The 3 P's to Perfect Your Pre-Encounter VA/DC HFMA March, 2015

The Problem Double-digit denial rates Cash flow Patient billing responsibility

The Opportunity = 3 Ps  In our Process  With our Patient  Boosting our Payment Pre-Encounter

Highlights  Defining the bottom line  Centralization of scheduling: the key to success  Defining where you are and where you will go  Develop and deploying a process  Training  Tracking, measuring, and evaluating the success

The $6 Million Question TM On a scale of 0 to 10, how well do you communicate your patients’ payment responsibility?

Lesson #1: Define your bottom line.  Define why you are implementing a pre-encounter process.  What efficiencies do you want to realize?

Here is what your colleagues said  Consistency  To create efficiencies to promote patient satisfaction and financial accuracy by education patients prior to service  To educate the patient, financially and clinically  Customer service  Reduce errors / streamline and improve the patient experience  Pre-financial screening  Patient Friendly!!  Financial clearance and education  Get it right the first time  Scheduling  Customer service and collection of money  Obtain authorization  Implement a new program Source: Answers given by attendees of NCHFMA Roundtable Discussion on Pre-Admission Procedures and Best Practices, July, 2012

Bottom Line: 5 Key Elements 1.Cleaner claims 2.Patient payment issues 3.Communication of payment expectations 4.Asking for payment upfront 5.Service excellence

Lesson #2: Centralize Scheduling  The foundation of a successful pre- encounter process  Scheduling is a patient access function  One calendar  One location  Everyone on the same page

Lesson #3: Define where you are and where you need to go Rate your responses on a scale of 0 to 10, 0 = extremely poor; 10 = extremely well.  ____ Overall, how would you rate your pre-encounter program?  ____ How would you rate the information you get from patients?  ____ How would you rate your clean claims?  ____ How would you rate your scheduling software?  ____ How would you rate your scheduling process?  ____ How would you rate your insurance eligibility capabilities?  ____ How would you rate your ability to estimate charges?  ____ How would you rate your ability to refer uninsured patients to their payment options?  ____How would you rate your current collection policies and procedures?

Lesson #4: Develop and Deploy a Process  Act  Centralize scheduling  Secure technology  Establish a plan and timelines  Complete buy-in

Lesson #5: Train, Inspire, Create  Create passion  Ask for money  Create service excellence  Communicate expectations

Lesson #6: Track, Measure, and Celebrate the Success  Reduction in AR days  Increase in clean claims  Increase in point of service collection  Increase in patient satisfaction scores

A Successful Process  Denial Rates  Cash Flow  An all new process

Results  Reduction of denials to 5.8% from 10%  Pre-Service collections at $400,000 average of $133,000 per month

Summary Questions  Where are you in this process?  What is your biggest obstacle?  What are your failures?  What are your successes?

If you put in place just a few of these ideas… How well could you communicate your patients’ payment responsibility?

John Cook Contact Information (Cell)

E Book: The Six Million Dollar Question How to reduce denial rates, improve patient satisfaction and increase cash flow.