Healthcare Revenue Cycle Management Optimization is Crucial as In-Person Visits Increase

July 25, 2021/7284 views / 0 Comments/in BLOG, Denied Claims, HIM, Medical Record Mix-ups, Patient Identification, Patient Outcomes, Revenue Cycle Management /by Matt Gibson

Believe it or not, while COVID-19 was arguably one of the worst problems faced by the U.S. healthcare system, it was just ONE of many. That’s right, there are a plethora of issues that have been hampering healthcare for years, causing patient safety incidents, lost revenue, and more. Unfortunately, these losses went through the roof due to COVID-19 – they were estimated to be around $323 billion in 2020. While the pandemic is slowly waning, things are going in the right direction as providers are opening their doors for in-person visits. To recover from the pandemic’s financial losses, healthcare revenue cycle management optimization must be one of the topmost priorities for health systems – let’s take a closer look at why it’s important and some strategies that can help with revenue cycle optimization.

Revenue cycle management in healthcare facilities

Healthcare revenue cycle management might be quite complex, as it contains many intricate processes, but it is simple enough to understand.

Revenue cycle management, in a nutshell, is used by hospitals and health systems to keep track of the “revenue” they receive by treating patients. It has many steps, but RCM starts from the first interaction with the patient, for instance, appointment scheduling, and continues until caregivers receive the final payment.

If broken down, revenue cycle of healthcare facilities usually contains 7 components:

Preregistration
Registration
Charge capture
Claim submission
Remittance processing
Insurance followup
Patient collections

As this list shows, the revenue cycle starts from the first interaction with the patient and ends with receiving the full amount for providing healthcare services to the patient.

While it might seem simple, healthcare revenue cycle management is quite complicated and difficult, especially when it comes to collecting claims from the payers (insurance providers).

Why optimizing RCM has never been more crucial

While it was always important for healthcare providers to improve RCM within their facilities, doing so now might ensure their survival and get them through this trying time. COVID-19 has drastically affected healthcare providers, and while some received bailouts in billions, others had to close their doors permanently. The rest of them are simply struggling through the financial losses, but as in-person visits are increasing, things look brighter for the caregivers, as long as they are implementing strategies that optimize RCM right from the start.

That being said, let’s take a look at some of the strategies that can be employed to optimize healthcare revenue cycle management.

Strategies that enhance healthcare revenue cycle management

Examine the entire RCM process to identify gaps

While the age-old saying is “If it isn’t broke, don’t fix it”, rapidly evolving environments beg to differ. How do you know that it’s working out fine for you? Unless your denied claims are reduced to virtually zero, there’s always room for improvement.

Analyze the entire RCM process to see if there are addressable gaps that require improvement – even the smallest ones matter. Talk to patients, survey your RCM team, take a look at the current numbers, and determine where you want the numbers to be. If issues are not found, then great – the problem might not lie in RCM, but if issues exist, work on them. RCM is evolving rapidly, and with the changes brought about by COVID-19, introducing technology in almost every aspect of the service to improve efficiency and collaboration has become the new normal. And speaking of collaboration, let’s move to the next point.

Improve collaboration between your front-end and back-end RCM teams

The traditional practice is that the front-end and back-end teams work towards the same goals, but separately. However, if they work more collaboratively then the entire process will become seamless and it will help optimize RCM as information is never lost or misinterpreted – helping to receive payments much faster and in greater numbers, improving the bottom line.

Using solutions that guarantee accurate patient information

When it comes to RCM, one of the biggest impediments to its optimization is denied or rejected claims – most of which can be traced back to billing and coding errors. On the front-end, if the patients are misidentified or if inaccurate medical records are used, then there are bound to be inconsistencies that are picked up by the payers. These errors lead not only to billing errors and denied claims, but can also be detrimental to positive patient outcomes – affecting the bottom line and the goodwill towards the hospital. As a result, ensuring patient data integrity and accurate patient identification is a must – both of which can be done with RightPatient.

RightPatient is a tried and tested biometric patient ID platform that safely and accurately identifies patients using their faces. The patient only needs to look at the camera – the platform does the rest, making it an entirely contactless process, something that is crucial in the post-pandemic world.

Not only does RightPatient make identification faster and accurate, but it also ensures that accurate information is fed to the registered patients’ EHRs every time they opt for healthcare visits, reducing billing and coding inconsistencies and denied claims in the process.

Hospitals Might Lose $122B – Can a Robust Patient Identification System Help?

June 2, 2021/9065 views / 0 Comments/in BLOG, COVID-19, Data Integrity, Duplicate Medical Records, healthcare, Medical Record Mix-ups, Patient Data, Patient Errors, Patient Experience, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Healthcare providers in every nook and cranny of the world have had their hands full with COVID-19 dealing damage everywhere. The US was not left out as its healthcare system could not cope with the unexpected events that persisted when the virus hit hard. The loss incurred in 2020 was massive for healthcare providers and difficult decisions had to be made. Unfortunately, the year 2021 doesn’t look like much of an improvement. The Kauffman Hall report suggested that healthcare providers could end up losing as much as $122 billion in 2021 in the worst-case scenario. On the less pessimistic side, they will lose up to $53 billion, which is still a significant amount. That being said, we need to look in-depth at how the impact could be reduced significantly and how the administration of an effective patient identification system can reduce significant losses.

Loss is inevitable for most healthcare providers in 2021

The major difference between 2020 and 2021 is that now people are getting treated with vaccines against the devastation that was the theme of the previous year. Most hospitals have opened up and there is a gradual decrease in the amount of COVID-19 cases. Hospitals will, however, have to settle for a loss of about 10%, which is still considered a pretty serious loss by experts.

Patient identification errors are still plaguing health systems and, even before the pandemic, there had been huge losses for caregivers. But not all of them were suffering from the losses.

NYU Langone Health, Baylor Scott & White Health, the Mayo Clinic, and some others are just some of the large hospitals that benefited from a bout of federal healthcare bailout grants. Baylor Scott & White, in particular, earned profits in 2020. Many others didn’t come off with such luck as they had to shut their doors permanently, lay off most of their workers, introduce pay cuts, and furlough employees. The losses have further extended into 2021 and it could persist into 2022. The focus must. however. be shifted to existing problems – ensuring positive patient identification is one of them.

How an effective patient identification system helps reduce losses

The major strategy which healthcare providers are using to mitigate losses is by cutting expenses. Reducing the workforce shouldn’t be a priority as they could focus on solving problems associated with patient safety problems, medical records mix-up, duplicate medical records, patient outcomes, denied claims, preventable medical errors – the list goes on. The cord that connects them all is patient identification errors.

Poor identification of patients will cause hospitals to administer wrong treatments that often result in patient safety incidents, harmful patient outcomes, readmissions, etc. There is a consequential ripple effect of patient misidentification on hospitals and patients alike. These effects can be too heavy and costly on either side. Preventable medical errors, denied claims, litigation costs, and fixing duplicate medical records can lead to massive losses for any healthcare provider. An effective patient identification system must be adopted by hospitals – RightPatient is the best fit for the task.

RightPatient is the leading patient identification system

RightPatient is a touchless biometric patient identification platform that solves the problems plaguing healthcare providers and patients nowadays. It is just what we all need in this post-pandemic era. It is easy to use and hygienic for both caregivers and patients due to its touchless nature. RightPatient can help to prevent losses in millions by preventing patient misidentification, medical identity theft, denied claims, duplicate medical errors, etc. It is a must-have for responsible healthcare providers to reduce losses and enhance positive patient outcomes.

Proper Patient Identification Mitigates Hospital Losses in Several Ways

May 31, 2021/7144 views / 0 Comments/in BLOG, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Experience, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Patient safety can easily be achieved by making proper patient identification one of the basic requirements within hospitals. Misidentification of patients creates a host of problems for the care provider, the patients, the insurance companies, to say the least. Medical record mix-ups, preventable medical errors, wrong administration, patient safety issues, or death can be the result of patient misidentification. Repetitive cases of misidentification can spell doom particularly if it is concurrent post-pandemic, caregivers have their hands full to deal with huge losses as a result of coronavirus.

Subsequently, we will look at the effects of patient misidentification on healthcare providers, the financial losses incurred, and how using RightPatient can be used for proper patient identity management to assist caregivers in overcoming issues that may arise as a consequence.

COVID-19 further compounds the financial loss on healthcare providers

In 2020, it was thought that hospitals will lose $323 billion due to COVID-19. Things are much better now that we have seen a large portion of the United States’ population get vaccinated but the immense financial pressure on hospitals remains an impediment. About $122 billion is the estimated value of the total possible loss for hospitals and health systems following the lingering effects of the pandemic. Despite the immense efforts invested in vaccination, the losses haven’t abated in 2021 according to experts. The situation is dire and healthcare providers have to cut down on unnecessary costs in a meaningful way.

2020 was a dark year for healthcare providers

In the wake of last year’s events, caregivers had to develop new strategies to overcome the challenges posed by the pandemic. They were forced to adopt cost-cutting strategies such as furloughing, temporarily closing down departments, closing hospitals, and laying off workers. These strategies aided some hospitals but it was pretty ineffective for others. The focus has to be on fixing existing problems that will ultimately minimize their losses. Proper patient identification is one of the most underrated and lingering problems that are being experienced in many hospitals and health systems. Next, we will be considering how we can reduce losses.

Ways how proper patient identification cuts losses

Accurate patient identification reduces denied claims

Denied claims often result from situations in which the person paying for a service observes discrepancies in the information sent by the caregiver compare to a patient’s actual data. Such claims are denied based on patient misidentification.

Possibly, the patient might have been misidentified right from the beginning. The case of patient misidentification does not necessarily mean that the patient was given another patient’s EHR, it could also be a case of duplicated medical details. If such occurs in the EHR system, and the fragmented data are used in treating the patient, the issues that may arise will be critical. Peradventure by a long shot, a miracle happens and no patient safety concern incident occurs, the claims will be flagged off by a statement of the insurance company that it was the wrong medical record. Medical record mixups may mean that a patient receives the wrong bills and these rarely pass through to approval.

It is, thus, important to properly identify a patient from the beginning. An adequately evaluated identification will mean that the same EHR will be used in developing appointment schedules as well as payment collection. It will also be useful in fighting denied claims. The necessary bills will be issued to the patients and the caregiver’s patient revenue cycles will be optimized and losses reduced drastically.

Accurate patient identification improves patient safety

Dangers to patient safety such as wrong treatments, readmissions, wrong surgeries, preventable medical errors depending on the situation can arise from a wrong EHR is used to administer treatment to patients. A patient with diabetes can get treated with a plan for a heart condition as a result of a patient record mix-up. Even the slightest patient safety incident can cost healthcare providers a lot of money, undesirable media attention, and others which can lead to penalties down the road.

Making sure that accurate patient identification often limits the chances of medical record mix-ups, drastically reduces the occurrence of otherwise preventable medical errors, and ensures improvement in healthcare outcomes by making the right patient get the right treatment plan. An averted problem of patient safety concerns saves the hospital a whole lot of trouble and financial implications.

RightPatient ensures proper patient identification

Efficient healthcare providers are finding great use for RightPatient in identifying their patients. Our touchless biometric patient identification platform is easy to use, and it is also ideal in a post-pandemic world as it limits the chances of infection control issues.

The platform has a proven track record of aiding healthcare providers to enhance patient safety, forestalling cases of patient medical record duplication, and diminishing denied claims. The bottom line is ultimately improved upon in the process. Are you ready to use a feasible solution like RightPatient to cut your losses?

5 Strategies That Can Rebuild Revenue Cycle for Healthcare Facilities

May 27, 2021/8469 views / 0 Comments/in BLOG, Data Integrity, Denied Claims, healthcare, Medical Record Mix-ups, Patient Data, Patient Experience, Patient Identification, Patient Outcomes, Patient Safety, Revenue Cycle Management /by Matt Gibson

As the pandemic wanes, at least for now, many businesses are rebuilding. The US healthcare sector is no exception, picking itself up and dusting itself down gingerly, preparing to welcome back patients and see an uptick in revenue again. Working on the revenue cycle for healthcare providers has never been more important.

For some hospitals and departments, it’s already too late – the pandemic forced them to close. Others are hanging on, with staff returning from furlough and machinery being switched on and recalibrated for the first time in over a year. As more people are fully vaccinated, it becomes simpler to see patients in person again, which will lead to the increase in revenue the healthcare sector badly needs. However, it’s not all plain sailing. Providers could still lose over $120 billion this year, so it is vital to be careful with any attempts to ramp up income. The fewer denied claims there are, the better the bottom line will be. That being said, let’s take a look at some strategies that will help optimize the revenue cycle for healthcare providers.

5 strategies to enhance revenue cycle for healthcare providers

Check the existing revenue cycle management processes

The first option is to see whether any immediate improvements can be made to the existing system. This will be down to the back-end developers and IT specialists and will not be visible to patients. After that, it’s time to look at the patient-facing part of the cycle. Ensuring staff members are fully trained in customer service is a good place to start with optimizing revenue cycle management. That way, they will know what questions to ask when registering or checking in patients and how to check their insurance, treatment codes, and eligibility. They will know how long to allocate for different types of appointments and when to ask for immediate payment.

Use technology to your advantage

The easiest way to ensure that everything runs smoothly is by identifying patients accurately right from the start of the treatment process. This could be done using a patient identity verification platform such as RightPatient that eliminates the need for asking patients questions, patient record mix-ups, and more, reducing denied claims in the process.

That was just one example – optimizing the revenue cycle for healthcare providers is not difficult, it just needs a bit of help at times. Technology can be that hidden assistance.

Prompt, correct coding, and billing is key

An organization should not expect prompt payment if its internal processes are lax. Ensuring accurate coding and billing leads to lower chances of denied claims. Complete elimination of denied claims is impossible, because of some uncontrollable factors, but rigorous checking of coding will, in turn, generate accurate bills which are more likely to be agreed on the first time by the insurers.

Utilize up-front collection

If possible, the up-front collection is the best way to optimize the revenue cycle for healthcare providers. This eliminates an entire step in the revenue collection process, as the bill does not need to be seen by accounts receivable at all. Instead, it lands on the collected revenue team’s side for processing. While this approach will not work for every patient, it can be an effective tool for immediate revenue generation.

Accurate patient identification underpins everything

Well-trained staff members are likely to know exactly how to identify a patient and take payment politely using a fast processing system, but the whole thing falls if the patient’s identity is incorrect on the system, or if changed details are input wrongly. Denied claims are annoying and time-consuming to rectify. There are ways in which technology can help minimize the chances of this happening, however.

Getting the patient’s identity and billing details correct from the first interaction with them makes things so much smoother. It prevents duplicate medical records and overlays, for a start. If a patient only has one EHR, there is little to no chance that the insurer will find fault with the claim and so will settle the amount faster. Denied claims cost millions of dollars for every provider, often due to poor electronic health records and a lack of robust identity checks. Incorrect patient identification puts the patients at risk too.

One of the most innovative ways of ensuring accurate patient identification from the get-go is by using RightPatient. This touchless biometric patient identification platform is being used by several healthcare providers and has several benefits. It allows patients to identify themselves even in virtual consultations and during in-person visits, all they need to do is look at the camera, meaning that they don’t have to run the risk of others overhearing sensitive personal data when checking into a clinic. Nor do they have to use touchscreens or keypads to enter information – making it hygienic and safer than ever.

RightPatient is the solution that ensures accurate patient identification, reduces denied claims, duplicate medical records, and ensures fast billing.

How to Improve Healthcare Outcomes and Reduce Readmission Rates

May 23, 2021/7477 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, EHR, healthcare, Medical Identity Theft, Medical Record Mix-ups, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Improving a patient’s outcome (for instance, their quality of life or life expectancy) is obviously the prime reason for treating them. Patients approach a medical professional with the hope of ‘being cured’ of whatever ails them, whether that’s by being prescribed medication to ease symptoms or having an operation or procedure to relieve pain or remove or transplant a body part to offer a better quality of life. When they are paying for their treatment, they have every right to expect that their life is better afterward. Hospitals that do not achieve the required levels of treatment outcome are routinely penalized, thus, they need to improve healthcare outcomes. These levels are measured by readmission rates. On average, over 2,500 hospitals are likely to be penalized because of their monthly readmission rates, even though the pandemic will have increased the chances of some patients having to be readmitted.

Improve healthcare outcomes with an effective patient identification platform

However, there are some very simple ways in which hospitals can improve healthcare outcomes and reduce readmission rates.

Identify your patient. Continue to identify your patient.

Correct patient identification is key. Ensuring that staff members are treating the right patient for the right ailment is, perhaps, needless to say, the best way to improve healthcare outcomes. Getting identification wrong can lead to any number of issues, from unnecessary operations or incorrect scans to potentially dangerous prescription medication being offered.

The best way of ensuring correct patient identification is by using a touchless biometric patient identification platform such as RightPatient. It helps improve healthcare outcomes, ensures timely sharing of appropriate information with other professionals, and ultimately helps lower the chances of a patient safety incident.

The data may be on the screen, and may well be correct. But front desk staff, nurses, medics, and others are only going to know this for sure if they use such a solution. The available data is also likely to show previous admissions, incidents that the patient may have been involved in, allergies, vital statistics, next of kin, and areas of concern for the patient’s health.

Many hospitals undertake patient surveys to help them improve patient care, and this option can be offered as a patient reaches discharge date, if appropriate.

Goals, KPIs, outcomes, HSMRs – whatever you call them, they help improve healthcare outcomes.

Improving the patient’s experience of their stay in the hospital will also improve their view of how well they were treated. A positive outlook has been shown to raise recovery rates. Plus, helping patients recover makes staff feel better too. Making a good outcome a key goal of the organization and the staff will help both sides. Suggesting a reduction in incidents from the previous year is a friendly way to ask for an improvement in figures, whilst still recognizing that employees are human and can make mistakes.

RightPatient identifies patient records accurately

No matter how good the records, unnecessary scans can be requested and patient information can be incorrectly recorded. It happens. If the patient’s identity can be verified accurately, then mistakes can be avoided.

Sharing is caring.

Sharing information with other caregivers can also improve healthcare outcomes and provide healthcare professionals with a rounded picture of the person they are treating. Not all patients will be happy with this option, but for primary care doctors, knowing where else their patients have already been treated is of great benefit when referring them to other specialties. Many people have to see a different physician for every ailment, and joined up care can make things much easier. When someone with a chronic condition ends up in the ER, a shared electronic health record allows everyone to know what medication the patient has already been prescribed and even whether certain common treatments have already been attempted.

CMS, therefore, requires healthcare providers to use CoP electronic notifications to let other named physicians know that they have a patient in their care. These notifications also alert others in the chain about patient discharge or transfer, which is important for ongoing care – using RightPatient can help with that. RightPatient also aims to prevent duplicate medical records, so acting against medical identity theft. All of this helps CMS compliance, which is good news for a facility’s finances, as fines for CMS breaches can be crippling after a while.

Contact us for more information on how RightPatient can help your facility and your patients stay safer from medical mix-ups and online impersonation by using our biometric patient identity management system.

4 Strategies for Patient Safety Quality Improvement

May 4, 2021/6957 views / 0 Comments/in BLOG, Duplicate Medical Records, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

Patient safety has always been a much-discussed topic for healthcare experts, hospitals, and well-informed individuals. After all, by not ensuring patient safety, healthcare outcomes will be detrimental due to medical errors, mix-ups, hospital-acquired infections (HAIs), lack of proper communication, and more. These events lead to hospitals being hit with lawsuits and losing goodwill. In fact, one of the issues that cause patient safety incidents is medical errors, and a study indicates that they are the third leading cause of U.S. deaths. Moreover, with COVID-19, ensuring patient safety is a much bigger challenge and responsibility than ever before. The focus of this article is patient safety quality improvement and it’s quite clear that it is a must for U.S. hospitals and health systems.

That being said, let’s take a look at 4 strategies that improve patient safety quality, how medical errors are related to patient misidentification and mix-ups, and how ensuring positive patient identification can help.

RightPatient improves patient safety.

4 strategies for patient safety quality improvement

Providing proper training to healthcare staff members

One of the first tasks for patient safety quality improvement is to evaluate and identify which employees within your healthcare facility require training – they’re the ones dealing with the patients directly, after all. Whether it be nurses, registrars, patient safety professionals, or other staff, improving their skills can significantly improve patient safety.

Use quizzes, short interviews, and their recent performance to identify the ones that require training regarding the do’s and don’ts and patient safety incidents. Ensure that they know the critical aspects that can make or break patient safety within your facility.

Identify and work on reducing patient safety incidents

Patient safety incidents are ever-present in hospitals – they’re just waiting to happen unless addressed appropriately. Take a more proactive approach than a reactive one in identifying issues that might cause patient safety incidents down the line by conducting audits. While this might seem repetitive, it does ensure patient safety quality improvement and can help you avoid hefty costs in the process.

One belief many healthcare providers have is that conducting routine checks is enough. However, healthcare is a dynamic environment and there are new challenges every day that need to be addressed appropriately and in due time. Conducting checks regularly or whenever a serious incident occurs in your facility and monitoring to prevent these incidents using apps can also boost patient safety significantly.

Work on reducing hospital-acquired infections

During COVID-19, this is a strategy all healthcare providers must implement for patient safety quality improvement. Enforcing social distancing practices for everyone in the facilities is the only way to reduce transmission of infectious diseases. Ensure that people (both patients and healthcare staff members) are standing six feet apart, and use proper PPE. Moreover, provide sanitizers or handwashing facilities at crucial points to ensure better protection. Also, minimize or eliminate physical contact as much as possible, especially in registration areas for all incoming patients. Using a touchless patient identity verification platform can significantly help with improving hygiene, and in turn, patient safety.

Preventing medical errors

As previously mentioned, one of the biggest issues that cause patient safety incidents is medical errors, and most of these can be associated with patient misidentification, patient mix-ups, and duplicate medical records.

Imagine this – if a patient is misidentified right from the start, or is associated with an incomplete medical record, their entire treatment will be full of errors. Not only does this lead to wrong medications, but also leads to wrong transplants, longer hospital stays, readmissions, irreversible physical damage, and even deaths. Preventing medical errors, thus, becomes the topmost priority to enhance patient safety within hospitals – and that’s exactly what RightPatient does.

Achieve patient safety quality improvement with RightPatient

RightPatient is a touchless biometric patient identification platform that is used by leading healthcare providers to identify their patients accurately at every interaction. By using patients’ photos, RightPatient identifies them accurately right from the start and across the care continuum, preventing duplicate medical records, patient safety incidents, and medical errors.

Are you a responsible healthcare provider that is working to enhance patient safety? Contact us now to learn how you can improve patient safety, and more, with RightPatient.

RightPatient Can Prevent Medical Mistakes, Patient Mix-ups, and More

February 26, 2021/10350 views / 1 Comment/in BLOG, Data Integrity, healthcare, Medical Identity Theft, Medical Record Mix-ups, Patient Data, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

While 2020 felt like a very long year for all the wrong reasons, it has been already two months into 2021, fortunately. However, COVID-19 is still having a significant effect, especially on the US healthcare system. One of the many issues that were present even during the COVID-19 waves was patient identification errors, and it demonstrated that healthcare providers need to upgrade their patient identification systems immediately. Patient record mix-ups, preventable medical mistakes, sending reports to the wrong patients, and not finding the patient records were just a few of the problems healthcare teams faced during the pandemic.

However, there’s a more serious concern up ahead. As the vaccine starts to slowly but steadily reach the general public, potential vaccine mix-ups might occur as a result of patient misidentification. This will severely jeopardize vaccine rollouts and make them lose their efficacy.

While patient identification issues and their several consequences have been present for a long time, they can be prevented with an effective patient identification platform like RightPatient – let’s explore.

How RightPatient works to prevent medical mistakes

RightPatient is a touchless biometric patient identification platform that helps hospitals and health systems prevent patient identification errors and mix-ups. It attaches the patent’s photo and biometric data to the medical records during registration. During subsequent visits, patients are required only to look at the camera – the platform verifies their identities and provides the appropriate medical records.

One of the best parts is that RightPatient is contactless, making it feasible for a post-pandemic environment, as it prevents HAIs (hospital-acquired infections). Moreover, it can also be used at any touchpoint across the care continuum, making it ideal for telehealth sessions.

That was a lot about how RightPatient works – let’s see the issues it prevents – and can prevent – for healthcare providers.

The problems RightPatient addresses

RightPatient prevents duplicate medical records

Duplicate medical records have been creating mix-ups, preventable medical mistakes, and more, leading to detrimental patient outcomes, impacting patient safety, revenue cycle issues, and lower bottom lines. Since RightPatient can identify registered patients right from the start, it prevents the creation of additional duplicate medical records as well as medical errors – improving patient safety and healthcare outcomes.

RightPatient eliminates preventable medical mistakes

One of the biggest issues patient identification errors create is medical errors. For instance, patient A will get medications that are actually required by patient B – a single mistake can be disastrous. Moreover, there have been cases where one patient received a transplant that was supposed to be received by an entirely different patient. However, since their names or demographic characteristics were similar, a mix-up occurred. Fortunately, RightPatient prevents such cases – ensuring quality and safety in healthcare facilities.

RightPatient prevents medical identity theft and protects patient data

One of the prominent reasons medical identity theft cases are successful is because there is no way to catch the fraudster. Conventional patient verification methods are not well-equipped to handle misidentifications, let alone detect fraudsters.

Fortunately, RightPatient can accurately identify patients using their photos; whenever the fraudster tries to pass themselves off as the patient (or victim), the platform red-flags them, preventing medical identity theft in real-time. This helps in a number of ways – patient information is protected from being corrupted, litigation costs are prevented by the healthcare provider and patient safety is ensured.

Can RightPatient prevent vaccine mix-ups?

While most of us among the general public wait for the vaccine rollouts, we have to remember that, at this point, to ensure maximum protection, we require two doses of the vaccine. However, imagine this – a hospital is housing vaccines from two different manufacturers. What if a patient receives the shot of Pfizer’s vaccine the first time and the second dose is from Moderna?

Unfortunately, vaccine mix-ups are occurring as we speak, and it might significantly reduce the effectiveness of the vaccines, putting numerous lives at risk. Moreover, many of these cases might occur due to patient misidentification.

Fortunately, RightPatient can help hospitals and health systems to determine patients’ identities accurately, prevent record mix-ups, and ensure efficient vaccine administration without any hiccups, enhancing patient protection against the virus.

Responsible healthcare providers have been using RightPatient for years – preventing patient safety issues, avoidable medical mistakes, duplicate medical records, and medical identity theft in real-time. Contact us now to be a more responsible healthcare provider.

Hospitals Can Reduce Denied Claims By Preventing 6 Issues

November 26, 2020/12591 views / 0 Comments/in BLOG, Denied Claims, healthcare, Medical Record Mix-ups, Patient Data, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety, Revenue Cycle Management /by Matt Gibson

The COVID-19 pandemic has caused arguably the worst financial strain the US healthcare system has ever experienced. While all healthcare systems around the world are facing similar challenges, the US is currently witnessing the highest number of cases in the world – over 10 million people! As the numbers continue to increase, so do the losses, and healthcare providers must reduce their costs to cope with these unprecedented numbers. That being said, reducing denied claims is more crucial than ever, as they cause caregivers to lose a significant portion of their revenue. Let’s take a look at denied claims, how they affect caregivers, and six errors caregivers must avoid to improve revenue cycle within their facilities, leading to improved bottom lines.

What are denied claims?

While this is a common term heard within healthcare facilities, many still don’t understand how much loss can be incurred for any given healthcare provider. To put it into perspective, Change Healthcare stated that denied claims can cost around $4.9 million on average for any hospital. But what are claim denials?

Simply put, denied claims are those that are classified as unpayable by the payers (insurance companies) after they receive the process them. Claim denials often occur because there’s some form of error present within the claim that becomes apparent after processing. Issues such as missing information, sending the wrong information, and non-covered services are the common reasons why claims are denied. However, there’s another form known as a rejected claim.

When one or more issues are detected within a claim even before it was accepted or processed by the insurance company, it is classified as a rejected claim. Coding errors and mismatched procedures are the most likely causes that lead to such claims.

How do denied claims affect healthcare providers?

Claim denials are a massive pain point for healthcare providers as they decrease already razor-thin margins, significantly increase collection times and reimbursement, and consume valuable resources such as FTEs (full-time equivalent).

As we can see, claim denials significantly affect a hospital’s bottom line. Moreover, while 63% of claim denials can be recovered down the line, the administrative costs are a nightmare – $118 per claim. Thus, it’s better to avoid denied claims right from the beginning.

That being said, let’s take a look at the top six issues that lead to claims being denied.

6 issues to avoid that can help reduce denied claims

Absence of information

One of the most common mistakes that lead to claim denials is sending inadequate information to the insurance company. Even the smallest details such as date of surgery, date of onset, demographic information, etc., are liable to classify claims as unpayable.

Issues with coding

Using an obsolete codebook or incorrect codes is a common mistake that leads to claim denials, as they cause revenue leakage.

Insufficient documentation occurs when there are missing elements required for the services billed, and it is extremely crucial to prevent them. Thus, immaculate documentation is critical to prevent legit claims from being converted to denied ones. If proper documentation is not present when coding and submitting claims, then insurance companies classify them as denied because they consider that the services were not performed.

Duplicate bills

Duplicate claims are quite common and are usually attributed to human errors. These occur when the revenue cycle staff forgets to remove a claim from the patient’s account after resubmitting the claim. However, as claims processing systems consist of tools that help detect duplicate ones, the systems flag and classify the anomalies as either suspect duplicates or exact duplicates. As the entire healthcare process is quite complex in nature, it might lead to original claims appearing as duplicate ones – resulting in a claim denial.

Simply preventing duplicate claims is not enough. Properly coding the billed service with required modifiers and documentation is crucial to help identify the bill as original and not as a duplicate.

Not filing claims at the right time

Various rules and regulations must be followed regarding claims and failing to do so will result in even legitimate claims being denied. For instance, the Affordable Care Act reduced the deadline window for submitting Medicare claims to 12 months from 15-27 months after the date of service.

Not verifying coverage eligibility for the services provided

Healthcare insurance is quite volatile, leading to constant changes. As a result, it is crucial to check eligibility every time services are provided to the patients. While this might seem like a tedious task, it will help save a significant amount of money down the line.

Whenever a patient comes in for healthcare services, it is essential to check whether the coverage is still in place (read: not terminated), the service provided is covered by the plan, and the cap has not yet been reached. However, a healthcare provider can cover its services using plans with a cap as long as it follows provided guidelines meticulously and provides the required documentation.

Patient identification errors

One of the biggest problems that leads to claim denials is patient identification errors. Imagine this: if a patient is not accurately identified right from the start, the claim will be filed against the wrong medical record and the insurance company may ultimately classify it as denied. To ensure that claims are not denied and are processed smoothly, patient identification is a must. That’s where RightPatient can help.

RightPatient is a touchless biometric patient identification platform that locks patients’ records with their photos – protecting patent data. It can even remotely identify patients, making it ideal to be used across the care continuum and any touchpoint.

After scheduling an appointment, patients need to provide a personal photo and a photo of their driver’s license. RightPatient matches the photos to verify their identities, and when patients arrive at the hospital, all they need to do is look at the camera. The platform matches the saved photo with the live one, instantly eliminating any chances of the claims being denied.

Healthcare providers can reduce denied claims, optimize the revenue cycle, avoid duplicate medical records, improve healthcare outcomes, and even prevent medical identity theft with RightPatient – enhancing patient safety in the process.

Improving Patient Safety Depends on Error-Free ADT E-Notifications

November 25, 2020/11478 views / 0 Comments/in BLOG, Data Integrity, Duplicate Medical Records, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

While COVID-19 has been ravaging almost the entire world, healthcare industries have been facing an unprecedented number of patients and challenges. Arguably, the US healthcare system has been hit the worst. Just look at the numbers – over 10 million cases with a record of 100,000 new cases for seven consecutive days. Unfortunately, things will get worse, as spikes are seen across the states and experts predict far more cases during the fall. Healthcare providers are facing huge challenges while they deliver care, while keeping patient and provider safety as a top priority. That being said, CMS (the Centers for Medicare and Medicaid Services) has mandated that caregivers must support sending and receiving e-notifications during ADT (admission, discharge, and transfer) events, something that many believe will help with improving patient safety and quality of care. Let’s take a closer look at the rule, how it will enhance care coordination, and why it requires accurate patient identification.

Interoperability has always been problematic

COVID-19 has already shown the importance of sharing patient data among caregivers. Most of the patients have multiple caregivers located at different sites, and for seamless care coordination and improved healthcare outcomes, their data needs to be shared accurately and in real-time with the appropriate parties. That’s exactly what CMS aims to achieve: improved interoperability between caregivers with patients in common.

Interoperability has been a massive issue within the healthcare space as caregivers fail to share patient data accurately, mostly because of patient identification issues – more on that later. In order to bolster interoperability, enhance coordinated care, and improve patient outcomes, CMS announced a new CoP (Condition of Participation) surrounding e-notifications as a part of their Interoperability and Patient Access Final Rule.

The new Condition of Participation (CoP) in a nutshell

This CoP requires applicable healthcare providers (critical access, psychiatric, and regular hospitals) that use digital medical records to share and receive alerts that are triggered in real-time due to ADT events – both inpatient and ED (emergency department) events. Applicable parties are PCPs (primary care physicians), post-acute care providers, and primary care practitioners, among others. The notifications should at the least include patient information, such as the patient’s name, the treating practitioner’s name, as well as the sending institution’s name. Caregivers can share more information if they deem it necessary.

The applicable healthcare providers need to support e-notifications by May 1, 2021. This means they have around half a year to comply with the requirements.

Why it is critical for improving patient safety

By sharing critical patient information with other parties across the care continuum, all of them can make informed decisions using the most recent data, leading to seamless care coordination and better healthcare outcomes – improving patient safety along the way.

Healthcare in the US has become multifaceted and complex – gone are the days when a patient would go to a single caregiver for receiving care. Now, a single patient can have multiple doctors that are located at different healthcare facilities. E-notifications enable such caregivers to quickly send and receive information that can lead to faster outcomes and better decision-making. When you compare it to previous methods – fax, phone calls, etc. – you will understand how this is going to change patient data sharing and interoperability. In time-sensitive cases, for instance, these real-time alerts will save lives.

How healthcare providers are addressing this CoP

Caregivers are brainstorming to identify the best way to address this CoP. Many will develop e-notifications solutions in-house, whereas others will use third-party solutions. While healthcare providers do that, they might overlook a crucial aspect that will make or break their e-notifications solution: patient identification.

To improve care coordination and interoperability efforts, e-notifications won’t be effective on their own – let’s see how.

Improving patient safety requires accurate patient identification

One serious but overlooked issue faced by healthcare providers is patient identification errors. Even during the pandemic, patient identification errors have been brought up a number of times, as they lead to delayed care, repeated lab tests, and can even hamper patient safety. But how exactly is this related to e-notifications?

It’s quite simple – imagine a hospital that does not utilize an effective patient identity verification solution. It is bound to face a number of issues, such as duplicate medical records, overlays, medical record mix-ups, and so on. Now, imagine that a patient is misidentified during registration; the entire caregiving process will be dangerous and inaccurate as it will use the wrong medical record. This will also hamper interoperability – false alerts will be sent out, raising credibility concerns. It will wreak havoc in the facilities that are associated with the wrong medical record. Thus, accurate patient identification is crucial for improving patient safety as well as making e-notifications work. Fortunately, RightPatient can help with that.

RightPatient has been improving patient safety

Used by several caregivers, RightPatient is the leading biometric patient identification platform for a number of reasons. First, it ensures hygiene as it is a touchless solution, eliminating risks of hospital-acquired infections. Second, it has a vast amount of experience over the years, making it a trusted name within the healthcare space.

By using patients’ photos, RightPatient locks the medical records. Patients are asked for a personal photo and a driver’s license after they schedule appointments. The platform matches the photos to verify the identities remotely.

When patients arrive at the hospitals, all they need to do is look at the camera – the platform identifies them using the saved photo and provides the appropriate medical record within seconds.

Use RightPatient now and eliminate misidentification, ensuring that you send out proper alerts to the correct caregivers, enhancing patient safety and care coordination in the process.

4 Strategies to Optimize Revenue Cycle in Healthcare and Mitigate Losses

November 24, 2020/12493 views / 0 Comments/in BLOG, Duplicate Medical Records, EHR, healthcare, Medical Record Mix-ups, Patient Identification, Patient Outcomes, Patient Safety, Revenue Cycle Management /by Matt Gibson

The US healthcare system has been going through a rough patch for a number of years now. When one problem is solved, other critical issues arise. However, with all these preexisting issues, it is now facing its biggest challenge in decades: COVID-19. With patients postponing regular visits and elective procedures, COVID-19 has created a severe financial strain and plunged hospitals and health systems into unprecedented losses. While hospitals are having to cope with these losses by closing down emergency departments, laying off employees, and so on, they can significantly reduce costs by focusing on their revenue cycles. Let’s explore why revenue cycle in healthcare is crucial, some strategies to optimize it, and how positive patient identification can help significantly.

Why is revenue cycle in healthcare important?

Revenue cycle management is one of the most crucial aspects of any given healthcare provider. In a nutshell, it is the series of events that starts when a patient schedules an appointment and ends when the provider receives payment and is reimbursed. Since it’s related to patient service revenue, it has a direct effect on any hospital’s bottom line.

If a hospital’s revenue cycle is optimized, then it will face higher margins, and if not, it will face significant losses. Complications such as billing and coding errors, patient misidentification at the front-end, and miscommunication lead to denied claims and delayed payments. In the end, patient volume won’t matter if a hospital takes a long time to capture the revenue or faces denied claims. Thus, optimized revenue cycle in healthcare facilities is extremely important if hospitals want to continue to operate in the foreseeable future.

4 Strategies to optimize revenue cycle management

Improve front-end and back-end collaboration

The front-end consists of activities where the hospital’s staff members interact with the patient directly: patient information collection, appointment scheduling, eligibility, verifying insurance coverage, upfront patient collections, and registration of new patients are just a few examples.

The back-end, on the other hand, consists of medical billing, claims management, denials management, as well as the collection of final “patient financial responsibility”.

Usually, when it comes to revenue cycle management, most healthcare providers have their front-end and back-end tasks separated. However, collaboration between the two can significantly improve revenue cycle management. Effective and seamless communication is the key, and if that can be facilitated between the front-end and back-end teams, then it will result in faster, more accurate, and improved collections.

Improve front-end activities

According to a recent webinar, half of denied claims incurred by hospitals can be traced back to front-end activities, with the top contributors being registration and eligibility issues. These ultimately cause issues at the back-end of the revenue cycle in healthcare facilities, and the caregivers are forced to allocate significant resources such as FTEs (full-time equivalents) to fix billing and coding errors. If the front-end issues are not addressed, then this will lead to an endless cycle of lower productivity and an unoptimized revenue cycle.

If the front-end processes can be improved by preventing common errors such as patient misidentification or missing patient information, then issues like claim denials, underpayments, and lower productivity of the FTEs can be vastly reduced. Automating the front-end workflow is just one step towards improvement – but more on that later.

Adopt revenue cycle automation

Revenue cycle automation is becoming more popular within the healthcare space, and for good reason. It leads to a significant reduction in the pressure that is put on healthcare professionals, reduces avoidable errors, and streamlines the entire process. However, organizations have to be cautious in their search for an effective automation tool.

Identify patients accurately

The most prominent issues that cause revenue cycle inefficiencies are patient identification errors, duplicate medical records, and medical record mix-ups at the front-end. If the accurate medical record isn’t identified, then the subsequent processes will be riddled with errors, leading to denied claims. Hospitals lose a huge amount of money – around $4.9 million – due to denied claims, many of which can be traced back to patient identification errors. Thus, revenue cycle in healthcare can be optimized if patient misidentification, duplicates, and mix-ups can be eliminated. This is exactly what RightPatient does.

RightPatient is a touchless patient identification platform that is used by several healthcare providers. It uses the patients’ photos to verify their identities, eliminating misidentification, avoiding duplicates, and preventing mix-ups at the front-end.

New patients need to take a photo during registration, locking their medical records with it. Enrolled patients only need to look at the camera – the platform identifies the patients accurately by matching the photos and provides the appropriate medical records within seconds.

By eliminating misidentification, mix-ups, and duplicates at the front-end, RightPatient ensures that the accurate medical record is used across the care continuum, eliminating denied claims, boosting bottom lines, and enhancing patient safety in the process.