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The New Frontrunners of Healthcare: Healthcare Consumerism and Patient Access Management

With healthcare consumerism becoming the new buzzword in the healthcare financial environment, many healthcare providers are driving their focus towards it. While consumers are aggressively becoming adaptive to the self-service healthcare, thanks to the access of patient portals and healthcare kiosks, still many patients want to see a major improvement in healthcare delivery process. But one simply cannot deny the ease of researching costs, scheduling appointments, receiving online statements and making electronic payments. These are some options which every consumer must get a hands-on knowledge of!

With each passing day, the healthcare revenue cycle managers seem to be understanding the effects of consumerism as employers want to focus more and more on containing healthcare costs.

Patient Access Management

Looking at the advent of changes in the healthcare reimbursement policies and a huge influx of patients with high-deductibles, healthcare patients need to evolve their policies to focus on improving their patient access management strategies. A registration process needs to be looked upon with an improved outlook and not just as a process of getting patients into a bed. A patient access management software should be smart enough to check for referrals, getting the right authorizations, verifying eligibility, determining the patients’ willingness and ability to pay, requesting payment at time of service and arranging technological-adept payment schedules to ensure collection of revenue for services rendered.

Owing to the pressure of high-deductible patients coming to healthcare organisations, the providers need to get smart when it comes to putting their revenue cycle performance to the next level.

  • The healthcare providers need to look deeply into the patient access management at an early stage so that later on financial disasters can be avoided.
  • A hospital information system must use smart insurance plan codes in order to understand what kind of products are offered by the insurance carriers – something that can be deciphered looking at the patient’s ID card. This will also help in keeping delays of claim submissions, rejected claims and delayed payments at bay.
  • A healthcare provider must also be able to look deeply into managed care agreements. This must be done to understand when to obtain preauthorisation and referrals and to check upon the appropriateness of the place of service.
  • Healthcare providers must be able to manage the demand of consumerism by outsourcing state-of-the-art call center services, which exclusively handles your patient inquiries. Experienced healthcare query-handling professionals can help with understanding the reason for call, make use of interactive voice response (IVR), automate credit card payments, tackle peaks and valleys in call volumes and deal with a real-time call management and reporting solution.

Patient access management has brought in much-required transparency in the healthcare management, but one also cannot forget that when someone suffers from a serious illness, he or she will always prefer to look upon as a ‘patient’, instead of a ‘consumer’. To unwrap the true potential of consumer-drive healthcare movement, we need to look at the encompassing model of patients, its goals and their priorities.

And yes, while managing the healthcare revenue cycle is just the beginning of unearthing the monumental effects of consumerism, improving patient access management through a 360-degree value will help you in certainly accelerating cash collection and improving payer’s performance.

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