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.

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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 to Optimize Revenue Cycle in Healthcare and Mitigate Losses

The US healthcare system has been going through a rough patch for a number of years now. When one problem is solved, other critical issues arise. However, with all these preexisting issues, it is now facing its biggest challenge in decades: COVID-19. With patients postponing regular visits and elective procedures, COVID-19 has created a severe financial strain and plunged hospitals and health systems into unprecedented losses. While hospitals are having to cope with these losses by closing down emergency departments, laying off employees, and so on, they can significantly reduce costs by focusing on their revenue cycles. Let’s explore why revenue cycle in healthcare is crucial, some strategies to optimize it, and how positive patient identification can help significantly.

RightPatient-helps-optimize-revenue-cycle-in-healthcare-and-facilities

Why is revenue cycle in healthcare important?

Revenue cycle management is one of the most crucial aspects of any given healthcare provider. In a nutshell, it is the series of events that starts when a patient schedules an appointment and ends when the provider receives payment and is reimbursed. Since it’s related to patient service revenue, it has a direct effect on any hospital’s bottom line. 

If a hospital’s revenue cycle is optimized, then it will face higher margins, and if not, it will face significant losses. Complications such as billing and coding errors, patient misidentification at the front-end, and miscommunication lead to denied claims and delayed payments. In the end, patient volume won’t matter if a hospital takes a long time to capture the revenue or faces denied claims. Thus, optimized revenue cycle in healthcare facilities is extremely important if hospitals want to continue to operate in the foreseeable future.

4 Strategies to optimize revenue cycle management

Improve front-end and back-end collaboration

The front-end consists of activities where the hospital’s staff members interact with the patient directly: patient information collection, appointment scheduling, eligibility, verifying insurance coverage, upfront patient collections, and registration of new patients are just a few examples.

The back-end, on the other hand, consists of medical billing, claims management, denials management, as well as the collection of final “patient financial responsibility”.

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Usually, when it comes to revenue cycle management, most healthcare providers have their front-end and back-end tasks separated. However, collaboration between the two can significantly improve revenue cycle management. Effective and seamless communication is the key, and if that can be facilitated between the front-end and back-end teams, then it will result in faster, more accurate, and improved collections.

Improve front-end activities

According to a recent webinar, half of denied claims incurred by hospitals can be traced back to front-end activities, with the top contributors being registration and eligibility issues. These ultimately cause issues at the back-end of the revenue cycle in healthcare facilities, and the caregivers are forced to allocate significant resources such as FTEs (full-time equivalents) to fix billing and coding errors. If the front-end issues are not addressed, then this will lead to an endless cycle of lower productivity and an unoptimized revenue cycle.

If the front-end processes can be improved by preventing common errors such as patient misidentification or missing patient information, then issues like claim denials, underpayments, and lower productivity of the FTEs can be vastly reduced. Automating the front-end workflow is just one step towards improvement – but more on that later.

Adopt revenue cycle automation 

Revenue cycle automation is becoming more popular within the healthcare space, and for good reason. It leads to a significant reduction in the pressure that is put on healthcare professionals, reduces avoidable errors, and streamlines the entire process. However, organizations have to be cautious in their search for an effective automation tool.

Identify patients accurately

The most prominent issues that cause revenue cycle inefficiencies are patient identification errors, duplicate medical records, and medical record mix-ups at the front-end. If the accurate medical record isn’t identified, then the subsequent processes will be riddled with errors, leading to denied claims. Hospitals lose a huge amount of money – around $4.9 million – due to denied claims, many of which can be traced back to patient identification errors. Thus, revenue cycle in healthcare can be optimized if patient misidentification, duplicates, and mix-ups can be eliminated. This is exactly what RightPatient does.

RightPatient is a touchless patient identification platform that is used by several healthcare providers. It uses the patients’ photos to verify their identities, eliminating misidentification, avoiding duplicates, and preventing mix-ups at the front-end.

New patients need to take a photo during registration, locking their medical records with it. Enrolled patients only need to look at the camera – the platform identifies the patients accurately by matching the photos and provides the appropriate medical records within seconds. 

By eliminating misidentification, mix-ups, and duplicates at the front-end, RightPatient ensures that the accurate medical record is used across the care continuum, eliminating denied claims, boosting bottom lines, and enhancing patient safety in the process.

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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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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.

Patient identification helps improve revenue cycle

Hospitals Can Improve Revenue Cycle With Positive Patient Identification

The importance of digitization in healthcare delivery is becoming inevitable. As medical institutions and hospitals try to deliver a more value-based care environment, the RCM (revenue cycle management) has become more critical. According to HFMA/Navigant analysis, healthcare revenue cycle leaders are willing to invest more in technologies that will boost their revenue integrity, eliminate human error, and increase productivity in the future. All in all, they are targeting to improve the revenue cycle. 

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According to a report from Sage Growth Partners, one-third of healthcare providers have confronted more than $10 million in outstanding debt every year. Every year up to $125 billion is lost due to unpaid bills and underpaid claims, and the situation is nowhere near improving. As a result, more healthcare providers are demanding revenue cycle managers to revamp and automate their processes. 

Understanding the process flow

To understand how to improve revenue cycle management, we should know that it is usually divided into two separate parts, the front-end and the back-end process. The front-end revenue cycle management deals with patients directly. For example registering new patients, collecting information for patients, and confirming insurance eligibility and coverage. The back-end involves dealing with claims management, denial management, medical billing, and ultimate patient financial responsibility collection.  

Even with all the innovative ideas the RCM managers are putting into effect, healthcare organizations are still worried about:

  • Decreasing cost to collect
  • Providing quality patient experience
  • Reducing initial denial rates, which have gone up in both public and private organizations
  • Concerns about increasing out of pocket costs from consumers, which leads to payments being held up, delayed care, and uncollectible receivables. 

What can be done?

Instead of reaching out to professional RCM vendors, the healthcare providers and medical institutions can solve the problem with proper patient identification. The first essential step which helps to improve revenue cycle and reduce denied claims is to identify the patients accurately and bill them accordingly. Let’s look at the solution and the possible gains from this solution. 

RightPatient – Biometric Patient Identification Platform

A biometric patient identification platform such as RightPatient is a cutting-edge digital cloud technology used by many healthcare providers to address the sorts of problems mentioned above. Using biometrics has proven to be effective in identifying patients accurately.

How it works

During initial enrollment at the hospital, a patient’s biometric data like their iris or facial photos, will be used to keep their information locked and secure. Next time when the patient arrives at the hospital to avail of healthcare services, all he/she needs to do is just look at the camera, and the platform will identify their accurate medical records within seconds.

Halt denials before they start

Eliminating the problem at the front-end will ensure that you do not have to worry about back-end RCM staff dealing with denied claims. RightPatient will do that for you. Accurate patient identification from the beginning of the care will eliminate the risk of improper use of patient information, resulting in the rejection of claims. 

Who is using this solution? 

Healthcare providers such as the University Health Care System and Terrebonne General Medical Center are using RightPatient’s biometric identification platform to reduce the number of denied claims and improve their revenue cycle.  

Improve revenue cycle now

Using biometrics to identify patients has also proven to be effective in improving patient experience, reducing administrative burdens, and eliminating errors. Naturally, more time and resources can be invested to ensure the provision of quality care. Adding the front-end and back-end functions through RightPatient can help the hospital create a steady revenue cycle that responds to an evolving industry.

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Can Revenue Cycle Improvement Prevent Hospital Closures?

So many hospitals are closing their doors that it is hard to keep count nowadays. These closures happen for several reasons which we will discuss later. One of the latest ones to join this unfortunate group is Nix Medical Center, located in San Antonio, Texas. 

The 208-bed hospital once owned by Prospect Medical Holdings was acquired in 2012 and operated by Nix Health as the Nix Medical Center for 89 years.  

In addition to closing its hospital’s doors, Nix Health also had to close its home health division as well as Nix Specialty Health Center & Nix Behavioral Health Center, generating an estimated layoff of over 970 employees. 

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But why are these hospitals being closed?

Hospitals are supposed to offer health care and save lives. Thus the most important institutions in any society. So why are they being closing down? 

Well, the largest and most common reason is the lack of revenue. 

In this instance, with fewer people visiting Nix Medical Center the hospital simply couldn’t generate enough revenue to sustain it’s operational costs thus resulting in its inability to provide effective health care and subsequently closing its doors.

What to take away from this example?

Hospitals need to learn from this scenario and focus their efforts on better financial management via reducing denied claims via revenue cycle improvement. 

Known to cost any health system an average of more than $5 million each year, denied claims often occur due to mistaken billing of patients. For example, a patient visiting the hospital for a routine checkup is billed the cost for a surgical procedure and vice-versa. While this may sound peculiar you would be surprised to know just how common it is. Although 63% of initially denied claims are recoverable, they can cost as much as $8.6 billion in appeals-related administrative costs and why hospitals must find ways to mitigate such losses.

How can hospitals achieve revenue cycle improvement?

One way health systems can achieve revenue cycle improvement and lessen denied claims is by ensuring patients are correctly billed for the healthcare provided. 

To achieve this many progressive health systems are using RightPatient – a biometric patient identification platform. By implementing RightPatient, medical records are locked to each patient’s biometric data thus preventing unauthorized identity theft. 

Health systems such as Terrebonne General Medical Center and University Health Care System are already using RightPatient and are preventing medical identity theft, patient mix-ups as well as denied claims. RightPatient effectively reduces loss in revenue by ensuring each patient is billed correctly for the healthcare provided. Using biometric data, patient misidentification is also prevented. Each patient is required to register only once after a health system deploys the platform – attaching the biometric data with the EHR of the patient. Afterward, whenever that patient visits the hospital, RightPatient uses their biometric data to access their respective medical records for the previous diagnosis and prescribe the necessary treatment.

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The Top 6 Reasons to Visit us in Booth #1252 at 2017 HFMA ANI

The Top 6 Reasons to Visit us in Booth #1252 at 2017 HFMA ANI

Visit us in Booth #1252 at the 2017 HFMA ANI Conference and learn more about the benefits of biometric patient identification.

The following post was submitted by Brad Marshall, Senior Enterprise Development Consultant with RightPatient.

If you are heading to Orlando this weekend for the HFMA show, please take a moment while you are walking the Exhibit Hall to visit RightPatient in Booth #1252. We will be on hand offering demos of our biometric patient identification solution and Smart App that converts any smartphone or tablet into a powerful patient recognition device. Not convinced? Here are the top 5 reasons why RightPatient is a must stop while navigating the exhibit floor:

  1. See the RightPatient Smart App –  As we just recently discussed on this blog, the RightPatient Smart App provides healthcare organizations the ability to extend the power and reach of our patient identification solution to any smart device equipped with a camera. Using augmented reality and deep learning to identify patients, the Smart App is an ideal tool for clinicians to quickly and accurately identify unconscious patients, verify patients prior to medical procedures, improve patient safety, and securely capture and share clinical images. 
  2. Learn How to Humanize Health IT – As you may already know, the RightPatient patient ID solution captures a high resolution image of the patient’s face and then links that image to their medical record. Several of our existing customers have provided feedback on these patient photos via their clinicians who say that these pictures serve an important clinical purpose and are helping to improve the patient experience. These patient photos are helping clinicians feel more comfortable and better connected to the patient often serve as reminders about the clinical context of the patient. Learn how RightPatient is helping healthcare organizations across the country become more patient-centered than ever before.
  3. RightPatient is a Finalist in CHIME National Patient ID Challenge – We think this is kind of a big deal. Being named a finalist in this important initiative that could very well change the face of patient identification in healthcare as we know it, we recognize that being named a finalist is a true testament to the validity of our solution. It’s worth mentioning that of the finalists named, RightPatient is the only vendor that has a solution already being used in healthcare by many hospitals throughout the country. Stop by and learn why our solution was named a finalist in the Challenge. Go Team RightPatient!
  4.  Safeguarding PHI – Cybersecurity has become quite a hot topic in healthcare as we have witnessed one hospital system after another falling victim to attacks and rushing to bolster their security defenses. We are elated to see the increased emphasis placed on protecting networks but what about taking the same steps to protect data? Network security and data security are two separate areas and any upgrade to cybersecurity defenses simply must be met with commensurate upgrades to safeguard protected health information (PHI). After all, the digitization of healthcare has opened many new doors to access PHI (e.g. – patient portals, mHealth apps, telemedicine), shouldn’t healthcare organizations be proactively taking measures to implement patient ID solutions that can secure it?
  5. Learn about our SaaS model – With our software-as-a-service (SaaS) model, healthcare organizations can implement the patient ID platform for a small monthly fee that includes software, hosting, and support. And don’t worry. Our artificial intelligence system runs in the secure, HIPAA-compliant RightPatient Cloud to minimize deployment and IT costs. What could be better? Stop by the Booth to learn more.
  6. Accurate Patient ID Helps Revenue Cycle Management – Since revenue is a dominating theme of the conference, we thought we would mention that it is a proven fact that increasing patient identification accuracy will help prevent duplicate medical records, reduce denied claims, and improve the revenue stream. Stop by Booth #1252 and learn how you can improve revenue cycle management through an investment in RightPatient.

Skimming the agenda, the HFMA staff has again assembled a very compelling, highly informative conference packed with outstanding curriculum. Don’t forget that the Exhibit Hall is a treasure trove of education too, and we encourage you to take time and stop by to see why our patient identification solution is dominating the healthcare industry. 

Take a moment to watch this short testimonial video from George Ann Phillips, Administrative Director of Revenue Cycle for University Health System in Augusta, GA:

Drop us an email at: sales@rightpatient.com to pre-schedule an appointment or drop in and see us at your convenience. We can’t wait to see everyone in Orlando!

The Top 6 Reasons to Visit us in Booth #1252 at 2017 HFMA ANIBrad Marshall is a Senior Enterprise Development Consultant with RightPatient® With several years of experience implementing both large and small scale biometric patient identification projects in healthcare, Brad works closely with key hospital executives and front line staff to ensure project success.

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Patient Safety a Focal Point for Latest RightPatient Deployment

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Community Medical Centers recently implemented RightPatient to improve patient safety and revenue cycle management. (Photo courtesy: The Fresno Bee)

Working to help increase patient safety in healthcare, Community Medical Centers (CMC) in Fresno, CA knew that implementing RightPatient using photo biometrics for patient identification was a step in the right direction. With a quick snap of a camera, patients can now rest assured that their medical identities are protected and clinicians will always have the most up-to-date, comprehensive medical record in their possession during treatment and care. 

The benefits of RightPatient extend beyond protecting patient medical identities however. A recent article in The Fresno Bee that covered the deployment of photo biometrics for patient identification at CMC illustrates the negative effect that chart corrections were having at the facility and how this was impacting revenue cycle management. The article states:

“Charting errors usually are caught early, before any treatment begins, but having to move information into the right chart is time consuming and expensive: Community Medical Centers spends about $190,000 a year to research and correct mismatched charts, she said. And that amount doesn’t include the approximately $300,000 a year the hospital system has estimated it loses on accounts that can’t be billed to insurance companies because the patient identification is incorrect.” (Source: http://bit.ly/2qaFJtw)

RightPatient helps establish accurate patient identification to ensure proper billing at CMC with the potential to drastically reduce chart corrections and increase CMC’s revenue collections. This is often an overlooked benefit of implementing biometrics for patient ID in healthcare.

Take a look at the video covering the deployment of RightPatient at CMC here:

Are you seeking to improve patient safety, reduce the time and money spent reconciling chart corrections, and increase revenue? RightPatient may be the answer. Contact us today for a free demo and let us help direct you on the path of accurate patient ID so you can realize the benefits of other healthcare organizations using photo biometrics.
RightPatient for patient ID to reduce duplicate medical records

Photo Biometrics Patient Identification Testimonial – University Health Care System

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The University Health Care System implemented RightPatient to help protect patient safety and reduce duplicate medical records.

We always relish an opportunity to visit hospitals and healthcare organizations who have made the smart choice to adopt photo biometrics for patient identification. Who better to share their story about events and conditions that lead to their decision to invest in RightPatient® Cloud?

We had an opportunity to sit down with George Ann Phillips, Administrative Director, Revenue Cycle at University Health Care in Augusta, GA to ask her why the hospital decided to invest in photo biometrics to increase patient safety, reduce chart corrections, duplicate medical records, improve revenue cycle collections, and humanize health IT by linking the patient’s photo to their electronic health record (EHR). Prior to implementing RightPatient®, University’s situation was not much different than many other healthcare organizations – a desire to prevent duplicate medical records, improve patient safety, streamline registration, and improve the patient experience.

After carefully evaluating RightPatient® against other biometric modalities, University decided that photo biometrics was a smarter investment and would help them to achieve their aforementioned goals. University staff liked the fact that by capturing the patient’s photo and storing it in the RightPatient® Cloud, they suddenly had the means to identify patients at any point along the care continuum – before portal login, during telemedicine sessions, and prior to administering medication or providing any clinical service. Clinicians immediately offered positive feedback to George Ann saying that having the patient’s photo linked to their medical record was an outstanding way to personalize their approach and gave them additional piece of mind to avoid any medical errors.

George Ann also pointed out that she was much more comfortable implementing photo biometrics because it supported hospital infection control policies and did not require the patient to touch any device to avoid the risk of contracting an illness or spreading germs. RightPatient® is the only biometric patient ID solution that is contactless and the only solution that truly has the ability to identify a patient no matter where they are along the care continuum. No other biometric identification solution can claim this.

University’s return on investment (ROI) has been strong since adopting RightPatient®:

  • 20% reduction in chart corrections
  • 99% patient acceptance (54,000+ patients enrolled so far)
  • Rapid deployment expansion to physician offices
  • Positive feedback from C-suite
  • Clinicians love seeing the patient’s photo
  • Streamlined patient registration
  • Improved patient experience

Take a moment to watch the short video here:

Thank you to George Ann Phillips and Beverly Bell from University for their assistance to make this video. Please share it with a friend or colleague!

revenue cycle management in healthcare

7 Tips to Improve Your Revenue Cycle Management in 2017

7 Tips to Improve Your Revenue Cycle Management in 2017

Follow these 7 practical tips to improve revenue cycle management at your healthcare facility. (Photo courtesy of pexels.com).

The following guest post on improving revenue cycle management in healthcare was submitted by Yeshwanth HV.

Amid ever-changing regulatory environment, Revenue Cycle Management (RCM) has become one of the most important concerns for healthcare leaders in the US. Effectively managing it ensures that there will be lesser accounts receivable, fewer complications and speedy recovery of patient payment, all of which will make a healthcare practice more efficient and responsive in terms of operational changes and growth. However, effective management of the revenue cycle has proven elusive to the providers in the current healthcare landscape. The good news is there are specific ways in which you can achieve this elusive feat. Here are seven tips that will help you to effectively manage your revenue cycle:

Set Benchmarks and Measure Them

Lord Kelvin, a famous British mathematician and engineer, once said: “If you cannot measure it, you cannot improve it.” This is very true with regards to healthcare, especially if you are thinking on the lines of improving efficiency and productivity of your RCM practices.
Hence start by identifying a set of benchmarks that are most important for the success of the organization such as average time taken to submit a claim, average reimbursement rate and so on. If necessary opt to use comparative data from your competitors to keep you on the right path. Next measure the performance of your practice using the benchmarks that you have zeroed-in on and see to it that you slowly improve your performance over time.

Get the Money You Are Owed

While evaluating the performance of metrics as suggested above, make it a point that you also keep a close watch on the collection rate. Tracking this metrics helps you to make sure that you don’t leave significant amount of accounts in collections on the table, which can impact the financial stability of your practice.

An ideal RCM practice should be able to recover around 96% percent of accounts in collection. Take appropriate measures to bring your rate up to this mark or at least ensure that your collection rate is above 85 percent so that percentage of patients with outstanding bad debt will not get out of hand.

Audit Workflow

Conducting regular audit of your typical RCM workflow – from patient scheduling to final claim submission – is a great way to streamline your operations. It helps you to discover issues and inefficiencies that may be hampering your ability to process claims in an expedient manner.
But make sure that you include your frontline staff in this process by taking feedback from them about things that are holding them back. This may help you uncover crucial flaws that you may have overlooked or taken for granted.

Track Denied Claims

Tracking every claim that is denied will help you to identify trends in mistakes with regards to billing, coding and other RCM related processes. The insights gained through these discoveries can be used to train your resources and augment your RCM practices.

Look Ahead to Regulatory Changes

Rules governing healthcare are in a constant state of motion. For instance consider the last five years. First it was the Affordable Care Act (ACA), then ICD-10 implementation and now it is a possible repeal of ACA. In such an every-changing environment, it is always beneficial to make it a regular practice to stay aware of new statutes, guidelines and codes that might come your way, and be prepared with effective counters to avoid revenue cycle disruptions arising due to these changes.

Pay Attention to Self-Pay Balances

A rise in the popularity of low-premium but high-deductible plans is likely to correspond with a rise in self-pay balances. And this can pose a serious challenge to the financial stability of a practice, just like in the case of accounts in collection.
To mitigate the hurdles posed by this trend, you have to proactive and find out a way to work with individuals so that their accounts do not have to go into collection.

Make Sure Your Current RCM Practice Meets You Needs

Never take anything for granted and make it a standard practice to periodically question the value that your RCM system offers. Also make research ongoing into pricing, service offerings and the latest software systems so that when your RCM system is lagging, you are perfectly aware of things that need to be done.

The Bottom-line

Navigating through the chores of today’s healthcare landscape is not easy. To be successful in such an environment, healthcare practices should be prepared to undertake a transformational RCM approach that focuses on improving the function as well as the flow of each moving part.

Author Bio: Yeshwanth HV is a healthcare writer at MedBillingExperts, a leading provider of healthcare business process outsourcing services such as medical billing, medical coding and revenue cycle management services to medical practitioners and healthcare organizations worldwide. Dedicated towards the healthcare industry, he has authored several blogs and articles that have received rave reviews in the industry. Prior to MedBillingExperts, Yeshwanth worked with CIO Review and has authored several bylined pieces for the quarterly editions of the magazine.