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Streamlining Patient Access and Billing Processes for Improved Healthcare Experience

This program focuses on improving patient access and billing by collecting critical data accurately, managing insurance requirements, and enhancing communication. It aims to impact revenue and reimbursement positively, emphasizing efficiency and accuracy. The initiative includes real-time quality reviews, manual audits, and denials management through process improvements and education.

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Streamlining Patient Access and Billing Processes for Improved Healthcare Experience

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  1. Connecting the Dots:Patient Access to Billing Katie Johnson, MMC Director of RegistrationBailey Holloway, MMC Admitting Manager

  2. Relationship of Access & Billing • Maintain & Enhance Input • Connecting the Dots Overview

  3. Relationship of Access & Billing

  4. Maintain & Enhance Input • Educate on purpose of each data element collected. • Communicate the importance & impact of completeness, accuracy, and timeliness. • Provide Feedback & Accountability:

  5. Today’s Patient Access Associate • Collect and verify 50 plus critical data elements that are required for various reasons including; patient care, revenue/reimbursement, meaningful use, and CMS requirements • Utilize multiple systems & applications that sometimes never interface • Collect basic clinical data • Interpret multiple, complex and ever changing insurance contract requirements • Manage financial, emotional and physical state of patient and their family members • Impact on Accounts Receivable and Reimbursement Yesterday's Registrar • Data Entry Clerks • Patient Transport • Switchboard • Order Entry You must complete all of this accurately and efficiently while;Managing financial, emotional and physical state of patient and their family memberBalancing demands of clinical stakeholdersAnd all with a SMILE 

  6. Provide Feedback & Accountability • Ownership of Accounts • Quality Review Process: • Real Time Edits/Warnings built in system • Manual Audit: • PreReg/PreAdmit • Discharge • Denials Coordinator attends team meeting to report out on last month’s activity • Special Projects Rep attends team meeting to report out on last month’s activity for Registration related Claim Edits & DNBs

  7. Claim Edits & DNB’s Related to Registration: • # of accounts • Total $ • Trends • Process Improvement - Education to resolve/minimize • Denials Received per payor: • # of accounts • Total $ • Trends • Process Improvement - Education to resolve/minimize Reg Related Claim Edits & DNB’s Monthly Report Out Denials CoordinatorMonthly Report Out

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