How Technology is Making Healthcare Happier
Vinnie Whibbs, Senior VP, Community Initiatives, SCI Solutions
Order Facilitator (formerly known as efileshare.com) is a web-based product that facilitates efficient exchange of medical information between physician offices and healthcare facilities. In an early study on its effectiveness at four hospitals, Order Facilitator reduced Medical Necessity write-off by a whopping 50%, created FTE savings in scheduling departments, cut phone wait times and improved patient and physician satisfaction.
Schedule Maximizer (formerly known as scheduling.com) is SCI Solution’s web-based Enterprise Access Management solution that combines with sophisticated workflow tools to streamline and maximize a hospital’s scheduling, resource allocation and pre-encounter revenue cycle requirements.
You know the scenario: A physician orders a diagnostic test or referral, but the order never makes it to the hospital. The fax machine ate it. Or the patient forgot to bring it. Or it’s missing a billing code. What if there were a way to eliminate the extra physician callbacks, wait times, and frustration that interrupt physician and hospital workflow?
Could the right communications solution drive physician loyalty to hospitals that have it? “Order Facilitator saves my office time and money and frees staff to be more available for patients and physicians,” says Dr. Coy Irvin of Portofino Medical Spa. “It’s a pleasure to refer patients to hospitals that have Order Facilitator. Because communication is efficient, my patients are happier.”
Do these scheduling stresses sound familiar? Having to call multiple departments or wait on hold for confirmation… calling multiple numbers to book a procedure…leaving voicemail messages…playing phone tag…and generally resulting in disjointed lines of communication. Compound these problems with medical necessity and insurance eligibility “issues” that occur because they were not verified prior to the patient’s arrival. Neither patients nor staff had advance notice of potential problems or issues that needed resolving and patients were unpleasantly surprised to find their insurance would not cover their scheduled procedures.
Doesn’t this scenario sound better? Scheduling personnel operating with maximum efficiency —de-stressing the process for both patients and providers. At Alamance Regional Medical Center (ARMC) physician offices appreciate the fact they can opt to call for patient appointments one at a time or they can make one phone call to schedule multiple exams for multiple patients.
According to ARMCs Connie Lawrence, Clinical Analyst/System Manager, “With our Account Management and Medical Necessity capabilities, our centralized scheduling staff are completing pre-registrations more efficiently. Now the hospital can verify whether a procedure is medically necessary and verify insurance coverage when a patient books an appointment. If the test or exam is not covered, hospital staff can notify the patient ahead of time to resolve the issue. If we find that the patient’s insurance will not pay or that the procedure isn’t medically necessary, we have a few days to work on it before the patient comes in. That eliminates a lot of frustration for staff and patients and helps make our process more efficient.”
At ARMC, the revenue cycle begins earlier, too – A patient account is created the moment the appointment is scheduled.
Revenue Accelerator
SCI Solution’s powerful combination of a financial rules engine, work flow module and integrated medical necessity checks ensures clean claims and quick reimbursements.
Are you challenged by your pre-encounter process? Decentralized scheduling and disparate systems make pre-registration and other pre-encounter functions especially challenging for Access staff. Pre-Registrars frequently must rely on copies of paper schedules that often change the moment they are received. Additionally, the process of coordinating revenue cycle functions to ensure clean back-end claims and fewer denials is complex. Knowing which procedures, payers and plans require pre-authorization, referrals and/or Medical Necessity Verifications can be disjointed, and presents difficulty in disseminating the necessary follow up to the appropriate staff.
How do you make your CFO happy? With a system that features the following:
- Enterprise-wide Repository of all future appointments
- Intelligent Workflow provided by Worklist for function or user specific follow-up combined with Auto-Escalation if not completed in advance of appointment
- Real-time list of pending Pre-Registrations and integrated Account Creation
- SMART Eligibility providing intelligent timing of benefits verification and mechanism for Denials to be “worked by exception”
- Automatic prompts and management of appointments requiring Authorization and/or Referral
- Automatic prompts of appointments requiring Medical Necessity and real-time verification
- Automatic generation and submittal of Patient Appointment Reminders via Email, Letter and/or Phone, supporting multiple languages
- Consumer Portal offering Integrated, Self-Service Web-Based Pre-Registration
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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