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5 Strategies That Can Rebuild Revenue Cycle for Healthcare Facilities

May 27, 2021/7672 views / 0 Comments/in BLOG, Data Integrity, Denied Claims, healthcare, Medical Record Mix-ups, Patient Data, Patient Experience, Patient Identification, Patient Outcomes, Patient Safety, Revenue Cycle Management /by Matt Gibson

As the pandemic wanes, at least for now, many businesses are rebuilding. The US healthcare sector is no exception, picking itself up and dusting itself down gingerly, preparing to welcome back patients and see an uptick in revenue again. Working on the revenue cycle for healthcare providers has never been more important.

For some hospitals and departments, it’s already too late – the pandemic forced them to close. Others are hanging on, with staff returning from furlough and machinery being switched on and recalibrated for the first time in over a year. As more people are fully vaccinated, it becomes simpler to see patients in person again, which will lead to the increase in revenue the healthcare sector badly needs. However, it’s not all plain sailing. Providers could still lose over $120 billion this year, so it is vital to be careful with any attempts to ramp up income. The fewer denied claims there are, the better the bottom line will be. That being said, let’s take a look at some strategies that will help optimize the revenue cycle for healthcare providers.

5 strategies to enhance revenue cycle for healthcare providers

Check the existing revenue cycle management processes

The first option is to see whether any immediate improvements can be made to the existing system. This will be down to the back-end developers and IT specialists and will not be visible to patients. After that, it’s time to look at the patient-facing part of the cycle. Ensuring staff members are fully trained in customer service is a good place to start with optimizing revenue cycle management. That way, they will know what questions to ask when registering or checking in patients and how to check their insurance, treatment codes, and eligibility. They will know how long to allocate for different types of appointments and when to ask for immediate payment.

Use technology to your advantage

The easiest way to ensure that everything runs smoothly is by identifying patients accurately right from the start of the treatment process. This could be done using a patient identity verification platform such as RightPatient that eliminates the need for asking patients questions, patient record mix-ups, and more, reducing denied claims in the process.

That was just one example – optimizing the revenue cycle for healthcare providers is not difficult, it just needs a bit of help at times. Technology can be that hidden assistance.

Prompt, correct coding, and billing is key

An organization should not expect prompt payment if its internal processes are lax. Ensuring accurate coding and billing leads to lower chances of denied claims. Complete elimination of denied claims is impossible, because of some uncontrollable factors, but rigorous checking of coding will, in turn, generate accurate bills which are more likely to be agreed on the first time by the insurers.

Utilize up-front collection

If possible, the up-front collection is the best way to optimize the revenue cycle for healthcare providers. This eliminates an entire step in the revenue collection process, as the bill does not need to be seen by accounts receivable at all. Instead, it lands on the collected revenue team’s side for processing. While this approach will not work for every patient, it can be an effective tool for immediate revenue generation.

Accurate patient identification underpins everything

Well-trained staff members are likely to know exactly how to identify a patient and take payment politely using a fast processing system, but the whole thing falls if the patient’s identity is incorrect on the system, or if changed details are input wrongly. Denied claims are annoying and time-consuming to rectify. There are ways in which technology can help minimize the chances of this happening, however.

Getting the patient’s identity and billing details correct from the first interaction with them makes things so much smoother. It prevents duplicate medical records and overlays, for a start. If a patient only has one EHR, there is little to no chance that the insurer will find fault with the claim and so will settle the amount faster. Denied claims cost millions of dollars for every provider, often due to poor electronic health records and a lack of robust identity checks. Incorrect patient identification puts the patients at risk too.

One of the most innovative ways of ensuring accurate patient identification from the get-go is by using RightPatient. This touchless biometric patient identification platform is being used by several healthcare providers and has several benefits. It allows patients to identify themselves even in virtual consultations and during in-person visits, all they need to do is look at the camera, meaning that they don’t have to run the risk of others overhearing sensitive personal data when checking into a clinic. Nor do they have to use touchscreens or keypads to enter information – making it hygienic and safer than ever.

RightPatient is the solution that ensures accurate patient identification, reduces denied claims, duplicate medical records, and ensures fast billing.

How to Improve Healthcare Outcomes and Reduce Readmission Rates

May 23, 2021/6754 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, Medical Identity Theft, Medical Record Mix-ups, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Improving a patient’s outcome (for instance, their quality of life or life expectancy) is obviously the prime reason for treating them. Patients approach a medical professional with the hope of ‘being cured’ of whatever ails them, whether that’s by being prescribed medication to ease symptoms or having an operation or procedure to relieve pain or remove or transplant a body part to offer a better quality of life. When they are paying for their treatment, they have every right to expect that their life is better afterward. Hospitals that do not achieve the required levels of treatment outcome are routinely penalized, thus, they need to improve healthcare outcomes. These levels are measured by readmission rates. On average, over 2,500 hospitals are likely to be penalized because of their monthly readmission rates, even though the pandemic will have increased the chances of some patients having to be readmitted.

Improve healthcare outcomes with an effective patient identification platform

However, there are some very simple ways in which hospitals can improve healthcare outcomes and reduce readmission rates.

Identify your patient. Continue to identify your patient.

Correct patient identification is key. Ensuring that staff members are treating the right patient for the right ailment is, perhaps, needless to say, the best way to improve healthcare outcomes. Getting identification wrong can lead to any number of issues, from unnecessary operations or incorrect scans to potentially dangerous prescription medication being offered.

The best way of ensuring correct patient identification is by using a touchless biometric patient identification platform such as RightPatient. It helps improve healthcare outcomes, ensures timely sharing of appropriate information with other professionals, and ultimately helps lower the chances of a patient safety incident.

The data may be on the screen, and may well be correct. But front desk staff, nurses, medics, and others are only going to know this for sure if they use such a solution. The available data is also likely to show previous admissions, incidents that the patient may have been involved in, allergies, vital statistics, next of kin, and areas of concern for the patient’s health.

Many hospitals undertake patient surveys to help them improve patient care, and this option can be offered as a patient reaches discharge date, if appropriate.

Goals, KPIs, outcomes, HSMRs – whatever you call them, they help improve healthcare outcomes.

Improving the patient’s experience of their stay in the hospital will also improve their view of how well they were treated. A positive outlook has been shown to raise recovery rates. Plus, helping patients recover makes staff feel better too. Making a good outcome a key goal of the organization and the staff will help both sides. Suggesting a reduction in incidents from the previous year is a friendly way to ask for an improvement in figures, whilst still recognizing that employees are human and can make mistakes.

RightPatient identifies patient records accurately

No matter how good the records, unnecessary scans can be requested and patient information can be incorrectly recorded. It happens. If the patient’s identity can be verified accurately, then mistakes can be avoided.

Sharing is caring.

Sharing information with other caregivers can also improve healthcare outcomes and provide healthcare professionals with a rounded picture of the person they are treating. Not all patients will be happy with this option, but for primary care doctors, knowing where else their patients have already been treated is of great benefit when referring them to other specialties. Many people have to see a different physician for every ailment, and joined up care can make things much easier. When someone with a chronic condition ends up in the ER, a shared electronic health record allows everyone to know what medication the patient has already been prescribed and even whether certain common treatments have already been attempted.

CMS, therefore, requires healthcare providers to use CoP electronic notifications to let other named physicians know that they have a patient in their care. These notifications also alert others in the chain about patient discharge or transfer, which is important for ongoing care – using RightPatient can help with that. RightPatient also aims to prevent duplicate medical records, so acting against medical identity theft. All of this helps CMS compliance, which is good news for a facility’s finances, as fines for CMS breaches can be crippling after a while.

Contact us for more information on how RightPatient can help your facility and your patients stay safer from medical mix-ups and online impersonation by using our biometric patient identity management system.

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

December 18, 2020/13794 views / 0 Comments/in BLOG, COVID-19, Data Integrity, Duplicate Medical Records, healthcare, Infection Control, Patient Errors, Patient Identification, Patient Matching, Patient Outcomes, Patient Safety /by Matt Gibson

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.

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!

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.

Improving Patient Safety Depends on Error-Free ADT E-Notifications

November 25, 2020/10897 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

While COVID-19 has been ravaging almost the entire world, healthcare industries have been facing an unprecedented number of patients and challenges. Arguably, the US healthcare system has been hit the worst. Just look at the numbers – over 10 million cases with a record of 100,000 new cases for seven consecutive days. Unfortunately, things will get worse, as spikes are seen across the states and experts predict far more cases during the fall. Healthcare providers are facing huge challenges while they deliver care, while keeping patient and provider safety as a top priority. That being said, CMS (the Centers for Medicare and Medicaid Services) has mandated that caregivers must support sending and receiving e-notifications during ADT (admission, discharge, and transfer) events, something that many believe will help with improving patient safety and quality of care. Let’s take a closer look at the rule, how it will enhance care coordination, and why it requires accurate patient identification.

Interoperability has always been problematic

COVID-19 has already shown the importance of sharing patient data among caregivers. Most of the patients have multiple caregivers located at different sites, and for seamless care coordination and improved healthcare outcomes, their data needs to be shared accurately and in real-time with the appropriate parties. That’s exactly what CMS aims to achieve: improved interoperability between caregivers with patients in common.

Interoperability has been a massive issue within the healthcare space as caregivers fail to share patient data accurately, mostly because of patient identification issues – more on that later. In order to bolster interoperability, enhance coordinated care, and improve patient outcomes, CMS announced a new CoP (Condition of Participation) surrounding e-notifications as a part of their Interoperability and Patient Access Final Rule.

The new Condition of Participation (CoP) in a nutshell

This CoP requires applicable healthcare providers (critical access, psychiatric, and regular hospitals) that use digital medical records to share and receive alerts that are triggered in real-time due to ADT events – both inpatient and ED (emergency department) events. Applicable parties are PCPs (primary care physicians), post-acute care providers, and primary care practitioners, among others. The notifications should at the least include patient information, such as the patient’s name, the treating practitioner’s name, as well as the sending institution’s name. Caregivers can share more information if they deem it necessary.

The applicable healthcare providers need to support e-notifications by May 1, 2021. This means they have around half a year to comply with the requirements.

Why it is critical for improving patient safety

By sharing critical patient information with other parties across the care continuum, all of them can make informed decisions using the most recent data, leading to seamless care coordination and better healthcare outcomes – improving patient safety along the way.

Healthcare in the US has become multifaceted and complex – gone are the days when a patient would go to a single caregiver for receiving care. Now, a single patient can have multiple doctors that are located at different healthcare facilities. E-notifications enable such caregivers to quickly send and receive information that can lead to faster outcomes and better decision-making. When you compare it to previous methods – fax, phone calls, etc. – you will understand how this is going to change patient data sharing and interoperability. In time-sensitive cases, for instance, these real-time alerts will save lives.

How healthcare providers are addressing this CoP

Caregivers are brainstorming to identify the best way to address this CoP. Many will develop e-notifications solutions in-house, whereas others will use third-party solutions. While healthcare providers do that, they might overlook a crucial aspect that will make or break their e-notifications solution: patient identification.

To improve care coordination and interoperability efforts, e-notifications won’t be effective on their own – let’s see how.

Improving patient safety requires accurate patient identification

One serious but overlooked issue faced by healthcare providers is patient identification errors. Even during the pandemic, patient identification errors have been brought up a number of times, as they lead to delayed care, repeated lab tests, and can even hamper patient safety. But how exactly is this related to e-notifications?

It’s quite simple – imagine a hospital that does not utilize an effective patient identity verification solution. It is bound to face a number of issues, such as duplicate medical records, overlays, medical record mix-ups, and so on. Now, imagine that a patient is misidentified during registration; the entire caregiving process will be dangerous and inaccurate as it will use the wrong medical record. This will also hamper interoperability – false alerts will be sent out, raising credibility concerns. It will wreak havoc in the facilities that are associated with the wrong medical record. Thus, accurate patient identification is crucial for improving patient safety as well as making e-notifications work. Fortunately, RightPatient can help with that.

RightPatient has been improving patient safety

Used by several caregivers, RightPatient is the leading biometric patient identification platform for a number of reasons. First, it ensures hygiene as it is a touchless solution, eliminating risks of hospital-acquired infections. Second, it has a vast amount of experience over the years, making it a trusted name within the healthcare space.

By using patients’ photos, RightPatient locks the medical records. Patients are asked for a personal photo and a driver’s license after they schedule appointments. The platform matches the photos to verify the identities remotely.

When patients arrive at the hospitals, all they need to do is look at the camera – the platform identifies them using the saved photo and provides the appropriate medical record within seconds.

Use RightPatient now and eliminate misidentification, ensuring that you send out proper alerts to the correct caregivers, enhancing patient safety and care coordination in the process.

4 Strategies to Optimize Revenue Cycle in Healthcare and Mitigate Losses

November 24, 2020/11766 views / 0 Comments/in BLOG, Duplicate Medical Records, EHR, healthcare, Medical Record Mix-ups, Patient Identification, Patient Outcomes, Patient Safety, Revenue Cycle Management /by Matt Gibson

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.

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”.

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.

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

November 16, 2020/10176 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, healthcare, Medical Identity Theft, Patient Data, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

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 rose across many states in the US. The American Hospital Association (AHA) also predicted that healthcare providers will face losses of at least $323 billion in 2020 due to the novel virus. As caregivers are still facing some of 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.

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 reportedly received 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 fined half of the hospitals in 2021 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.

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.

Patient Identifying Information Used Determines Patient Safety Within Hospitals

November 9, 2020/7437 views / 0 Comments/in BLOG, Duplicate Medical Records, healthcare, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Even before the COVID-19 pandemic hit the US, its healthcare system was plagued by a multitude of issues. Increasing costs, the lack of price transparency, medical identity theft, healthcare data breaches, duplicate medical records, and the lack of interoperability are just some of the many problems surrounding healthcare. While these are persistent issues, many of them took a backseat when COVID-19 struck the US – except for patient misidentification. During the pandemic, healthcare providers profoundly felt the lack of an effective patient identifier. It led to patient safety issues, result mix-ups, patient misinformation, and so on. Let’s explore what healthcare experts are doing, why a national patient identifier might not be enough on its own, and how patient identifying information used by a healthcare provider heavily influences patient safety.

The current state of patient identification

Patient identification has been a mess within the US healthcare system due to a number of factors. However, the biggest reason is that there is no standardized patient identifier that can be used to accurately identify patients’ medical records. As a result, many healthcare providers are still using the archaic process of finding electronic health records manually. Even though EHR systems provide search functionalities, issues such as common names and demographic characteristics as well as duplicate medical records make it harder to identify the accurate medical record. Thus, using names as patient identifying information is inefficient, dangerous, and, in high-stress environments such as registration desks of hospitals, might lead to misidentifications.

As a result, even this year, coalitions were formed where healthcare leaders came together to demand a state-funded UPI (Universal Patient Identifier) and expressed why accurate patient identification is crucial to ensure desirable healthcare outcomes. Back in July, healthcare leaders across the industry were relieved when the House of Representatives finally voted to overturn the ban on the UPI.

Its creation, though, depends on the Senate now; they must approve the policy change. While we are closer to a national patient identifier than we’ve been in years, the Senate didn’t approve of abolishing the ban last year, citing privacy concerns.

Why is patient identification so crucial?

Let’s take it from an expert, Tom Leary, HIMSS VP of Government Relations. During a session organized by the ONC (Office of the National Coordinator), Mr. Leary stated that incorrect patient data hampers public health response initiatives, such as those during the pandemic. As a result of patient identification errors, improper data sharing, delayed test results, and inaccuracies in medical records were seen during the crisis. Also, whenever the vaccine for COVID-19 is created, accurate patient identification is a must to deploy large-scale immunizations. While these were just some of the anomalies observed during the pandemic, patient identification errors have been rampant for years.

Hospitals using ineffective patient identifying information to identify proper medical records have been facing issues such as denied claims, patient safety issues, duplicate record creation, overlays, and poor care coordination across their facilities. With all that said, along with years of medical record errors, duplicates, and so on, will the UPI be enough on its own to eliminate all the existing issues?

Choosing the right patient identifying information won’t be enough for the UPI

Short answer: the UPI won’t be enough in the near future. First, creating a UPI will be quite expensive and time-consuming. In terms of implementation, it will take years to cover the entire population. Also, its efficacy will entirely rely on the patient identifying information used. For instance, many healthcare providers already use Social Security numbers, and they’ve proven to be ineffective identifiers. These numbers can be easily lost, stolen, or even forgotten by the patients, making them unreliable identifiers.

Thus, the only way to make the UPI a success is to couple it with an existing and robust patient identification platform, one that has experience ensuring positive patient identification. That’s where RightPatient comes in.

RightPatient uses the most practical patient identifying information

Many healthcare providers are using RightPatient as their patient identification platform, and they chose it for a number of reasons. One factor that sets RightPatient apart is it uses the one feature that cannot be stolen, forgotten, or misplaced as patient identifying information – patients’ faces.

After successfully scheduling an appointment, the patient receives an SMS or email requiring a personal photo as well as a photo of their driver’s license. RightPatient matches the photos to ensure remote patient authentication.

Within healthcare facilities, registered patients only need to look at the camera – the platform matches the photos and ensures accurate and touchless patient identification. This helps to provide a hygienic environment for both patients and registrars, eliminating infection control issues and enhancing patient safety.

RightPatient has years of experience ensuring accurate patient identification – try us now to learn how we can help you reduce denied claims, prevent duplicate records, improve healthcare outcomes, and more.

Patient Safety and Quality Improvement Can be Achieved with Positive Patient Identification

October 21, 2020/9430 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, healthcare, Infection Control, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Among the several issues faced by the US healthcare system, one of the more prominent is patient misidentification. We know this to be true because even during the coronavirus pandemic, experts have stated that patient matching issues were continuing. Moreover, coalitions were formed to demand the fabled “unique patient identifier” once again. But why do healthcare providers demand patient identifiers time and again? Let’s take a look at some statistics that show how serious the issue is, some consequences caused by the absence of effective patient identification, and how patient safety and quality improvement are related to it.

Patient identification issues are nothing new

The last decade has been a transition towards technology for the US healthcare system. Caregivers such as physician practices, hospitals, and health systems have made the jump from traditional paper medical records towards the more standard electronic health records (EHRs). However, as they did so, they saw the issues that occurred due to the absence of an effective patient identifier nationwide. One of the biggest challenges is matching patients to their accurate medical record whenever they arrive for healthcare services. Let’s review some recent statistics about how common misidentifications are.

Some stats to back it up

According to a study conducted by eHealth Initiative, approximately 38% of the respondents have suffered from an unwanted event caused by patient misidentification within the last 2 years. Many of these events are caused by duplicate medical records, and an overwhelming 66% of the respondents blame data entry errors that lead to duplicates. Moreover, 80% of the providers have dedicated FTEs (full-time employees) or third-party contractors to solve these issues. The biggest barriers to reducing poor patient matching were the lack of prioritization and the lack of technology. 32% of the caregivers stated that they had around 3-10% duplicates within their EHR systems. All of these statistics show that patient misidentification is growing and needs to be addressed by caregivers. Fortunately, many hospitals and health systems are already using touchless patient identification platforms like RightPatient to solve these issues, but more on that later. Let’s see how patient misidentification is a barrier to patient safety and quality improvement.

Patient misidentification hampers patient safety and quality improvement

While patient misidentification causes a lot of problems for any given caregiver and patient, let’s take a look at how it impacts patient safety, and in turn, healthcare quality.

Patient misidentification is closely related to duplicate medical records

Duplicates can lead to patient misidentification and vice versa. For instance, if a patient comes in and provides their nickname instead of the name on the medical record, the registrar won’t be able to accurately identify the medical record. Thus, after failing to find the record, a new one gets created, leading to another duplicate record within the EHR system.

Likewise, if there are many duplicates within the system against the same patient, there are high chances that all of them have incomplete and inconsistent information. This will lead to matching the patient to the improper medical record. Both of these scenarios will lead to incorrect procedures, adversely impacting patient safety.

Patient misidentification hampers patient data integrity

As previously stated, data entry errors are quite common during registration. Thus, if patients are associated with the wrong medical record, they will be treated based on someone else’s medical history, illnesses, allergies, and so on. One single pill can severely impact the patient’s health – one can imagine what would happen if the whole procedure was wrong! Such cases have led to delayed care, repeated lab tests, and compromised patient safety.

Patient misidentification leads to medical errors

Quite closely tied with the previous point, patient safety and quality improvement cannot be achieved if medical errors keep occurring. While medical errors happen for a variety of reasons, many are preventable, and as stated previously, 38% of the healthcare providers surveyed reported that they suffered from medical errors tied to patient misidentification. These errors could have easily been prevented had the caregivers used robust patient identity matching solutions.

Patient safety and quality improvement is achievable with RightPatient

Leading healthcare providers such as Catholic Health Services of Long Island, Terrebonne General Medical Center, Community Medical Centers, among others, have been using RightPatient and improving patient safety and quality of care. As the healthcare industry’s leading touchless patient identification platform, RightPatient has years of experience helping hospitals and health systems identify patients’ accurate medical records across the continuum of care. The platform uses patients’ photos to identify their accurate medical records, prevent medical identity theft, avoid duplicate records, and prevent medical errors – enhancing patient safety and ensuring a hygienic environment that will be crucial in a post-pandemic world.

Patient Safety and Quality Can Be Improved by Preventing Duplicate Medical Records

October 12, 2020/8968 views / 0 Comments/in BLOG, Connected Health, Data Integrity, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Matching /by Matt Gibson

Patient safety is one of the more integral aspects of any given healthcare system. It ensures that patients are getting the required treatment without any medical errors or harm, healthcare outcomes are optimal, and healthcare services are delivered to the highest possible standard. While those are the common aims, the reality is quite different in the U.S. healthcare system. It has always been inundated with a number of serious issues – healthcare data breaches, medical identity theft, patient identification issues, lack of price transparency, and duplicate medical records are just some of them. The root cause of many of the issues are duplicate medical records. While we already had a closer look at duplicate medical records and how it impacts revenue cycle optimization, let’s have a look at how preventing duplicates can lead to enhanced patient safety and quality, among other things.

How duplicates impact patient safety and quality of healthcare

In a previous article, we’ve already seen how medical record errors like duplicates and overlays are created and how they cause claim denials. Let’s see how they impact patient safety and quality of healthcare as well.

AHIMA’s Shannon Harris and Shannon H. Houser stated in an issue of the Journal of AHIMA that duplicates and overlays don’t only cause financial woes, but lead the physicians and healthcare staff to inadvertently causing medical errors. For instance, imagine that a single patient has duplicate medical records in a hospital’s EHR system. While treating the patient, the physician will see the duplicates but chooses the one that has obsolete information. Since the information is not updated, the treatment or medication might very well cause adverse effects. Such cases might even lead to transferring the patients for emergency treatments, leading to jeopardized patient outcomes.

That’s not the only way duplicate medical records impact patient safety and quality of healthcare – let’s look at the latter. When you have fragmented information within duplicate records, issues such as repeated lab tests and delays in treatment are quite common. Since the majority of the healthcare providers’ registration systems have ineffective patient identity matching techniques, the number of duplicates keeps on increasing, leading to patient safety issues, patient data corruption, and financial troubles in the form of denied claims.

How are hospitals addressing duplicates?

Sadly, rectifying duplicates and overlays are quite complex and a nightmare for any given healthcare provider. While most of the hospitals are trying to fix duplicates by reallocating their HIM resources and even dedicating some of their FTEs (full-time employees) to identify and rectify the erroneous records, unless they address the frontend issues (read: identify patients accurately), it will be a never-ending cycle. Patients will be misidentified, duplicates will be created, and FTEs will be assigned to fix them on the backend, taking up valuable time and resources.

So, can hospitals address these issues and prevent duplicate medical records on the frontend?

RightPatient enhances patient safety and quality of healthcare

As previously mentioned, if the patients are accurately identified during the registration process, duplicates can be prevented right from the beginning. That’s what we do best with our industry-leading patient identification platform. RightPatient, with its touchless design, ensures that patients are identified across the care continuum, starting from appointment scheduling. Patients only need to provide their selfies and a photo of their driver’s license when they schedule appointments. RightPatient matches the photos and makes sure that the accurate patient record is identified every time the patient accesses healthcare services, remotely or otherwise.

When the patients arrive at the hospital, all they need to do is look at the camera – RightPatient matches the saved photo and the real-time photo during the check-in process, preventing duplicates, eliminating denied claims, and enhancing patient safety. The best part of RightPatient is that the entire identification process is touchless, creating a safe environment for all involved in a post-COVID-19 world.

Revenue Cycle Optimization Efforts Are Hampered by Duplicate Medical Records

October 9, 2020/9718 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, HIM, Medical Record Mix-ups, Patient Experience, Patient Identification, Patient Matching, Patient Safety /by Matt Gibson

Medical record errors such as duplicate medical records and overlays are issues that keep resurfacing time and again, especially when they lead to patient identification errors. We’ve already taken a closer look at duplicate medical records, how they are created, and how they impact patient safety. However, these are not the only problems medical record errors create. Another prominent issue is that duplicates jeopardize your revenue cycle optimization efforts by creating denied claims. Let’s take a look at exactly how that happens, how denied claims can take up your valuable resources, and how RightPatient can help combat duplicates and overlays, and in turn, optimize revenue cycle management.

How duplicates get created

To understand how duplicate medical records affect the revenue cycle, let’s take a brief look at how duplicates and overlays get created. These usually originate during the registration process, especially if the healthcare providers don’t have any effective patient identity verification system in place.

For instance, patients keep coming in and they need to be identified immediately so that they can be treated. This clearly shows that hospital registration desks are environments that are always hectic and staff is under pressure, more so for busy or larger hospitals. If you factor in outdated or ineffective patient identification platforms, duplicates are bound to occur, along with problems such as infection control issues that are associated with touch-based patient identification platforms.

Coming back to duplicates, the registrars have a very small window to identify the accurate medical records from an EHR system that might house thousands of records. Name changes, common names, misspellings, and nicknames only make matters worse. For instance, the medical record is saved under the name “Richard Grayson”, but the patient uses his nickname “Rick Grayson”. These are bound to create identification issues, and when the registrar can’t find the accurate record, they might end up creating a new one – leading to a duplicate record. Furthermore, existing duplicates will create more confusion for the registrars – AHIMA (The American Health Information Management Association) has stated that larger healthcare facilities have around 20% duplicates.

That’s how medical record errors usually begin, and while we’ve already talked about how it impacts patient safety, how exactly does it affect revenue cycle optimization and a hospital’s financial performance? Let’s analyze the issue.

How revenue cycle optimization is hampered by duplicates

According to a Black Book report, 33% of denied claims were caused by patient identification errors in 2017, costing the average healthcare provider $1.5 million and the entire U.S. healthcare system a whopping $6 billion per year. Let’s see how duplicates lead to denied claims that hamper the revenue cycle.

It’s quite straightforward – as duplicate medical records consist of incorrect, obsolete, fragmented, or incomplete information, these lead to coding and billing errors. Moreover, as duplicates hamper patient care, litigation costs regarding such cases are not unheard of. Not only do healthcare providers lose money, but they also lose their goodwill – these stories spread like wildfire, whenever they occur.

Coming back to duplicate records and revenue cycle, let’s take a look at how they are related. One of the more common places where denied claims occur due to duplicates is during surgical procedures, according to an article from HIM Briefings. Let’s use the example provided by Letha Stewart from QuadraMed within the article.

During the presurgery phase, the patient comes in and is registered as “Richard Grayson” and has the medical record number 111. As previously mentioned, common names lead to confusion among the registrars, and thus, without an effective patient identifier, the registrar couldn’t find the accurate medical record on the day of the surgery. As a result, a new record gets created under “Rick Grayson” with a different number, for instance, 222. When the insurance provider verifies the claims regarding this surgical procedure, it will notice the glaring discrepancy – there are different medical records involved for a single procedure. Moreover, the insurer most likely will use the patient record available at their end, and seeing that the records don’t match, the claim will be denied. While this is a simple but illuminating scenario, this is how most of the claim denials that stem from duplicate medical records occur. To sum it up, incorrect, fragmented, or incomplete patient data and discrepancies lead to denied claims that impact revenue cycle optimization efforts.

Providers dedicate FTEs for fixing medical record errors

Duplicate records and overlays need to be identified and fixed to prevent impediments to revenue cycle optimization. Most providers do that by dedicating their full-time employees (FTEs) from their HIM departments. While these activities are necessary, they also consume a significant amount of resources and time. According to Stewart, many providers dedicate around five FTEs to solve these issues. However, if providers don’t have an effective patient identifier in place, they cannot take the load off their FTEs and they’ll need to continue fixing these errors for quite some time, leading to lower productivity and higher costs. Given the current pandemic, providers need to mitigate costs as much as possible. That’s where RightPatient can help them.

RightPatient enhances revenue cycle optimization

As we’ve mentioned several times, going to the root of the issue, patient identification, is the best strategy. If you avoid duplicates and overlays at the frontend, you won’t have to deal with them later and face consequences like denied claims, allocating FTEs for fixing the issues, and higher costs. But how can RightPatient help with that?

RightPatient is the leading touchless biometric patient identification platform used by many providers to prevent duplicates. With its photo-based search engine, RightPatient identifies patients from appointment scheduling and beyond. Be it remote patient validation or identification within the healthcare facility, RightPatient ensures that the correct medical record is provided every time within seconds. Reduce denied claims, prevent duplicates, and enhance patient safety with RightPatient now.