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Accurate-patient-identification-with-RightPatient

RightPatient Can Prevent Medical Mistakes, Patient Mix-ups, and More

While 2020 felt like a very long year for all the wrong reasons, it has been already two months into 2021, fortunately. However, COVID-19 is still having a significant effect, especially on the US healthcare system. One of the many issues that were present even during the COVID-19 waves was patient identification errors, and it demonstrated that healthcare providers need to upgrade their patient identification systems immediately. Patient record mix-ups, preventable medical mistakes, sending reports to the wrong patients, and not finding the patient records were just a few of the problems healthcare teams faced during the pandemic.

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However, there’s a more serious concern up ahead. As the vaccine starts to slowly but steadily reach the general public, potential vaccine mix-ups might occur as a result of patient misidentification. This will severely jeopardize vaccine rollouts and make them lose their efficacy.

While patient identification issues and their several consequences have been present for a long time, they can be prevented with an effective patient identification platform like RightPatient – let’s explore.

How RightPatient works to prevent medical mistakes

RightPatient is a touchless biometric patient identification platform that helps hospitals and health systems prevent patient identification errors and mix-ups. It attaches the patent’s photo and biometric data to the medical records during registration. During subsequent visits, patients are required only to look at the camera – the platform verifies their identities and provides the appropriate medical records.

One of the best parts is that RightPatient is contactless, making it feasible for a post-pandemic environment, as it prevents HAIs (hospital-acquired infections). Moreover, it can also be used at any touchpoint across the care continuum, making it ideal for telehealth sessions. 

That was a lot about how RightPatient works – let’s see the issues it prevents – and can prevent – for healthcare providers. 

The problems RightPatient addresses

RightPatient prevents duplicate medical records

Duplicate medical records have been creating mix-ups, preventable medical mistakes, and more, leading to detrimental patient outcomes, impacting patient safety, revenue cycle issues, and lower bottom lines. Since RightPatient can identify registered patients right from the start, it prevents the creation of additional duplicate medical records as well as medical errors – improving patient safety and healthcare outcomes.

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RightPatient eliminates preventable medical mistakes

One of the biggest issues patient identification errors create is medical errors. For instance, patient A will get medications that are actually required by patient B – a single mistake can be disastrous. Moreover, there have been cases where one patient received a transplant that was supposed to be received by an entirely different patient. However, since their names or demographic characteristics were similar, a mix-up occurred. Fortunately, RightPatient prevents such cases – ensuring quality and safety in healthcare facilities.

RightPatient prevents medical identity theft and protects patient data

One of the prominent reasons medical identity theft cases are successful is because there is no way to catch the fraudster. Conventional patient verification methods are not well-equipped to handle misidentifications, let alone detect fraudsters.

Fortunately, RightPatient can accurately identify patients using their photos; whenever the fraudster tries to pass themselves off as the patient (or victim), the platform red-flags them, preventing medical identity theft in real-time. This helps in a number of ways – patient information is protected from being corrupted, litigation costs are prevented by the healthcare provider and patient safety is ensured.

Can RightPatient prevent vaccine mix-ups?

While most of us among the general public wait for the vaccine rollouts, we have to remember that, at this point, to ensure maximum protection, we require two doses of the vaccine. However, imagine this – a hospital is housing vaccines from two different manufacturers. What if a patient receives the shot of Pfizer’s vaccine the first time and the second dose is from Moderna? 

Unfortunately, vaccine mix-ups are occurring as we speak, and it might significantly reduce the effectiveness of the vaccines, putting numerous lives at risk. Moreover, many of these cases might occur due to patient misidentification.

Fortunately, RightPatient can help hospitals and health systems to determine patients’ identities accurately, prevent record mix-ups, and ensure efficient vaccine administration without any hiccups, enhancing patient protection against the virus.

Responsible healthcare providers have been using RightPatient for years – preventing patient safety issues, avoidable medical mistakes, duplicate medical records, and medical identity theft in real-time. Contact us now to be a more responsible healthcare provider.

Improving-quality-of-care-for-patients-is-possible-with-RightPatient

Improving Quality of Care for Patients – 3 Tech Trends to Watch Out for

2020 feels like yesterday – while it did seem like the longest year due to COVID-19 and a number of other issues, we’ve finally stepped into 2021. The pandemic did bring a lot of hardship, took a lot from us, and has changed our lives forever. However, it did also show new ways to do things we thought were never possible. For instance, virtually everyone has worked remotely (many still are doing it) and telehealth usage exploded. COVID-19 changed reality for everyone and everything, but it affected healthcare the most, especially that of the US. Many hospitals had to shut their doors, whereas many health systems closed down some of their facilities. However, one of the most dramatic changes to healthcare was telehealth, and it looks like it’s here to stay. The pandemic has also forced many to adopt or come up with technology that has the potential to improve the quality of care for patients – let’s take a look at some of the promising ones.

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3 tech trends that can improve the quality of care for patients 

Telehealth

Quite unsurprisingly, telehealth is the tech to look out for in 2021. Telehealth has been growing immensely, and it’s finally getting all the attention it deserves. Since the pandemic started, the focus has been on two things – treating COVID-19 patients by allocating whatever resources required and diverting non-critical patients to virtual sessions. Months later, telehealth has been the icing on the cake – it helped reduce infections as well as helped patients receive care online without having to leave the safety of their homes. While it still might have some issues to iron out, all trends point toward a healthcare system that significantly uses virtual care. 

Moving toward the cloud

Some large players are entering the healthcare system and they are definitely going to attract the attention of hospitals and health systems to store their data online. With data breaches becoming more common than ever, it shows that most of the existing cybersecurity measures taken by hospitals are not up to the mark, mostly because of budgetary issues. 

While not everything can be moved to the cloud, many critical pieces of information can be, and that can ultimately help healthcare providers as it can be used to securely access data from anywhere – something that has become mandatory since the pandemic. 

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All of this cannot only make sharing and retrieving data more convenient but also improve healthcare processes by making them faster and more reliable – improving the quality of care for patients.

Touchless solutions 

Due to the pandemic, the entire world is working hard to reduce or eliminate touch-based processes or solutions. Even in the healthcare space, touchless solutions will be seen in the coming years. However, did you know that such a solution already exists and that many forward-thinking hospitals have already been using it? 

RightPatient is a touchless biometric patient identification platform that has been helping responsible healthcare providers for years. It is tried and tested, is versatile, and is helping enhance patient safety. But why exactly should more healthcare providers adopt it going forward? Well, that’s because the pandemic has shown everyone how deadly physical contact can be and how quickly people can get infected.

Quite naturally, it means that everyone knows about the cons of touch-based solutions. Most patient identification platforms require physical touches from patients – raising infection control issues. Fortunately, RightPatient is entirely touchless – it attaches a photo and biometric data of the patient with their EHR. After enrollment, all a patient needs to do is look at the camera – the platform performs a search and provides the appropriate medical record in seconds. 

Moreover. RightPatient is versatile enough to be used at any touchpoint within the healthcare facility, making it feasible for telehealth sessions. Patients are sent an SMS or email after they schedule appointments. They are required to provide a selfie and a photo of their driver’s license – RightPatient automatically compares the pictures, ensuring remote authentication. 

RightPatient not only solves a crucial problem of healthcare providers (patient misidentification), but it also helps improve patient safety, reduce duplicate medical records, and prevent medical identity theft effectively. Be a responsible healthcare leader now and use RightPatient to improve your bottom line by improving the quality of care for patients.

RightPatient-enhances-patient-outcomes

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

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

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Having said all that, let’s focus on: 

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

Patient misidentification is nothing new

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

Improving patient outcomes is difficult due to existing issues

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

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

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

Healthcare providers are urging for the UPI

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

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

Improving patient outcomes is possible with RightPatient 

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

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

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

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

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

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

RightPatient-ensures-positive-patient-outcomes

Positive Patient Outcomes Are Still Hampered by Patient Identification Issues

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

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

Patient misidentification and how it hampers positive patient outcomes

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

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

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

Why is patient identification such a mess?

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

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

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

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

What healthcare providers are doing

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

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

RightPatient ensures positive patient outcomes

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

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

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

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

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

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

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

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.

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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.

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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.

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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.

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

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.

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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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Wrong Patient Identification Errors Lead to Several Issues – Are You Preventing Them?

Patient identification has always been hit or miss within the US healthcare system. Wrong patient identification errors cause a plethora of serious issues for not only healthcare providers but also patients. Patient mix-ups, patient safety issues, medical identity theft, duplicate medical records, and overlays are just some of the many issues that can be traced back to patient identification errors. These issues have been popping up even more during the pandemic, leading many experts to demand a patient identifier. While we’ve talked about all of that in previous articles, let’s take a look at a very recent patient mix-up, its consequences, and how positive patient identification can prevent such cases.

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Another one added to the list of wrong patient identification

The mix-up took place back in August at Washington-based Sacred Heart hospital. Interestingly, the person with whom the hospital mixed up the information was a former patient of the healthcare provider. 

For simplicity’s sake let’s call the actual patient Samantha and the former patient (who got the call) Rebecca.

Back in August, Rebecca’s daughter was called and she was informed that her mother was hospitalized due to a critical injury. However, the daughter responded that Rebecca was right in front of her and fine, but the staff at the hospital was adamant and said that her mother was injured and admitted. Understandably, Rebecca was quite worried about the real patient, Samantha.

Rebecca and her daughter reportedly informed the healthcare provider that they had a case of mix-up on their hands – she said that she didn’t know who was being treated under her name or why. In response, she was told that the hospital would rectify the issue. However, that was only the start.

What happened down the road?

Since Rebecca was a former patient of Sacred Heart, she checked her records to see if it was fixed or not. Unfortunately, the wrong information was still present, and to make things worse, other irrelevant materials were added, such as $3,000 worth of bills. Moreover, the provider also tried to bill her old insurer, which naturally didn’t work. Subsequently, the provider attempted to help her get insurance.

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The actual patient was safe

Rebecca heaved a sigh of relief when she found out that Samantha was out of danger – she kept in contact with the hospital over the phone. When this was over, Rebecca was also relieved that she didn’t receive the wrong bills as a result of the mix-up.

Wrong patient identification errors are quite common

While this case didn’t have any adverse consequences, not everyone is as lucky. Wrong patient identification errors occur every day and most are not identified until it’s too late. Not only are they problematic for patients, but they create issues for caregivers as well.

Patients face delays in treatment, incorrect procedures, and repeated lab tests – ultimately hampering patient outcomes as well as jeopardizing patient safety in the process. Moreover, they receive shocking bills for medical procedures or treatments they never received. The lucky ones can have them written off as denied claims, but this is still a huge cost for the providers. 

On the other hand, healthcare providers face unwanted attention, loss of goodwill, denied claims, lower scores, and might even risk losing CMS reimbursements (as they are tied to patient safety). 

All of this is leading to healthcare experts and leaders rallying for a state-funded patient identifier. While this appeal has been denied for over two decades, forward-thinking hospitals and health systems are not waiting for it, and have taken the initiative themselves to eliminate issues related to wrong patient identification errors.

Leading providers are using RightPatient

RightPatient is the industry’s leading touchless patient identification platform trusted by providers such as Grady Health, Catholic Health of Long Island, Terrebonne General Medical Center, and University Health Care System. Using the photos of patients, it prevents patient identification issues like mix-ups, duplicates, medical identity theft, denied claims, and more.

After successfully scheduling an appointment, patients receive an SMS or email, after which patients are required to provide a personal photo and a photo of their driver’s license. RightPatient matches the photos automatically and verifies the identity of the patients remotely. 

Be a responsible healthcare provider and prevent mix-ups and the issues associated with patient misidentification by deploying RightPatient.

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Revenue Cycle Optimization Efforts Are Hampered by Duplicate Medical Records

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.

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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.

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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.

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CMS Interoperability and Patient Access Final Rule Requires a Robust Patient Identification Software

This has been quite a year for the U.S. healthcare system – nobody could’ve predicted all the series of events. While the novel coronavirus is still raging on, telehealth is experiencing unprecedented growth. On the other hand, hospitals are facing immense financial strain due to the pandemic’s consequences such as the cancellation of elective procedures and lower inpatient visits. However, despite all the recent developments healthcare providers need to work on something else as well – supporting e-notifications. CMS has made some additional changes to the Medicare Conditions of Participation (CoPs), and while providers will be busy brainstorming about how to best approach the requirements, many will overlook one critical factor that will either make or break their e-notifications – patient identification. Let’s take a look at what the rule specifically says about e-notifications, who is eligible, how it helps caregivers, and how a robust patient identification software like RightPatient is a must for ensuring proper e-notifications.

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The Interoperability and Patient Access Final Rule – in a Nutshell

While the rule itself is quite vast and detailed, we’ll cover the e-notifications part briefly. The basic meaning of the rule is clear from its name. For years, the U.S. healthcare system has been suffering from the lack of proper interoperability for a number of issues – patient misidentification being a major reason. However, with the “companion final rule”, as per CMS, things are about to change for the better, as it will introduce a certain level of interoperability that will ultimately boost coordinated healthcare efforts.

The “companion final rule” states that healthcare providers such as critical access providers, acute care, or psychiatric hospitals must send out real-time e-notifications during ADT (admission, discharge, or transfer) events to a patient’s caregivers such as established primary care practitioners, post-acute providers & suppliers,  primary care practice groups & entities, as well as any other practitioners, groups, or entities primarily responsible for the patient’s care. The information sent must contain the patient’s name, the treating practitioner’s name, and the sending institution’s name, at the very least. Finally, these are applicable during inpatient ADT events and ED admissions or discharges.

Any caregiver that uses digital medical records such as EHRs or EMRs must support e-notifications by May 1, 2021, to ensure CMS compliance.

With that out of the way, let’s look at how the rule requires accurate patient identification and how a robust patient identification software is critical for its success.

Why patient identification will make or break your CMS compliance

Healthcare providers are already busy working on e-notifications support, and while there are a lot of great solutions out there, providers shouldn’t forget the foundation upon which e-notifications depend on – proper patient identification.

The Interoperability and Patient Access Final Rule requires hospitals to identify their patients accurately across the care continuum, especially if they want to send out e-notifications to the proper caregivers. Sadly, patient identification has always been problematic – it is an overlooked but significant concern for the U.S. healthcare system. One might ask how are patient identification and e-notifications related – let’s learn more.

Imagine this – a hospital already has patient misidentification cases because they don’t use an effective patient identification software. If a patient comes in and is misidentified, not only will the treatment be affected, but the hospital will be sending out false alerts to the wrong caregivers. This will wreak havoc for all the caregivers involved with the patient. 

If such cases become common, then the patients, as well as the care coordination teams, will start questioning the credibility of the caregiver sending out false alerts. As a result, the hospital will lose goodwill and risk its CMS reimbursements. After COVID-19, not a single hospital can afford to make such mistakes – the pandemic has already caused the worst financial strain on hospitals and health systems in recent times. Thus, patient identification is a crucial component for the e-notifications to work. If caregivers don’t have a robust patient identity matching system in place, they need to upgrade it before the e-notifications support deadline.

RightPatient is the most robust patient identification software

RightPatient has been accurately identifying patients for years. With its touchless patient identification platform, RightPatient ensures that patients are identified accurately and safely right from the start.

After a patient schedules an appointment, they are sent an SMS or email and are required to provide a selfie and a photo of their driver’s license. The platform automatically matches the photos and remotely ensures patient identification. If it’s a new patient, the platform will automatically assign new biometric credentials for them. 

During hospital visits, patients only need to look at the camera – RightPatient matches the saved photo with the photo taken by the camera – ensuring accurate patient identification. Best of all, it’s an entirely touchless process, something that is mandatory in a post-pandemic world.

RightPatient is the leading patient identification software in the healthcare industry and is used by prominent caregivers such as Terrebonne General Medical Center, Community Medical Centers, and Catholic Health Services of Long Island. Be a responsible healthcare provider and upgrade your patient identification system now to prevent misidentification cases, medical identity theft, and ensure compliance with the Interoperability and Patient Access Final Rule.