SCI first to recognize importance of Access Management’s far-ranging impact.

Solving Access Management Problems—One at a Time

Jennifer Maul, SVP Operations, SCI Solutions

Access is a critical component of high-quality, efficient healthcare. Without streamlined access, you cannot effectively compete. As business and healthcare managers, we face difficult problems concerning methods of access to the hospital, to departments, to outpatient clinics, and to specialty areas. Access issues are felt across the enterprise and can cause sleepless nights. What top access problems plague you and keep you awake? Are you experiencing any of the following Access Management problems?

Disjointed paper-based or varied electronic scheduling systems throughout the enterprise
Unsophisticated scheduling method that lacks automatic rules
Paper-intensive pre-registration processes
Complaints from physicians that open appointment slots are two months in the future and that telephone wait times are too long
High denial rates due to errors in pre-registration and/or lack of insurance eligibility and medical necessity
High no-show rates affecting bottom-line revenue
Little understanding of resource (people, equipment) productivity and cyclical volumes
Patients waiting too long for scheduled appointments after they arrive and patients arriving without proper preparation
New specialized competitors opening across the street with promises of open appointments, online access, and no wait times
Lack of integration between access, financial, and clinical systems
Inefficient workflow between access, financial, and clinical systems

The access to-do list is long and looming. Complicating matters is that these problems are enterprise-wide, historically complex to solve, ripe with political barriers, and seemingly impossible. But there is hope! You can solve these problems without tackling them all at once. Remember “One small step for mankind” and “You have to walk before you can run”? Imagine solving these access problems from this perspective. Do not solve them enterprise-wide, rather solve them one department, one problem at a time.

Getting Started

The first step in your access evolution is to select one, and only one, department to serve as a model. Make it one where you want to resolve access problems quickly. The department manager should become the champion because without his/her commitment, the project will fail. Once you have your champion on board and gained departmental buy-in (from schedulers, clinicians, managers, and directors), it’s time to select an Access Management system. You’ll soon realize during your search process that from a budget and board perspective, it’s much easier to gain buy-in for a departmental project rather than for an enterprise one.

You need a single system that will solve every access problem. SCI Solutions offers a complete set of Access Management solutions including rules-based scheduling (scheduling.com solution), pre-registration, automated reminders, online insurance eligibility and medical necessity verification, web-based portals for physician and consumer self-scheduling, and sophisticated integration that sends/receives demographic, account, schedule, and order transactions. Complementing the benefits of this product suite, SCI Solutions deploys a software as a service (SaaS) formerly called Application Service Provider, delivering a quality system quickly with minimal capital outlay. To round out the solution, SCI Solutions has tools that help you easily rollout the solutions by automatically building departmental content and seamlessly migrating new departments from your test environment to your production environment without hours and hours of manual entry.

Steps to Access Management Success

With your champion department and SCI Solutions, you can tackle these manageable steps to solve one access problem at a time:

1. Implement SCI solutions sophisticated productivity analysis tools, basic demographic interfaces, and automated reminders (telephone, email, and/or letter).

Results: Rules are applied at the point of scheduling, electronic preparation instructions are shared or faxed with callers, and the no-show rate will fall due to automated phone reminders.The day of yellow sticky-note reminders to ask specific questions, gather certain information, and call this person are gone forever. From a resource perspective, scheduling is streamlined, allowing clinicians more time for patient interaction.

2. Activate SCI Solutions online insurance eligibility and medical necessity verification components.

Results: Denial rates decrease and revenues rise. From a workflow perspective, efforts to work denials on the backend are reduced, since insurance plans are validated and medical necessity verification with Advance Beneficiary Notices are in place at the point of scheduling.

3. Create and implement the pre-registration component and the account interface.

Results: Schedulers can pre-register patients at the point of scheduling, and pre-registrars have online access to the schedule. Patient demographic and account data are collected in advance, saving time for the patient and improving billing information at the first point of contact. Workflow between scheduling and pre-registration is seamless and paperless, which allows you to combine both processes within one team.

4. Deliver the Provider and Consumer Portals, enabling your customers to schedule online.

Results: Inbound phone volume is dramatically reduced (expect 40 percent of your volume to be scheduled online). Scheduling errors are reduced since the physician’s office is booking the procedures directly, eliminating miscommunication over the phone. Patients have online access to make appointments, print a calendar of future appointments, and review preparation instructions. You are realizing gains in both provider and patient satisfaction.

5. Implement the schedules interface to your PACs application.

Results: Films are pulled in advance, streamlining workflows between the access and clinical applications.

6. Implement the orders interface to your radiology and other clinical systems.

Results: Orders do not have to be manually keyed in and they are triggered when the appointment actually occurs, reducing unnecessary order cancellations. These steps happen according to your timetable. Because the scheduling.com application is modular, you can add a new component any time to fit your user needs and solve specific problems. Moreover, because our web-based solution can easily handle departmental, centralized or decentralized enterprise-wide scheduling, it can grow with you as your access implementation evolves. Finally, implementing a successful access solution in one department lets you demonstrate excellent results and positive return on investment to the skeptics in your enterprise. You may create frenzy in the organization, prompting department managers to crave the same solutions! Now you lie awake at night for a totally different reason. Your stakeholders all want to be next in line for these successful access solutions!

A Success Story: Alamance Regional

Medical Center

Alamance Regional Medical Center (ARMC) took this approach to better revenue cycle management—one department at a time. ARMC selected Radiology as their model department. Radiology at ARMC is a high-dollar, high-volume department with rampant access problems. Physicians were dissatisfied with the process of scheduling into the Radiology department and frustrated by long phone waits and having to call multiple phone numbers. Coordination across Scheduling and Registration departments was disjointed, and the majority of medical necessity checks were performed when the patient walked in for their exam. Workflow and communication links between departments were often repetitive, and ARMC was facing strong competition by a new specialized radiology facility that opened across the street.

Because patient and provider satisfaction outcomes and revenue cycles are directly impacted by the access and pre-registration process, ARMC implemented scheduling.com in Radiology to centralize scheduling, pre-register patients, check medical necessity, and share orders with the radiology management system. These efforts generated tremendous results:

Centralizing and automating scheduling showed that an additional room for mammography could open to sustain peak volumes of screening exams.
Automating scheduling shortened the duration of the mammography screens and built sophisticated templates and rules applied at the point of scheduling.
Reduced decentralized Radiology phone numbers from 7 to 1.
With FTE reallocation, technicians were saved over $44,000 per year in time no longer spent on scheduling activities.
Reduced two FTEs due to centralization, saving just under $43,000 in annual salaries.
Reduced Radiology scheduling resources from 15 to 6.
Over five years, ARMC will realize more than a $308,000 benefit in salary, time, and FTE savings by implementing scheduling.com in its Radiology department.

Now that Radiology’s access problems have been resolved, ARMC has solved the same issues in additional departments. They built upon their success in Radiology and shared the solution enterprise-wide. But, the first step was successfully implementing a model department and making quantifiable improvements. Once radiology was live and the foundation in place, solving access problems in other departments became a successful and repeatable process.

client quote:

“With SCI we reduced our lab monthly denials from $23,000 to 0, and increased utilization from 400 average orders a month to 3,230, as well as improved patient, physician and staff satisfaction.”

Eisenhower Medical Center

	Sign up for a free Webinar
	Watch our 3-minute PowerView summary
	Request an SCI Patient Access consultation
	Put the SCI Superheros to work for you