchless, ensuring infection control and reducing hospital-acquired infections.

By locking medical records with patients’ photos, RightPatient protects patient data and accurately identifies patients. Moreover, it is versatile enough to be used across any touchpoint within a healthcare facility, starting from appointment scheduling.

After scheduling an appointment successfully, patients receive an SMS or email, and they are required to provide selfies as well as a photo of their driver’s license. The platform compares the photos for a match, ensuring remote authentication. If these are new patients, RightPatient provides them with new biometric credentials – making it a hassle-free experience. 

Within healthcare facilities, patients only need to look at the camera – the platform compares the live photo with the saved one. After finding a positive match, RightPatient provides accurate medical records within seconds. This helps prevent patient mix-ups, duplicate medical records, medical errors, denied claims, and patient safety incidents – improving patient outcomes. Moreover, it can also prevent medical identity theft in real-time, as it red-flags fraudsters who try to assume patients’ identities. 

RightPatient can enhance healthcare outcomes, improve patient safety, and reduce significant costs – something which is extremely crucial for hospitals right now in order to survive.

Contact us now to learn how we can help you improve your bottom line.

RightPatient-ensures-positive-patient-outcomes

Positive Patient Outcomes Are Still Hampered by Patient Identification Issues

At this point in time, virtually everyone knows about the coronavirus pandemic, unless they have been living under a rock. Unfortunately, COVID-19’s effects on the US have been disastrous, especially on its healthcare system. The numbers for the US are mindboggling – over 13 million people have contracted COVID-19, whereas over 268,000 people have lost their lives. Moreover, cases are increasing rapidly as was predicted by experts. Things are more serious than ever – restrictions are being placed in many states, encouraging social distancing and fewer social gatherings. Suffice to say, the novel coronavirus has been pushing healthcare to its limits. While doing so, it has also highlighted the existing issues that have been hampering positive patient outcomes for years and need to be addressed quickly.

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Let’s take a closer look at one of the overlooked but more prominent issues – patient misidentification, why it’s such a mess, what caregivers are doing to address it, and how RightPatient ensures positive patient identification for responsible caregivers.

Patient misidentification and how it hampers positive patient outcomes

It is quite straightforward – patient misidentification refers to patients being associated with the wrong, incomplete, inconsistent, or fragmented EHR (electronic health record). This usually happens at registration desks as well as EDs (emergency departments). But it sounds so simple, right? Actually, patient identification errors are much more complicated than that. 

Both registration desks and EDs are high-pressure environments where patients’ EHRs need to be identified quickly and accurately. Unfortunately, issues such as duplicate medical records, common patient names or demographics, and basic search functionalities lead to confusion, after which patient record mix-ups occur. While this was a simplified example, this is how most misidentification cases occur, leading to lower positive patient outcomes down the line.

Thousands of patients are affected every year – facing delayed care, repeated lab tests, shocking bills, detrimental healthcare outcomes, medical errors, and even deaths. Using an effective, standardized patient identifier across the hospitals would be enough to eliminate such issues, but there’s a snag.

Why is patient identification such a mess?

Well, a state-funded UPI (unique patient identifier) was supposed to be created to ensure accurate patient identification, eliminating all the issues associated with mix-ups, and ensuring positive patient outcomes. Fast forward around two decades, and there’s still not a national patient identifier on the horizon.

RIghtPatient-identifies-patients-accurately-ensuring-positive-outcomes

A ban has been in effect since the beginning – Section 510 of the Labor-HHS Appropriations bill restricts the use of federal funding to allow HHS (the US Department of Health and Human Services) from creating or adopting a unique patient identifier.

For the past twenty years or so, healthcare providers have been struggling with patient identification errors and as a result, are experiencing duplicate medical records, overlays, detrimental healthcare outcomes, lower scores, denied claims, and more. Moreover, medical identity theft can be prevented in real-time if patients can be properly identified during registration.

While it has been an overlooked issue, patient misidentification has been causing adverse outcomes during the pandemic – repeated testing, medical errors, lost results, and so on. Imagine if a COVID-19 test result was sent to the wrong person and they were admitted into the isolation wing! 

What healthcare providers are doing

Every year, healthcare providers and experts come together to urge Congress and the Senate to abolish the ban so that a unique patient identifier can be made. Unfortunately, they’ve been turned down every year, leading to another year of struggle.

However, responsible healthcare providers are not waiting around for a unique patient identifier – they are implementing effective solutions to prevent mix-ups, the most feasible one being RightPatient.

RightPatient ensures positive patient outcomes

RightPatient is a touchless biometric patient identification solution that has been helping responsible healthcare providers for years. It uses the patients’ faces to verify their identities and provide accurate medical records within seconds.

After appointment scheduling, patients need to provide a selfie and a photo of their driver’s license. RightPatient automatically compares the photos for a match, verifying patient identification remotely. New patients are provided with biometric credentials for future use. It locks the medical records with patients’ photos to prevent mix-ups. Moreover, the platform is flexible enough to be used at any touchpoint, making it ideal for telehealth sessions too. 

Within hospitals, the patients only need to look at the camera – the platform compares the live picture with the one saved with the EHR. The accurate medical records are provided within seconds, ensuring positive patient identification, enhancing healthcare outcomes, and preventing medical errors and all other issues associated with misidentification. Moreover, it can red-flag fraudsters who try to assume patients’ identities, preventing medical identity theft in real-time.

RightPatient is the most feasible patient identification solution currently because it is contactless – leading to a more hygienic environment and reducing infection control issues, something which is crucial for COVID-19.

Even if the UPI gets approval in the future, it will take years for it to be created, implemented, and be effective. Forward-thinking caregivers will thus be coupling it with an experienced patient identifier like RightPatient to ensure immaculate identification across the care continuum.

Healthcare providers such as Baptist Health South Florida, MediSys Health, Grady Health, and Catholic Health Services of Long Island have been using RightPatient to ensure positive patient outcomes, eliminate misidentification, and ensure patient safety across their facilities.

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2021’s Patient Safety Goals Show that Patient Identification Is the Topmost Concern

This has been a devastating year all around for the entire world due to the COVID-19 pandemic and its effects. Even though there have been a lot of issues within the US healthcare system that surfaced during the pandemic, one of the more prominent problems healthcare providers faced (and are still facing) is patient identification errors. Experts have talked about and how patient misidentification is detrimental to both patient safety and quality healthcare. Thus, it isn’t surprising that improving the accuracy of patient identification takes the top spot of 2021’s patient safety goals as per the Joint Commission.

RightPatient-can-help-achieve-patient-safety-goals

Let’s take a look at the new goals set by the Joint Commission, why improving patient identification can help achieve the other goals, and how RightPatient can help healthcare providers.

Patient safety goals for next year

The Joint Commission outlines the top patient safety concerns that healthcare providers must address each year based on available information. Patient identification has been on the list almost constantly because errors can cause a lot of adverse effects for patient safety, healthcare outcomes, hospitals’ finances, etc. – more on that later.

Let’s take a look at the national patient safety goals for the upcoming year 2021:

  • Identify patients accurately.
  • Improve staff communication.
  • Safely use medicines.
  • Reduce patient harm by improving clinical alarm systems.
  • Reduce hospital-acquired infections.
  • Identify patient safety risks within the healthcare facility.
  • Prevent surgical mistakes.

While these are different issues, some of these patient safety goals can be met, or at least the unwanted incidents can be reduced, by ensuring accurate patient identification with RightPatient.

How patient identification ties in with other patient safety goals

While patient identification errors might seem trivial to some, there have been many complaints about the different problems which were consequences of misidentification – not finding the accurate medical record, delays in care, repeated tests, etc. As a result, many healthcare experts are clamoring for the mythical national patient identifier once again this year. However, national patient identifier or not, patient identification must be accurate to mitigate patient safety issues. Moreover, by ensuring accurate patient identification, other patient safety goals can be met – let’s explore how.

Patient-safety-can-be-improved-with-identifying-patients-accurately

Improving staff communication

Communication is crucial for ensuring improved healthcare outcomes and reducing patient safety incidents across the care continuum. By ensuring that patient data is accurate and consistent, it will enhance outcomes, as most patient safety incidents occur when patient data is corrupted, fragmented, obsolete, or inconsistent.

When patients are accurately identified every time at any touchpoint across the hospital, it helps maintain patient data integrity, ensures that the correct information regarding the patient is used, leading to accurate test results being passed to the appropriate personnel at the right time.

Safely use medicines

Many patient safety incidents occur because of simply giving the wrong patients the wrong medicine, incorrect doses, and/or at the wrong time, leading to preventable medical errors. While clearly labeling and rechecking do help, many medical errors occur because of patient misidentification. For instance, if the patient is misidentified right from registration, rechecking the name or information won’t help, as it belongs to someone else entirely.

If patients are accurately identified from the start, not only will patient misidentification be eliminated, but medical errors will be prevented too, enhancing patient safety and improving healthcare outcomes in the process.

Prevent surgical mistakes

This is somewhat related to the previous point, but medical record mix-ups do lead to the wrong surgeries being performed as well. If the patient is misidentified during registration, rechecking won’t help, as it will lead to the wrong surgery being performed on the wrong patient. 

Only by identifying patients accurately at the front-end can mistakes such as patient record mix-ups be prevented effectively.

Reduce hospital-acquired infections

Now, how can patient identification reduce hospital-acquired infections (HAIs)?

Well, as there is no standardized patient identifier present in the US healthcare system, many caregivers are using different solutions to fit their needs. However, many of these solutions can be ineffective and are touch-based, which is a major challenge, given the pandemic. These touch-based solutions can lead to infection control issues, as they require contact by multiple individuals. If an infected person uses it, the subsequent patients will be infected as well, leading to a disastrous situation.

However, many caregivers are using innovative solutions such as RightPatient – a touchless biometric patient identification platform. It uses the patients’ photos to ensure that the patients are who they claim to be, preventing patient identification errors, mix-ups, duplicate medical records, and more. It can also be used across any touchpoint, starting from appointment scheduling.

How RightPatient works – improving patient safety

Patients need to provide a selfie and a photo of their driver’s license – the platform automatically compares them for a match, remotely verifying their identities. During inpatient visits, the patients only need to look at the camera – the platform provides accurate medical records within seconds after comparing the live picture with the saved one.

RightPatient thus prevents HAIs as it is a contactless solution, enhancing patient safety, improving patient outcomes, and reducing preventable medical errors across the care continuum.

RightPatient-reduces-infection-control-in-hospitals

Infection Control in Hospitals is Imperative as COVID-19 Cases Increase

COVID-19 is a phenomenon that has crippled almost the entire world. Even in those very rare countries where it didn’t infect many people, it did hurt their economies. The majority of developing countries are severely affected by the novel virus, leading to disruption in international businesses and global transactions. However, one can safely say that COVID-19 has affected America the worst – it is currently seeing huge spikes across the states, where officials are introducing new safety measures. Let’s take a look at the most recent record-breaking statistics of US COVID cases, some measures officials are implementing to mitigate its spread, and practices that will help ensure infection control in hospitals – improving patient safety and quality of care.

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US COVID-19 cases keep breaking records

Unfortunately, the US has the highest number of COVID-19 cases in the world – over 11.3 million! Moreover, it keeps on making new records: November 13 saw 184,514 new cases, according to John Hopkins University. This is in line with experts’ predictions – many stated that things will get worse during the fall. Ultimately, all of this will add to the huge amount of pressure healthcare providers are already facing – the COVID Tracking Project saw over 68,000 hospitalizations on November 13 where 6% of the patients were on ventilators and 19% in ICUs.

Needless to say, these numbers are frightening, with officials introducing measures to mitigate further spread. Let’s review some of the emergency measures introduced within some states.

Some recent measures to mitigate COVID-19’s spread

Oregon will see restrictions on gyms, restaurants, and retail stores. Virginia issued a mask mandate for anyone older than five starting on the 15th of November. New Mexico will be facing a two-week shutdown that consists of nonessential activities starting from 16th November.  Many other locations are seeing similar restrictions to ensure social distancing practices as a result of ever-increasing cases.

While these measures are in place to lower potential COVID-19 cases, infection control in hospitals must be ensured so that cases don’t spread within healthcare facilities. Let’s explore why this is important.

Why is infection control in hospitals important?

Of healthcare providers’ many responsibilities, preventing hospital-acquired infections (HAIs) has been a topmost priority for many of them. Hospitals are constantly looking to improve practices that enhance infection control and prevent HAIs. It is a crucial role of any hospital because, if not ensured, it will lead to compromised patient safety, undesirable healthcare outcomes, and create a chain of events that will jeopardize the entire healthcare facility. However, prior to the pandemic, HAIs used to be a headache of healthcare providers only; but now, contracting diseases is the concern of virtually everyone, especially those in hospitals.

RightPatient-ensures-hygiene-with-its-touchless-platform

COVID-19 has shown how effective communication can be in this day and age – any new update regarding the novel virus can be shared and seen by anyone, thanks to the internet. Almost everyone has extensive knowledge about the do’s and don’ts, and they are quite reluctant to visit hospitals since they know that’s where the COVID-19 patients are going. Thus, healthcare providers need to ensure infection control in hospitals and enhance patient safety as well as the safety of the frontline staff members. Let’s take a look at how hospitals can reduce HAIs, some of which are according to WHO, and improve healthcare outcomes as a result.

Practices to ensure infection control in hospitals

Create an effective infection control policy

The foundation of having zero to minimal HAIs is to have an effective infection control policy at hand. Healthcare providers wanting strict infection control must plan for it in advance, and this plan should contain guidelines for dealing with HAIs, identifying affected patients, locations to place the patients in isolation, and the duration of such events.

Washing hands thoroughly and regularly

While this might seem obvious at this point, it is still one of the most important practices to ensure infection control in hospitals and save lives in the process. Washing hands regularly with liquids containing antimicrobial agents for twenty seconds is a must, especially after interacting with extractions, contaminated items, blood, secretions, etc. Keep sanitizers within a short distance of each other so that patients and caregivers both have access to them. If possible, use automatic dispensers to make it a touchless and safer experience for everyone involved.

Enforce PPE usage

PPE is a term that has been tossed around since the beginning of the pandemic, and for good reason. While healthcare professionals have been using it for decades to prevent HAIs, virtually everyone uses some form of PPE nowadays to protect themselves. Unfortunately, not everyone follows best practices, which will ultimately put others at risk.

Enforcing PPE usage for everyone within a healthcare facility is a good practice, regardless of their designation. Simply putting up signs saying “No PPE, No Service” will be quite effective for patients. For the healthcare staff members, surgical masks, face shields, gloves, gowns, etc., must always be present whenever they are within the facilities.

Keeping surfaces clean

Viruses linger on surfaces for days, and keeping them clean is the best solution to prevent HAIs. We can significantly reduce HAIs by monitoring the materials and environmental surfaces that are touched frequently and disinfecting them regularly and thoroughly, such as beds, handles, etc.

Using touchless solutions that ensure infection control

While many touchless solutions will be popping up within the next few years, there is one that is already being used by many healthcare providers to prevent infection control issues – RightPatient. It is a touchless patient identification platform that uses patients’ photos to lock medical records and verify their identities. Enrolled patients only need to look at the camera – the platform matches the live photo with the saved one, providing the appropriate medical record within seconds without requiring any physical contact, and ensuring patient safety and hygiene.

Reducing-denied-claims-is-possible-with-RightPatient

Hospitals Can Reduce Denied Claims By Preventing 6 Issues

The COVID-19 pandemic has caused arguably the worst financial strain the US healthcare system has ever experienced. While all healthcare systems around the world are facing similar challenges, the US is currently witnessing the highest number of cases in the world – over 10 million people! As the numbers continue to increase, so do the losses, and healthcare providers must reduce their costs to cope with these unprecedented numbers. That being said, reducing denied claims is more crucial than ever, as they cause caregivers to lose a significant portion of their revenue. Let’s take a look at denied claims, how they affect caregivers, and six errors caregivers must avoid to improve revenue cycle within their facilities, leading to improved bottom lines.

Reducing-denied-claims-is-possible-with-RightPatient

What are denied claims?

While this is a common term heard within healthcare facilities, many still don’t understand how much loss can be incurred for any given healthcare provider. To put it into perspective, Change Healthcare stated that denied claims can cost around $4.9 million on average for any hospital. But what are claim denials?

Simply put, denied claims are those that are classified as unpayable by the payers (insurance companies) after they receive the process them. Claim denials often occur because there’s some form of error present within the claim that becomes apparent after processing. Issues such as missing information, sending the wrong information, and non-covered services are the common reasons why claims are denied. However, there’s another form known as a rejected claim.

When one or more issues are detected within a claim even before it was accepted or processed by the insurance company, it is classified as a rejected claim. Coding errors and mismatched procedures are the most likely causes that lead to such claims.

How do denied claims affect healthcare providers?

Claim denials are a massive pain point for healthcare providers as they decrease already razor-thin margins, significantly increase collection times and reimbursement, and consume valuable resources such as FTEs (full-time equivalent).

As we can see, claim denials significantly affect a hospital’s bottom line. Moreover, while 63% of claim denials can be recovered down the line, the administrative costs are a nightmare – $118 per claim. Thus, it’s better to avoid denied claims right from the beginning.

That being said, let’s take a look at the top six issues that lead to claims being denied.

6 issues to avoid that can help reduce denied claims

Absence of information

One of the most common mistakes that lead to claim denials is sending inadequate information to the insurance company. Even the smallest details such as date of surgery, date of onset, demographic information, etc., are liable to classify claims as unpayable.

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Issues with coding

Using an obsolete codebook or incorrect codes is a common mistake that leads to claim denials, as they cause revenue leakage.

Insufficient documentation occurs when there are missing elements required for the services billed, and it is extremely crucial to prevent them. Thus, immaculate documentation is critical to prevent legit claims from being converted to denied ones. If proper documentation is not present when coding and submitting claims, then insurance companies classify them as denied because they consider that the services were not performed.

Duplicate bills

Duplicate claims are quite common and are usually attributed to human errors. These occur when the revenue cycle staff forgets to remove a claim from the patient’s account after resubmitting the claim. However, as claims processing systems consist of tools that help detect duplicate ones, the systems flag and classify the anomalies as either suspect duplicates or exact duplicates. As the entire healthcare process is quite complex in nature, it might lead to original claims appearing as duplicate ones – resulting in a claim denial.

Simply preventing duplicate claims is not enough. Properly coding the billed service with required modifiers and documentation is crucial to help identify the bill as original and not as a duplicate.

Not filing claims at the right time

Various rules and regulations must be followed regarding claims and failing to do so will result in even legitimate claims being denied. For instance, the Affordable Care Act reduced the deadline window for submitting Medicare claims to 12 months from 15-27 months after the date of service.

Not verifying coverage eligibility for the services provided

Healthcare insurance is quite volatile, leading to constant changes. As a result, it is crucial to check eligibility every time services are provided to the patients. While this might seem like a tedious task, it will help save a significant amount of money down the line.

Whenever a patient comes in for healthcare services, it is essential to check whether the coverage is still in place (read: not terminated), the service provided is covered by the plan, and the cap has not yet been reached. However, a healthcare provider can cover its services using plans with a cap as long as it follows provided guidelines meticulously and provides the required documentation. 

Patient identification errors

One of the biggest problems that leads to claim denials is patient identification errors. Imagine this: if a patient is not accurately identified right from the start, the claim will be filed against the wrong medical record and the insurance company may ultimately classify it as denied. To ensure that claims are not denied and are processed smoothly, patient identification is a must. That’s where RightPatient can help.

RightPatient is a touchless biometric patient identification platform that locks patients’ records with their photos – protecting patent data. It can even remotely identify patients, making it ideal to be used across the care continuum and any touchpoint.

After scheduling an appointment, patients need to provide a personal photo and a photo of their driver’s license. RightPatient matches the photos to verify their identities, and when patients arrive at the hospital, all they need to do is look at the camera. The platform matches the saved photo with the live one, instantly eliminating any chances of the claims being denied.

Healthcare providers can reduce denied claims, optimize the revenue cycle, avoid duplicate medical records, improve healthcare outcomes, and even prevent medical identity theft with RightPatient – enhancing patient safety in the process.

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4 Strategies Hospitals Use to Prevent Medical Identity Theft Cases

The US healthcare system has been plagued with several issues over the years. The lack of price transparency, interoperability issues, sky-high prices, and the lack of a standardized patient identifier are just some of them. One of the more concerning, and increasingly common, issues is medical identity, affecting more and more healthcare providers and patients. While providers are already facing huge losses due to the pandemic, they need to mitigate them by reducing preventable costs. One viable solution can be to reduce medical identity theft cases, and doing so will bring several benefits.

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Let’s take a look at how medical identity theft happens, how common it is, and some strategies that can prevent it and mitigate losses.

How do medical identity theft cases happen?

Medical identity theft can occur in many ways, but it can usually be traced back to stolen patient information or records – a consequence of healthcare data breaches. There’s a reason why medical identity theft cases are so common: hackers are focusing more on healthcare data breaches because stealing and selling patient information is quite lucrative.

After a hospital suffers a data breach, the hacker(s) then tries to sell the stolen patient information on the black market. Unfortunately, there are many buyers available for many reasons, and they are also willing to pay high prices – up to $1000 per record!

After buying the stolen patient data, the fraudster assumes the identity of the patient. This can happen within healthcare facilities as well as during telehealth sessions (which are surging in popularity right now).

The majority of hospitals have no effective patient identifier and therefore they fail to red flag the individual, leading to medical identity theft. The scammer then illegally uses the victim’s credentials to obtain prescription drugs, medical equipment, and healthcare services, charging the victim for the services. Not only that, but since the fraudster uses the medical record, their information will be recorded within the EHR (Electronic Health Record) and can lead to patient safety issues down the line.

While that was a simple example, many complex medical identity theft cases are occurring almost daily.

Is medical identity theft common?

The numbers don’t lie –more patient records were breached in 2019 compared to the prior three years combined! Moreover, 9.7 million patient records were affected by data breaches this September. There’s no doubt that the majority of these patient records will be used for medical identity theft, as experts are also predicting a sharp increase in the near future.

RightPatient-prevents-medical-identity-theft-with-accurate-patient-identification

Hospitals must ensure that they are preventing medical identity theft cases to guarantee patient safety and reduce associated litigation costs. Let’s take a look at some strategies that can help prevent medical identity theft and all of its consequences.

4 strategies hospitals can use to prevent medical identity theft cases

Follow the rules and regulations

First and foremost, the healthcare facility must ensure that they are properly following the rules. For instance, HIPAA mandates that there should be some technical, administrative, and physical safeguards present to protect patient information, known as PHI (Protected Health Information).

While this might seem like a straightforward strategy, a lot of healthcare providers fail to ensure HIPAA compliance. This not only leads to data breaches and medical identity theft down the line, but also incurs HIPAA penalties. HIPAA itself is a multi-layered and complex law that requires continuous effort to ensure compliance.

Fortunately, healthcare organizations can use HIPAA Ready, a robust HIPAA compliance software, to reduce the administrative burden. It streamlines HIPAA compliance, ensures training management, keeps all the HIPAA-related information in a centralized location, and also helps conduct internal audits. 

By ensuring HIPAA compliance, healthcare organizations can detect security gaps and address the vulnerabilities, mitigating data breaches and, in turn, medical identity theft.

Devise a policy to enhance security

As previously mentioned, HIPAA has several requirements and requires that networks and devices are secure at all times. To do that, hospitals must come up with and follow a strict device policy so that sensitive patient information is not leaked inadvertently. While a BYOD (bring your own device) practice might be more flexible, it will inevitably lead to data breaches and leakage of sensitive information.

Thus, the following tips will help enhance security:

  • Only allow official devices for storing sensitive information
  • Only allow logging into secure networks
  • Encourage usage of VPN
  • Ensure data encryption at all times
  • Keep logs of access requests to track any suspicious activity

Train employees regularly

Staff members such as registrars and nurses are the ones who regularly access patient data. Training them will provide them with the knowledge to avoid suspicious emails, as that is the primary weapon of hackers. Moreover, providing regular training – especially if it includes information on recent data breaches – can be beneficial. As previously mentioned, HIPAA Ready can help with training management.

Ensure accurate patient identification

Even if a data breach occurs, medical identity theft can be prevented if healthcare providers can red flag the fraudster during identity verification. That is exactly what RightPatient does.

 

RightPatient is the leading touchless patient identification platform used by several caregivers. It verifies identities by using patients’ photos. After scheduling appointments, patients need to provide a personal photo and a photo of their driver’s license. The platform matches them and verifies their identity remotely, red-flagging fraudsters. This system is ideal for telehealth sessions.

During inpatient visits, the scammer is red-flagged when the platform identifies that their face does not match the saved photo attached to the medical record, preventing medical identity theft in real-time.

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How to Improve Patient Safety and Add Millions to Hospitals’ Bottom Lines

The US healthcare system has been having a tough time for many years due to several issues, but the pandemic arguably tops all of them. It has damaged everything, leading to the cancellation of regular healthcare services in order to aid COVID-19 patients. While COVID-19 cases had decreased over time, cases are rising across many states in the US. The American Hospital Association (AHA) also predicted that healthcare providers will face losses of at least $323 billion this year due to the novel virus. As caregivers are facing these challenges, as well as lower reimbursements, they can save significant costs and add millions to their bottom lines if they improve patient safety. Let’s take a closer look at the losses, what caused them in the first place, and how patient safety can be improved.

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What contributed to the losses?

In short, a variety of factors contributed to the unfathomable losses. However, the key factors were elective procedures being canceled or postponed, drastically lower patient volumes, and high costs due to the surge in demand for crucial materials such as PPE (personal protective equipment). All of these were necessary so that caregivers could treat COVID-19 patients.

The losses didn’t stop there, which forced many healthcare providers to resort to cost-cutting strategies. Furloughing, laying off employees, restructuring the organization, introducing pay cuts, and even shutting down departments or entire healthcare facilities were just some common strategies seen during the pandemic. Unfortunately, there’s more bad news.

Hospitals are receiving lower reimbursements for treating uninsured COVID-19 patients. It was estimated that the reimbursements might total from $13.9 billion to $41.8 billion. However, around $881 million has been provided at this point. Moreover, CMS will fine half of hospitals next year as these hospitals readmitted patients too frequently. From every angle, hospitals are facing the worst financial strain in decades. Thankfully, these losses can be mitigated significantly if healthcare providers improve patient safety within their facilities with RightPatient.

How can RightPatient improve patient safety?

Ensures a hygienic environment

One aspect that makes RightPatient different from other patient identifiers is that it is touchless. The platform uses the faces of patients to verify their identities. In healthcare facilities, all a patient needs to do is look at the camera – the platform matches the saved photo and the live one for verification, making it a hygienic and safe experience for everyone involved.

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Prevents medical identity theft

By identifying patients accurately across the care continuum, starting from appointment scheduling, RightPatient ensures that patients are who they claim to be and not some fraudster. After scheduling an appointment online, patients receive an SMS/email instructing them to provide a personal photo and a photo of their driver’s license – RightPatient does the rest. It red-flags any anomalies when it sees that someone else is assuming the patient’s identity, preventing medical identity theft in real-time.

When a scammer uses the victim’s medical record, it is contaminated with their data, rendering it dangerous, fragmented, and inconsistent. If such cases are undetected, they severely hamper patient safety and impact healthcare outcomes. Thankfully, RightPatient can prevent such cases and improve patient safety along the way.

Prevents duplicate medical records

Duplicate medical records are quite dangerous, as they lead to treatment based on incomplete and inaccurate medical data, creating incidents that hamper patient safety. RightPatient identifies patients right from the start, avoiding duplicates and overlays.

Protects patient data integrity

Patient data is useless and dangerous if it is corrupt, and such cases increase when patient misidentification is common. RightPatient eliminates patient misidentification and helps improve patient safety by using the most appropriate characteristic to identify them – their faces.

Reduces medical errors

Medical errors occur on a regular basis. In fact, a John Hopkins study claimed that each year, over 250,000 American patients lose their lives due to medical errors, whereas others claim the number to be above 440,000. This would make medical errors the third leading cause of death in the US, and as most of these errors stem from something as simple as patient identification issues, those deaths are preventable.

Imagine this – when a patient walks into the hospital, the registrar needs to identify their accurate medical record. However, if the wrong medical record is chosen, even if it is a duplicate medical record of the same patient, the treatment will be based on obsolete or incomplete information – even a single medication can severely hamper the patient’s outcome. RightPatient prevents these cases and eliminates preventable medical errors associated with misidentifications. 

RightPatient can improve patient safety and mitigate losses simultaneously

RightPatient does all of the above and more – it reduces denied claims, litigation costs, and eliminates the costs associated with preventable medical errors. Leading caregivers have already experienced how useful RightPatient is and reduced losses significantly. Use RightPatient now to be a responsible caregiver and enhance patient safety, all while boosting your bottom line.

RightPatient-ensures-hospital-readmission-prevention

Hospital Readmission Prevention is a Must as CMS Fines Half of Hospitals

The US healthcare system is in an unfortunate state – it just can’t seem to catch a break. While it was already coping with a number of issues – such as medical identity theft, the lack of price transparency, interoperability issues, and healthcare data breaches, among others – COVID-19 hit it hard. As a result, healthcare providers across the US are facing huge losses. With increasing COVID-19 cases across the States and with experts predicting even more during the fall, healthcare providers received yet another blow. CMS (Centers for Medicare & Medicaid Services) will fine about half of hospitals due to readmissions of Medicare patients, although this is for the pre-pandemic period and therefore COVID-19 cannot be held accountable for the lower payments. Let’s take a look at the numbers, how this will affect the hospitals further, and how hospital readmission prevention can be achieved with a proper patient identity verification platform.

RightPatient-ensures-hospital-readmission-prevention

CMS will lower payments

While it’s already been quite a harsh year for healthcare providers, it’s about to get worse. Many caregivers are resorting to cost-cutting strategies by laying off employees, furloughing them, or even shutting down; however, the lowered payments will only add to the unprecedented costs.

Some numbers surrounding the penalties

During the fiscal year 2021, CMS will fine 2,545 hospitals due to increased Medicare patient readmissions that occurred within 30 days. The penalties were based on patient data ranging from July 2016 through June 2019. A staggering 83% of the hospitals received penalties, and they will be facing payment cuts as high as 3% per Medicare case during 2021. 39 caregivers will face the maximum penalty next year, which is an improvement over this year, when the number of hospitals hit with the maximum penalty was 56. However, with the pandemic disrupting everything, hospitals will lose more than ever. As a result, hospital readmission prevention becomes a topmost priority.

Why is the program important?

This is the ninth year of the Hospital Readmissions Reductions Program, and it has been created to improve patient care quality while lowering overall costs. As previously mentioned, it takes into account the readmissions of Medicare patients that occur within 30 days. While CMS is considering a suspension of the penalty program due to COVID-19, the penalties are still in effect this year.

Improve-patient-outcomes-and-reduce-readmissions-with-RightPatient

Some exceptions

Congress has exempted 2,176 hospitals out of the 5,267 from penalties due to a number of reasons. The hospitals exempted are either:

  • Critical access hospitals,
  • The only inpatient facility in the area,
  • Hospitals specializing in long-term care, children, veterans, or psychiatric patients.

What the industry thinks about hospital readmission prevention

While many participants within the US healthcare system have voiced disapproval regarding the penalty program, others have said that, while not perfect, the Hospital Readmissions Reductions Program is useful – it pushes caregivers to find innovative solutions to provide better quality care. 

The penalties will further increase hospital losses

Moreover, as healthcare providers are already facing huge losses due to the pandemic, they need to ensure hospital readmission prevention if they want to survive in the long run. Several hospitals are heavily relying on CMS reimbursements, and if they can reduce readmissions, it might help them survive the pandemic’s financial strain. By improving patient safety and quality of care, hospitals can significantly lower readmissions. Fortunately, RightPatient can help with that.

RightPatient enhances hospital readmission prevention

RightPatient has been helping leading healthcare providers with its touchless patient identification platform for years. It ensures improved healthcare outcomes by eliminating one of the most overlooked problems within hospitals: patient misidentification.

Patient misidentification leads to duplicate medical records and overlays, jeopardizing patient safety. Moreover, it provides the wrong medical records to caregivers, resulting in negative healthcare outcomes. Naturally, these are the patients who are readmitted within hospitals frequently. So, how does RightPatient help?

It locks the medical records of the patients using their photos during registration. Patients receive an SMS/email after they schedule appointments, and they are required to provide a personal photo and a photo of their driver’s license. RightPatient compares the photos for a proper match, eliminating any chance of misidentifications. All of this is done without requiring the patients to touch any foreign objects, eliminating infection control issues – something that is crucial during and after the pandemic.

Reduce patient readmissions, improve healthcare outcomes, and ensure patient safety with RightPatient – contact us now to learn how we can help you.

Preventing-wrong-patient-errors-is-possible-with-RightPatient

Preventing Wrong Patient Errors Can Mitigate Hospitals’ Losses During the Pandemic

The US healthcare system has been facing one of its worst periods in decades due to the pandemic. Not only does the US have the highest number of COVID-19 cases in the world, but because of this – as well as the cancellation of elective procedures, regular appointments, etc. – its healthcare system is also facing unprecedented financial strain. AHA has estimated that $323 billion will be lost this year – can you believe that? In order to cope with this financial strain, providers are having to lay off employees, close down facilities, introduce furloughing, and some are even shutting their doors permanently. But are these cost-cutting strategies enough, or should providers also look into improving other areas that can help mitigate losses, such as reducing wrong patient errors? Let’s explore some of the recent losses incurred by hospitals, how some of them are trying to cope with it, and how upgrading the patient identity verification process can significantly reduce costs.

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Consequences hospitals are facing due to the pandemic

M Health Fairview will lay off 900 and more

The health system stated that 16 of its 56 clinics in Minnesota and Wisconsin will be closed, it will shut the doors of its 90-bed Bethesda Rehabilitation Hospital, and will also reduce some of the services it offered at St. Joseph’s Hospital. Moreover, neurology and bariatrics, as well as other specialties, will be moved to other facilities, and it will also close the doors of St. Joseph’s ED at the end of 2020. All of this is being done to cope with the financial losses that the pandemic introduced – around $250 million – leading to the layoff of 900 employees.

Saint Luke’s Health System will close 2 hospitals

Missouri’s Saint Luke’s Health System has made the hard decision to close down two of its community hospitals at the end of this year. While it has been reported that it’s being done to streamline services, these hospitals have seen lower patient volumes – a direct result of the pandemic. They’ve also stated that the hospitals are being closed to help deal with the pandemic more efficiently. 

Wellforce laid off 232 employees

Wellforce, located in Massachusetts, laid off 232 employees due to the losses caused by the pandemic. Quite naturally, some of its facilities faced huge reductions in patient volume, leading to an operating loss of around $32 million. Prior to that, the health system had opted for furloughing over 700 employees and introduced pay cuts for others. It even subsequently culled many of the affected employees, ultimately laying off 232 of them.

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Why these techniques might not work

While healthcare providers are doing everything they can to offset the losses caused by the pandemic, it’s clear that strategies like pay cuts, furloughs, or laying off employees will not be enough, and may have undesirable consequences for the future.

For instance, when potential employees see that a hospital is laying off its employees, they’ll lose faith in it and apply at other workplaces. As a result, hospitals will lose out on talented individuals. Many are even laying off their topmost officials – it might be hard to find someone else to fill that position when the candidates see what happened to their predecessor!

Moreover, even after implementing such cost-cutting strategies, many are still having to resort to others as well – look at Wellforce, for instance. While these strategies might reduce costs, what about reducing costs by eliminating other financially significant issues, such as wrong-patient errors?

Preventing wrong patient errors can reduce more costs than you think

Patient identification errors have always been a huge issue within the US healthcare system. Especially during the pandemic, it is now causing more errors than ever – wrong patient data, mix-ups, and inaccurate healthcare outcomes are some of the unfortunate consequences.

Incorrectly identified patients lead to more duplicate records, preventable medical errors, litigation costs, denied claims, and more – all of these cause hospitals to lose a lot of money. Moreover, if caregivers don’t have an effective patient identifier in place medical identity theft cannot be detected in real-time, which leads to significant costs down the line. 

Looking to the future, healthcare providers will need to ensure CMS (Centers for Medicare/Medicaid Services) compliance by supporting e-notifications by May of 2021. If the facilities are suffering from wrong-patient errors, the caregivers will lose out on CMS reimbursements in the future.

It’s quite clear that preventing patient identification errors is a feasible strategy to reduce costs, but how should caregivers do so?

RightPatient effectively prevents wrong patient errors

RightPatient has been the touchless patient identification platform of choice for several caregivers. By confirming patients’ identities using their photos, RightPatient ensures that all the issues associated with patient misidentification are eliminated. Even medical identity theft can be prevented – fraudsters are flagged when they face its verification process, reducing significant costs for providers and enhancing patient safety.

Contact us now to learn how we can help mitigate your losses and ensure accurate patient identification across the care continuum.