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Optimize the Patient Journey with 3 Front-End Strategies

by Stacie Fults, Senior Vice President of Client Services

nimble is attending the 2024 asc Nurse leadership conference in dallas, texas on April 25-26. more information here.

Exceptional customer service drives customer satisfaction, repeat business, and referrals. For your ambulatory surgery center (ASC) to thrive, a positive patient experience is key. To optimize your customer service, map the patient journey to see how you interact with patients and where you can improve. Since the patient journey starts at the front desk, building a strong first impression and meeting expectations are essential for converting inquiries into appointments. 

Unfortunately, the front end of the revenue cycle is also where most of the errors within the billing process originate. That’s why the success of your ASC – both in terms of patient satisfaction and revenue capture – hinges on improving specific front-end processes within the revenue cycle.   

Here are three tactics that’ll improve your rate of collections and create a positive first impression – making patients more likely to choose you for their surgeries. 

#1 – Invest in Front-end Technology

The patient registration process includes capturing patient demographic information, verifying insurance eligibility, and receiving prior authorizations. These are the initial steps that begin the foundation of your revenue cycle. If the information your coding and billing team is relying on is inaccurate or contains errors, these initial steps can significantly impact your cash flow.  Plus, these inaccuracies can lead to surprise bills for your patients.  
 
We recommend investing in a tech-enabled workflow that simplifies the data capture process and decreases manual entry – including:  

  • Patient Registration: When patients complete the registration process through an online portal, the process is convenient for them and it reduces the manual burden for your staff. Instead of entering patient information when the patient arrives for that first appointment, your staff can confirm what the patient entered is accurate. Real-time data authentication gives the added benefit of discussing copayments and deductible amounts, improving the revenue cycle and providing estimates for the cost of care. 
     
  • Insurance Verification: Verify insurance and confirm patient benefits with real-time eligibility verification tools that provide details on patient benefit configurations and out-of-pocket expenses. Even if a patient’s insurance provider is in-network, the reimbursement process for employer plans and narrow networks can be complex; each patient may have slightly different coverage and documentation requirements.  
     
  • Pre-authorization: Waiting to receive authorization can often delay the patient’s ability to receive treatment, but the process is necessary to ensure payment. We often recommend requesting prior authorization for a range of possible codes before surgery to decrease the likelihood of denials. For example, as with CPT 29827 (Arthroscopy Shoulder Rotator Cuff Repair), the extent of damage or necessary procedures may not be clear until surgery begins, even with prior imaging. Knowing which procedures may require multiple authorizations can be difficult to track, but you can rely on trend identification and consult with your ASC’s physicians for recommendations. 
     
  • Chart management storage: Simplify and automate your entire chart management process to eliminate the hassle of paper chart preparation, storage, and retrieval. While investing in an EHR system might not be practical or cost effective, there are affordable, digital chart management solutions that integrate transcription, coding, and billing workflows and interface directly with your existing practice management software. This will save your staff time, improve accuracy within your revenue cycle, and allow you to know the status of each case in real time.  

Investing in advanced technology that accurately captures and stores patient data can help eliminate claim issues which, in turn, improves clean claim rates and increases cash flow.  

These processes also improve the patient experience as they confirm if the patent is in-network and help determine the patient’s financial obligation. 

#2 – Offer Patients Accurate Price Transparency 

With the rise of high-deductible health plans and the increasing influence of consumerism in healthcare, patients are seeking price transparency to confirm if they can afford the cost of service or if they can receive the same service for less from another provider.  

Paying for a surgical procedure can be a significant source of financial stress for many Americans. In fact, research has shown four in ten adults currently have debt due to medical or dental bills, which has resulted in the total amount of medical debt in collections exceeding the amount of nonmedical debt. 

Due to this trend, there’s been an overall focus on price transparency within the healthcare industry. The Department of Health and Human Services’ hospital price transparency ruling, effective since January 1, 2021, set the stage for the No Surprises Act in 2022. Providers are now required to produce good faith estimates when asked. In addition, many states are passing legislation to require healthcare providers to make costs available online to help patients make informed healthcare decisions.  

Offering price transparency at the time of service is becoming a crucial component of care from a compliance standpoint for ASCs, physician offices, and other providers. Plus, the more knowledgeable a patient is about out-of-pocket expenses, the more likely the patient will pay their portion of the bill when it’s due. 

Investing in front-end technologies that evaluate patient benefits and eligibility will help your ASC provide price transparency prior to a procedure, which will improve patient satisfaction and the likelihood of payment. 
 

#3 – Patient Financial Counseling and Online Bill Pay 

While we advise surgery centers to collect some portion of the payment upfront prior to the procedure, financial counseling educates patients on their payment responsibility to improve the likelihood of collections. Financial counseling should include payment plans and loan options to ensure patients can fulfill their obligations before the bill is due. 
 
Additionally, providing patients with online bill pay or automated payment through a portal improves the likelihood of getting paid on time for your services. Patients also prefer the convenience of digital payments, and you can improve the patient experience and streamline the collections process with this offering. 

Plus, automating patient financial responsibility and incorporating re-occurring payment reminders via email or text can eliminate or at least minimize the manual burden of following up with patients by phone, email, or mail.  
 
By investing in technologies and resources that ensure compliance with price transparency regulations, your ASC can meet the evolving needs of patients and regulatory requirements while improving your revenue cycle.

Final Thoughts: Patient Satisfaction and Front-end Processes 

While investing in front-end technology improves operations, be sure your front desk staff is trained in the necessary aspects of scheduling, including: gathering essential patient and payer information, providing proper documentation, verifying insurance eligibility, and scheduling surgeries for multiple surgeons. 

Expert knowledge of ASC industry trends and payer updates is also crucial in navigating the intricacies of the ASC revenue cycle. A dedicated team with a deep understanding of revenue cycle management will help your staff accurately address patient questions and foster a professional relationship that enhances your customer service. 

Every time patients interact with your staff and your technology you have an opportunity to put your surgery center ahead of the competition. Whether you partner with a revenue cycle management company or hire and train an exceptional front desk team, implementing the right technology will improve revenue cycle efficiency and increase overall patient satisfaction.  

Streamlining front-end processes improves accuracy, revenue, and patient satisfaction – read the details in our front-end case study. 

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