Visions of the Revenue Cycle Process in Access Management
John Holton, CEO, SCI Solutions
In the pursuit of their mission statements, hospitals focus on four primary areas. The first is to provide quality clinical care. The second is to organize resources in such a manner as to be able to provide this care. Third is to collect enough revenue to continue operations and fourth is to plan and adapt to the future demands of the healthcare environment. If an institution executes well in these four areas, they will survive; if they don’t, they will perish. At SCI Solutions, our focus is (and will continue to be) to help hospitals thrive. We see our Access Management solution as contributing to their success in each of these four primary areas.
Quality clinical care
First, in helping hospitals deliver the best care possible, SCI Solutions focuses significant research and development on maintaining the industry’s most advanced scheduling system, the scheduling.com solution. Our system “understands” and operates within the complex clinical rules required for efficiently and effectively scheduling patients in today’s diverse healthcare environment. Additionally, we provide a unique expert system so adapted to the clinical setting as to effectively permit direct physician and consumer booking without the assistance of their hospital staff. This concept will dramatically change how healthcare services are accessed as we enter the age of consumer-driven healthcare.
Organize resources
The efficient scheduling practices of SCI Solutions help our customers evaluate and refine their business processes, saving them money while providing better customer service. The most obvious operational benefit is the orderly workflow that results from a properly scheduled department. With the exception of emergency patients, the vast majority of healthcare delivery is highly predictable, and as such, flourishes when efficient scheduling practices are in place. A strong scheduling system allows a hospital to predict demand, staff accordingly, and fully utilize its valuable resources, thereby increasing its efficiency. Management feedback through a strong reporting system about department activity, all captured by SCI Solutions, leads to new ideas for other performance improvements.
Improve revenue cycle
Equally significant as the dramatic effect on clinical operations, SCI Solutions Access Management customers make strong improvements in their revenue cycle. By centralizing their scheduling and preregistration activities, they not only reduce labor expenses associated with departmental scheduling, but also make dramatic improvements in their ability to collect more revenue without incurring the additional expenses associated with denied payments.
SCI Solutions valuable pre-registration workstation combines appointment viewing, enterprise patient identification, insurance demographic collection, eligibility checking, medical necessity validation, referral and authorization tracking, and interfaces to a hospital’s registration and financial billing systems. Hospitals now have an integrated tool to ensure that a patient’s ability to pay for any proposed service will be known in advance of service and that the bill the hospital produces for payment will be complete for processing by the insurance company the first time it is submitted.
Hospitals spend over $100 per bill to rework errors for resubmission. And 60 percent of these re-worked bills have errors caused by the upfront registration process. Legacy systems simply do not have the integration, workflow and rules required to perform in today’s complex environment. The ability to eliminate upfront errors and reduce billing rework becomes significant in a tight financial environment and too often is overlooked.
These advantages, the ability to pay and a clean bill the first time, can capture up to 20 percent of a hospital’s collectible revenues. Also, scheduling.com provides additional revenues and reductions in operating expenses that let hospitals further extend their mission of providing healthcare to the community.
Hospital CEOs spend much time making sure their customers (physicians and patients) are happy with the hospital’s service level. Like you or me, their constituents want convenient, quality service. Most hospitals compete for their physician referrals. By installing Schedule Maximizer, hospitals are equipped to make a giant leap forward in customer service by enabling physician offices and patients to schedule their services directly via the Internet. This scheduling convenience assures improved efficiency over traditional telephone reservations. Hospitals with web-based scheduling are more competitive and will see increased business because physician offices are frustrated by waiting on the telephone for appointments. SCI Solutions customers, using our Provider and Consumer portals, report that up to 25 percent of their appointments are self-scheduled—all under the hospital’s brand. By making it convenient to do business with them, SCI Solutions’ customer hospitals provide the quality services required with consumer-driven healthcare.
Addressing future demands
SCI Solutions’ focus is to continue to produce tools that help hospitals make dramatic improvements in getting their patients in front of their providers in an efficient and financially effective way—and with a high degree of customer satisfaction.
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
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