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Patient Verification Helps Hospitals Deal with Decreasing Revenue as COVID-19 Cases Rise

August 31, 2021/7644 views / 0 Comments/in BLOG, COVID-19, Data Integrity, Duplicate Medical Records, EHR, healthcare, Medical Record Mix-ups, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Hospitals and health systems are constantly being challenged by the pandemic. Sure, COVID-19 has affected virtually every business – many organizations have declared bankruptcy while others have shuttered their doors. However, most, if not all of these organizations, had their employees work from home. Healthcare providers, on the other hand, had to face unprecedented challenges head-on, such as frontline healthcare teams risking their lives, losing billions of dollars, patient verification issues, data breaches, and more.

Unfortunately, it looks like the battle with COVID-19 is far from over for healthcare providers. With the Delta variant once again wreaking havoc, caregivers are experiencing razor-thin margins. That being said, accurate patient verification CAN prevent many issues, helping hospitals survive this challenging period. Let’s take a look at a few stats that show how concerning the new variant is and how positive patient identification can help caregivers.

Some recent statistics that show a rise in margins and expenses

While things were definitely getting better with millions being vaccinated across the U.S. and businesses slowly opening up, the Delta variant of COVID-19 has struck back with full force. While healthcare providers have been facing lower losses and improved margins when compared to the first half of 2020, a new report sheds light on many facts. While many indicators show that things are going in the right direction, some show that the effects of COVID-19 are far from over.

The “median operating margin index” in June was 2.8%, excluding funding from the CARES (Coronavirus Aid, Relied, and Economic Security) Act. When taking funding into account, it was 4.3%.

What do these numbers mean for hospitals and health systems? Well, it’s an increase of almost 90% (excluding CARES Act Funding) or 48.7% (including the funding) when compared to the first half of 2020. All of these numbers are based on 900 hospitals that have participated monthly for the last three years.

When it comes to patient volumes, it’s a mixed bag. Patient volumes were higher when compared to 2020, but lower than they were before the pandemic. For those who want specifics, discharges between January and June of 2021 were 10.1% higher than in the first half of 2020, but when compared to the first half of 2019, patient volumes are down 4.4%. A similar trend can be seen for ER visits in hospitals, i.e. higher than in the first half of 2020 but lower than in the first half of 2019.

Fortunately, the revenue of hospitals and health systems has increased compared to both 2020 and 2019! According to the same report mentioned above, this is because of outpatient visits. “Gross operating revenue,” excluding CARES Act funding for January to June of this year, was 18.2% higher than the same period of 2020 and 7.9% higher than the same period of 2019.

But all of these statistics look good for hospitals, right?

Well, while all of these do look good, expenses have also increased – affecting margins significantly. The first half of 2021 saw an 8.5% rise in expenses when compared to the first half of last year, and an increase of almost 10% when compared to the first half of 2019.

While margins are increasing, expenses are increasing as well

Unfortunately, the COVID-19 pandemic is far from over – the Delta variant has reached the U.S. and has been in the news for the past few weeks. While healthcare providers have opened their doors to regular patients, COVID-19 cases are spiking once again, and this might be detrimental to hospital margins according to an official associated with the study mentioned above.

Hospitals need to identify ways to reduce losses, improve patient safety, and avoid unwanted incidents that hurt the bottom line. But how can patient verification help?

How patient verification helps improve hospital margins

Accurate patient identification has been a topic of discussion for several years now, and identification errors have also given rise to a number of studies.

Accurate patient identification helps

Prevent medical record errors such as duplicate medical records and overlays
Prevent medical identity theft in real-time
Protect patient data integrity
Reduce denied claims by ensuring accurate, consistent information within medical records
Prevent medical errors that might lead to patient safety incidents
Avoid dangerous patient mix-ups, including transplant mix-ups
Ensure CMS compliance by sending out proper e-notifications to appropriate caregivers
Improve patient outcomes
Reduce hospital readmissions

All of the above, when considered together, can drastically reduce losses and improve a hospital’s margin. We know this because our leading patient identification platform has been helping several healthcare providers for years.

Patient verification made easy with RightPatient

A number of healthcare providers have chosen RightPatient to manage their patients’ medical records. In a post-pandemic world, RightPatient’s touchless patient ID platform makes the most sense, as it keeps everyone safe by preventing physical contact (when compared to other methods of identification).

RightPatient reduces denied claims, improves patient safety, prevents duplicates and overlays, and prevents patient identity theft – boosting the bottom line of hospitals.

How are YOU planning to reduce losses and improve margins at your healthcare facility?

How to Protect Patient Information as Data Breaches Become a Topmost Concern

August 25, 2021/6651 views / 0 Comments/in BLOG, Cybersecurity, Data Breach, Data Integrity, healthcare, Medical Identity Theft, Patient Data, Patient Identification, Patient Safety /by Matt Gibson

We’ve talked about data breaches in hospitals and health systems more times than we can count. Unfortunately, these unwanted incidents just keep on happening, and even when the pandemic was at its peak, hackers didn’t stop. Thus, it isn’t a surprise that many healthcare executives are wary about cyberthreats that loom in the dark, just biding their time and waiting to attack more hospitals and steal patient information. That being said, let’s take a look at some recent cyberthreats faced by hospitals, what healthcare execs are saying, and how to protect patient information even if there is a data breach.

Most healthcare experts are worried about cyber threats

Let’s take a look at some of the recent worrying trends in health IT, according to some respected healthcare executives.

Half of them stated that the frequency of cyber-attacks on healthcare facilities is one of their primary concerns now – let’s explore the issue in detail.

Out of these execs, one of them expects that this will continue to be a huge problem for the foreseeable future – a worrying but accurate prediction, unfortunately.

Another exec stated that such cyber-attacks put patient data, arguably one of the most sensitive pieces of information available within hospitals, at huge risk. We’re inclined to agree, as most data breaches end up with hackers stealing patient information and selling it to fraudsters who commit medical identity theft down the line. Many caregivers, as a result, are searching for answers to the billion-dollar question – how to protect patient information.

Another exec stated that cyberattacks are rapidly evolving as hackers come up with innovative ways to attack and lock or steal patient information – something quite challenging to keep up with.

One of the execs that is worried about cyber-attacks stated that hackers and these issues hinder them from doing their jobs properly, which is to care for their patients. He also stated that effective cybersecurity practices and far more assistance are required to tackle cybersecurity and keep costs in check.

Another of these execs predicts that more hospitals and health systems will be focused on improving some aspects such as better integration between platforms, patient consumerization, and strategies that help with cybersecurity efforts.

However, not all healthcare executives chose cyber-attacks as their primary worries.

Others chose:

The boom of startups that give unrealistic expectations, taking up a lot of money from investors.
Mergers and acquisitions.
Mandates about sharing health information that are quite unclear and might be detrimental.
Clinician burnout due to EHR coding, among other issues.
Ensuring equity during telehealth visits.

While all of them are quite valid concerns, the biggest concern is how to protect patient information effectively – healthcare data breaches are occurring as we speak.

Hospitals must protect patient information effectively as data breaches are rampant

On the 15th of April, a phishing attempt was successful – unauthorized individual(s) got access to login credentials of an employee of Orlando Family Physicians. After a thorough investigation, it was found that three other employee accounts were accessed. While the access has been revoked, over 447,000 patients were exposed, such as names, health insurance data, Social Security numbers, and more. This is just a classic case of data breaches – something that has been repeating itself for several years in many hospitals and health systems.

Fortunately, as we mentioned at the beginning of the article, doing something about protecting patient data and preventing medical identity theft IS possible – let’s see how to protect patient information even if there is a data breach.

How to protect patient information with RightPatient

RightPatient is the leading touchless patient identification platform trusted by responsible hospitals and health systems for several reasons. Firstly, it ensures accurate patient identification starting from appointment scheduling and at any touchpoint across the care continuum. Secondly, it is easy-to-use, safe, and hygienic, as the interactions are contactless – something that is extremely valuable in a post-pandemic world. Thirdly, it protects patient data and blocks fraudsters during identity verification – preventing medical identity theft in real-time.

During the registration process, the patient just needs to look at the camera – the photo taken is attached to their medical record, essentially “locking” it from being meddled with by fraudsters. When the patient returns for future visits, all the patient needs to do is look at the camera – RightPatient automatically runs a search and presents the appropriate EHR when it finds a match between the saved photo and the patient’s live image. Any fraudster attempts will be red-flagged by RightPatient during this process – stopping medical identity theft in its tracks.

How are YOU protecting your patients’ information?

Denied Medical Claims Are Costly but Preventable with Patient Identification

August 23, 2021/6895 views / 0 Comments/in BLOG, Data Integrity, Denied Claims, Duplicate Medical Records, EHR, healthcare, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

The U.S. healthcare system is no stranger to problems, unfortunately. In fact, it has been plagued by a plethora of issues for several years. While some of the problems are definitely solvable, external issues alongside other factors cause the problems to continue. Some of the many problems are astronomical prices, the lack of price transparency, interoperability issues, the abundance of data breaches, medical identity theft, and patient safety issues. While we have covered some of these topics at one point or the other, let’s take a look at another crucial problem, denied medical claims, how they are problematic for everyone, and how positive patient identification can prevent them.

Denied medical claims are costly and cumbersome for everyone involved

Denied claims are not a recent problem within U.S. healthcare – most hospitals and health systems are quite familiar with them. One can safely say that denied medical claims are quite expensive – an average hospital can lose around $3.5 million due to them. However, denied claims not only affect hospitals but also insurers and patients, albeit in different ways – let’s see how.

Claim denials in a nutshell

In the U.S., healthcare is closely related to reimbursements from Medicare, Medicaid, and commercial insurers. Patients get health insurance, go to their healthcare provider, get treated, and that’s about it. However, a lot more goes on behind the scenes regarding healthcare reimbursements.

After providing healthcare services to the patients, the hospital processes the information and sends the claims to the insurance company. While healthcare providers usually get reimbursed by the payer, some of them face expensive hiccups. Due to billing or coding issues, patient identification errors, medical record mix-ups, or other problems, the payer identifies inconsistencies after receiving claims, and they might reject or deny said claims. While some claims can be resubmitted, checking for and fixing the errors is time-consuming, costly, and requires a considerable number of resources.

All of the above leads to back-and-forth exchanges between care providers and payers. Insurers have to reject claims, caregivers lose out on a significant amount of revenue, and many patients even receive shocking, incorrect bills. However, some even lose healthcare services, especially those associated with Medicaid.

Let’s take a look at a few statistics to see how Medicaid patients suffer due to denied medical claims. However, do keep in mind that denied claims can be detrimental for any patient.

A worrying study regarding denied claims

A very recent study has shed light on denied claims and how physicians or hospitals are reluctant to see Medicaid patients due to reimbursement issues.

According to the study, at least 25% of Medicaid claims have been denied upon initial submission. On the other hand, 7.3% of Medicare claims were denied whereas commercial insurers denied 4.8%.

Moreover, the study also states that around 17% of revenue is lost due to billing problems associated with Medicaid patients, whereas the numbers are quite lower for patients covered by Medicare (5%) and other payers (3%).

While any type of denied claim is extremely costly, the statistics show that the Medicaid ones are quite problematic. Moreover, since Medicaid is associated with low-income families, reimbursements are lower as well.

All of this just leads to caregivers being reluctant to look after Medicaid patients.

Denied medical claims are preventable

One of the topmost priorities of physicians and healthcare providers is to look after the patients, Medicare or otherwise. Instead of worrying about denied claims, hospitals and health systems can work on reducing or eliminating them with the right tools and strategies.

Fortunately, RightPatient, the industry’s leading touchless biometric patient identification platform, can help reduce denied claims substantially.

Denied and rejected claims typically occur because of billing and coding errors – most of which can be traced back to medical record errors, patient mix-ups, and identification issues. RightPatient eliminates all of that, and more, as it ensures that the accurate information is fed to the correct EHR at all times. As a result, billing and coding errors are drastically reduced and so are denied claims – boosting the bottom line.

How are YOU reducing denied claims in your healthcare facility?

Another One Added to Wrong Patient Surgery Cases – Is Patient Misidentification To Blame?

August 1, 2021/7819 views / 0 Comments/in BLOG, EHR, healthcare, Medical Record Mix-ups, Patient Errors, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

We’ve been talking about patient misidentification for quite a long time now, and for very good reasons. While many think that patient identification errors in hospitals are not that common or serious, but every now and then, a piece of news comes up that shows just how serious it can be. This time, a patient received a kidney that was actually meant for someone else – can you imagine? Without further ado, let’s dive deep into the unfortunate tale and see how wrong patient surgery cases can be prevented with positive patient identification.

A classic case of transplant mix-up

This unfortunate case of transplant mix-up is exactly what we warn healthcare professionals against – we’ve seen our fair share of wrong patient surgery cases.

It occurred in University Hospitals (UH) on the 2nd of July, and fortunately, the recipient survived, as the kidney was compatible with the patient. The patient is slowly recovering, according to a spokesperson, and the surgery of the actual patient who was supposed to get the kidney has been delayed. UH also notified UNOS (United Network for organ Sharing) about the transplant mix-up.

Moreover, UH isn’t divulging any more details about the situation as of now – they are analyzing the situation, investigating what caused the issue, and are working so that it never occurs again. However, the employees that were involved with the medical error are on administrative leave until the issue is figured out.

However, while this might seem quite unusual, wrong patient surgery cases do occur every now and then – something which we can confidently say occurs because of patient mix-ups due to poor patient identification systems.

Wrong patient surgery cases are uncommon, but not unheard of

Back in 2019, before the pandemic changed everything, wrong patient identification led to another transplant mix-up in Lourdes Hospital Transplant Center (which we’ve covered already). Coincidentally, it also was a case of a kidney transplant.

However, this was a much more transparent case as the patients had a similar name and age – something that we very well know leads to patient mix-ups, among other things. Fortunately, in that case, the patient who got the kidney survived as it was a perfect match.

This case was also reported to UNOS and the patient who was supposed to get the kidney had the transplant down the line.

However, in UH’s case, the patient who’s supposed to get the transplant is still on the waiting list. As already mentioned, UH isn’t releasing any details about the mix-up – but we are too familiar with such cases.

Wrong patient surgery cases occur due to poor patient identification

In Lourdes Hospital Transplant Center’s case, the patients had common names and were of similar age. This is a classic case of patient identification errors. Patient’s medical records are usually mixed up during registration, and if they have common characteristics, such devastating cases are generated.

We believe that whatever occurred in UH was due to patient misidentification, or the lack of proper patient identification.

Medical record mix-ups, poor quality patient data, medication administration errors, wrong transplants, detrimental healthcare outcomes, mistreatments, and adverse incidents are just some of the consequences of poor patient identification, and can even claim patients’ lives. The patients involved in the two wrong patient surgery cases above are extremely lucky to be alive – not everyone makes it out alive.

Such transplant mix-ups or patient mix-ups are deadly, but they ARE preventable – as long as the healthcare provider is ensuring accurate patient identification. We’re so concerned about such cases is because we help responsible hospitals and health systems prevent patient mix-ups with our industry-leading touchless biometric patient identification platform, RightPatient.

RightPatient prevents patient mix-ups and patient safety incidents

RightPatient prevents patient identification errors right from the start. It takes patients’ photos during registration and locks the medical records with them. Whenever a patient comes up later on, the platform provides the accurate medical record after comparing the saved photo with the live one. This makes sure that patient mix-ups are eliminated, as it uses the one characteristic that cannot be mixed up – patients’ faces.

RightPatient has a vast amount of experience with ensuring accurate patient identification in several hospitals and health systems, and we’re confident that it could’ve prevented such cases.

Are you preventing such mix-ups at your healthcare facility effectively?

The Importance of EHRs Shows Why Medical Record Errors Must be Prevented

July 30, 2021/7711 views / 0 Comments/in BLOG, Data Integrity, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

When caregivers are asked about the most important tool they have at their disposal to treat their patients, what answers are expected? Some would say their healthcare team, the cutting edge technology/procedures they have access to, the different solutions they have that improve healthcare outcomes, and so on. However, the most underrated and crucial tool is definitely the electronic health records or EHRs. Think of it – where would healthcare be without EHRs? EHRs ensure that the right information regarding the right patient is provided to the right medical team. However, this is applicable only as long as certain issues are prevented, especially medical record errors.

That being said, let’s take a deeper dive into how EHRs are the most important tool for healthcare providers and why ensuring patient data integrity is a must.

Healthcare is evolving but the starting point remains the same

Let’s go back to a time before the deadly pandemic. If someone went to a healthcare provider and told them that telehealth would become mainstream in the future, the provider would most likely say that they’re crazy! Look at the reality now – telehealth is still preferred by many, even while users are decreasing due to hospitals opening up.

Healthcare has been evolving – rapidly in some areas and steadily in others. One certain thing is that healthcare isn’t limited to the four walls of hospitals and health systems anymore – one of the consequences of the pandemic. However, whether it’s in-person visits or virtual ones (telehealth/telemedicine), the foundation for providing care to patients remains the same – EHRs.

EHRs are more important than most realize

Patients, caregivers, and others are quite satisfied with telehealth now.

Patients on the younger side have stated that they would like to continue using telehealth even if the national health emergency is over. That’s probably because it’s more convenient, easier, and safer – all the patients need is an internet connection with a communication device.

Caregivers have a bit more complex process to go through.

Caregivers who are providing telehealth services have to consider a lot of factors – the telehealth platform, the portal, the EHR system, identifying the right patient, rules and regulations, ensuring patient safety online, and more. Also, while providing virtual services to the patients, the physicians need to ensure that the necessary information is being fed to the EHRs of the patients accurately – just as they do during an in-person visit.

The bottom line is that whether the healthcare provider is seeing the patient within their facility or online, the one thing that basically remains constant is the patient’s EHR. However, issues such as medical record errors can mess EHRs up, derailing healthcare outcomes among other things – let’s see how.

Why it’s crucial to prevent medical record errors

One of the starting points of providing healthcare is the EHR. When the patient interacts with their healthcare provider, usually to schedule an appointment, one of the first things done by the caregiver is pulling up the patient’s EHR. It basically provides the entire medical history, recent lab test results, and other information required to treat the patient. Moreover, any new information captured by the caregiver will be added to the EHR. EHRs, by providing timely, relevant, comprehensive, and accurate information to the physicians, improve healthcare outcomes, optimize healthcare delivery, boost coordinated care, and reduce adverse events.

Now, imagine if an inaccurate EHR is selected – the consequences can be devastating!

Medical record errors such as duplicates and overlays lead to patient mix-ups. Patient A’s treatment will be based on patient B’s medical record, leading to detrimental healthcare outcomes, adverse effects, and worse. Patient data within the EHRs becomes unreliable as it is fragmented, erroneous, and inconsistent.

However, all of this can be prevented with positive patient identification with RightPatient.

RightPatient prevents medical record errors – and more!

By identifying patients correctly right off the bat, RightPatient ensures that accurate, high-quality data is fed to the EHRs every time the patient checks in for a healthcare visit. Patients only need to look at the camera – the touchless biometric patient identification platform does the rest.

With RightPatient, responsible healthcare providers are not only ensuring patient data integrity, but they are also improving patient outcomes, preventing patient safety incidents, and providing optimal healthcare services to patients.

Another Patient Misidentification Case Shows Why Hospitals Must Prevent It

July 28, 2021/7191 views / 0 Comments/in BLOG, EHR, healthcare, Medical Record Mix-ups, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Patient misidentification strikes again. It’s not surprising at this point, as patient misidentification cases have been occurring frequently in hospitals and health systems. There are a plethora of consequences attached to it, which is why patient safety goals quite frequently have “improving patient identification” listed as one of the top goals to address. That being said, let’s take a look at the patient identification error in detail and how these cases are preventable with a robust patient ID solution.

A recent occurrence of patient misidentification, but certainly not the last one

Fortunately, the problem was detected before it caused any patient harm. While the patient, Ronnie (pseudonym), was waiting for a virtual visit, she was trying to convince the medical assistant that she didn’t have the rare condition called hereditary nonspherocytic hemolytic anemia. Ronnie doesn’t know how it got added to her EHR, however, that was not her only concern regarding the matter. As she was trying to get this inaccurate information removed, she experienced a lengthy and tedious process.

The assistant informed Ronnie that only the person who added the condition can remove it – EHRs are quite sensitive documents, and access to modify them is restricted to only a handful of people. However, the assistant provided the name of the doctor, and the surprise here is that Ronnie had never had any physician by that name.

The assistant was adamant that Ronnie might have had some encounter she forgot about – for instance, it might have occurred in an ER visit. However, Ronnie never went to the ER and got diagnosed with such a rare condition. She backed up her statement by adding that if she actually had hereditary nonspherocytic hemolytic anemia, she would’ve been informed about it. The assistant just reiterated that the physician has added it. Most probably, this occurred because Ronnie’s EHR was mixed up with some other patient and it was a condition that belongs to another “Ronnie” – a classic case of medical record mix-up caused by wrong patient identification.

Unfortunately, the tale doesn’t end here – there’s far more to it.

Ronnie had to go to extreme lengths to address the problem. As the discussion with the medical assistant got her nowhere, the condition was still present in her EHR. When Ronnie explained it to her physician, the latter tried to remove it but couldn’t, and neither could Ronnie’s other physicians. After trying everything, Ronnie submitted a formal request to modify her EHR – something many patients need to do to resolve patient identification errors.

We believe that Ronnie’s among the lucky ones – many such cases remain undetected until it’s too late, causing detrimental healthcare outcomes.

EHRs are beneficial but are bogged down due to patient misidentification

EHRs have a host of benefits and have been helping physicians see everything in one place, improve patient outcomes, and more. However, since EHRs contain sensitive information, editing them to rectify the errors is quite cumbersome – just look at the case above! Moreover, since caregivers have to share with other physicians due to coordinated care, these errors are seen by everyone involved in the patient’s treatment.

This is just one case, and fortunately, Ronnie was able to identify the issue. As previously mentioned, this might have occurred because of a medical record mix-up – we know, because we’ve heard about numerous cases from hospitals and health systems. Unfortunately, there are thousands of patient identification errors in hospitals that are undetected and cause a plethora of issues – both financial and physical. How do we know so much about patient misidentification?

Because our touchless biometric patient identification platform, RightPatient, prevents it and helps healthcare providers identify their patients correctly at all times.

RightPatient ensures accurate patient identification at all touchpoints

RightPatient could have very well prevented the error in this case study – we have prevented such cases in numerous hospitals and have even drastically reduced duplicate record creation. The patients only need to look at the camera – our platform does the rest. During registration, RightPatient takes a photo of the patient and attaches it to the EHR. Whenever the patient comes in, the platform takes another photo and matches it with the saved one – providing an accurate EHR every time.

RightPatient has been protecting millions of patient records in several hospitals and health systems. It ensures accurate patient identification, prevents medical identity theft in real-time, prevents duplicates and overlays, and more – ensuring positive patient outcomes.

Don’t become a mistaken patient identification story and contact us now to see how we can help you boost your bottom line.

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

July 25, 2021/7333 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.

Ensuring Healthcare Data Quality Boosts Hospitals’ Digital Transformation Efforts

July 23, 2021/6615 views / 0 Comments/in BLOG, Data Integrity, EHR, healthcare, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

The U.S. healthcare system has always had a complex relationship with technology, to say the least. While it has always been open to ideas that can transform healthcare, there have been certain impediments. For instance, the concept of a unique patient identifier is around two decades old, but due to many concerns, one doesn’t exist yet. As a result, healthcare providers are either struggling with patient identification errors or are using a robust patient identification platform to resolve the issues. Moreover, new research demonstrates the complex relationship between healthcare and technology – healthcare is lagging behind other industries in terms of digital transformation. Let’s take a closer look at the study, why some are reluctant to pursue digital transformation, and how ensuring healthcare data quality can boost digital transformation, among other things.

Some stats regarding digital transformation

The study was conducted with over 300 C-level executives, and while it includes a variety of industries, it also compares healthcare with the others, providing a different perspective.

Overall, a whopping 82% of the respondents from all industries stated that data quality is a barrier to data integration. This falls in line with the problems faced in U.S. hospitals and health systems – healthcare data quality can be inconsistent and problematic.

Healthcare was found to be comparable to financial services and the telecommunications industry in digital transformation – most of the respondents from these organizations stated that they were witnessing success rates of around 60%. While this number might be encouraging to some, healthcare lags behind organizations such as software and tech companies, who naturally are advanced in digital transformation, as well as transportation and logistics firms.

While different industries were surveyed, some commonalities show digital transformation exists as a common problem between them. For instance, around 80% of respondents stated that they found “enriching” existing data quite difficult, impeding the quest to find new insights or meaningful patterns. This is also an issue seen in hospitals and health systems, as ensuring healthcare data quality can be a considerable challenge for many – something which is preventable with proper patient identity management – more on that later.

Healthcare data quality issues also lead to losing time and resources as data needs to be rectified for usage. The survey also reflected this issue – around 40% of the respondents stated that their data teams have to spend time to clean the data, time which they could’ve spent doing something more productive, as data quality issues should not exist in the first place.

Healthcare data quality issues have a long history

It’s no secret that patient misidentification is a crucial issue in health systems and hospitals, and it leads to patient data integrity failure. Just imagine that a patient named Sam Jackson comes to the hospital and is assigned the medical record with the name “Sam Jackson”. However, the EHR actually belongs to a different Sam Jackson! The modified EHR will be full of errors and will be unusable and dangerous for both the Sams.

Such problems have been going on for a long, long time, leading to patient data quality issues, medication errors, wrong treatments, detrimental healthcare outcomes, readmissions, and more.

High-quality patient data is a must

Hospitals and health systems have been investing considerable money and resources in population health management, big data, analytics, and other projects that can transform healthcare for their patients in a variety of ways. However, the only way these efforts can work is if they have access to patient data that is complete, accurate, timely, and relevant. Unfortunately, when patient data is corrupted because of duplicate and overlay records from identification issues, these investments are diluted and affect ROI, patient safety, and healthcare outcomes.

Digital transformation in healthcare, as a result, requires high-quality patient data, and everything depends on identifying the accurate patient record right from the start – something which RightPatient is built for.

RightPatient ensures patient data integrity

RightPatient has been ensuring patient data integrity for several hospitals with its touchless patient identification platform. Registered patients are identified accurately right from the start – all they need to do is look at the camera and the platform provides the right medical record. By ensuring that accurate patient information is fed into EHRs every time, RightPatient ensures that high-quality data is present within the facilities to boost digital transformation efforts and investments – improving patient outcomes and reducing unwanted incidents in the process.

To Enjoy Advantages of Telemedicine in Healthcare, Providers Must Protect Patients Online

July 16, 2021/6792 views / 0 Comments/in BLOG, healthcare, Medical Identity Theft, Patient Data, Patient Identification, Patient Outcomes, Patient Safety, Telehealth /by Matt Gibson

Telemedicine, many times used interchangeably with the word telehealth, has grown tremendously during last year because of COVID-19. Whilst it’s been available for a long time (decades, really), its future was uncertain before now. Healthcare experts mainly debated about the possible advantages of telemedicine in healthcare, while patients were wary regarding online doctor appointments.

Still, because of COVID-19, practically everything is different, and desperate times required drastic measures. Rules enveloping virtual visits got relaxed, so, more providers and their patients got exposed to this new phenomenon called telehealth.

Online appointments currently have numerous supporters

The user base for telehealth has soared, with numerous healthcare professionals and their patients supporting it and saying they want it to be a permanent part of healthcare after the emergency is over. It was also extremely helpful and convenient throughout the pandemic. That being said, let’s look closer and examine the advantages of telemedicine in healthcare plus the way providers can safeguard their patients throughout these appointments.

A few advantages of telemedicine in healthcare

Telemedicine is cost-efficient for all

The universal understanding regarding virtual healthcare is that it is less expensive than in-person visits. Plus, it saves time, no need to travel to use it, etc. Whilst that’s correct, online healthcare is also less expensive for healthcare providers. Think about it – for most online appointments, all the provider requires is an online platform, the proper devices to connect with their patients, plus a steady, secure online connection. These types of appointments get rid of a lot of the costs linked with traditional healthcare – i.e. registration desks, using paper products, fewer staff members required, etc.

The AHA (American Hospital Association) even agrees with the aforementioned – online healthcare saved over 11% of costs for many hospitals.

Online appointments provide access to many more patients

Even the toughest critics can’t refute the fact that telehealth offers top-notch care to many more patients than in-person appointments. Consider how it worked before COVID-19 – the majority of patients in rural areas were unable to get to a suitable hospital for several reasons.

An example of one of the top advantages of telemedicine in healthcare is that one can use it from any place – so it’s quite convenient for those who live in rural areas. Whilst a tiny amount of providers offered online appointments prior to the pandemic for rural patients, the pandemic showed how helpful telehealth can be for routine patients too. Online appointments assisted in providing top-notch care to a huge number of patients who had various problems – a lot still use this and the experts want it to become a permanent option for healthcare.

Telemedicine fits more people’s needs

Preventive medicine, improved quality, superior scheduling experiences – online appointments can meet all those things and even more!

Numerous experts say because patients are more involved with telehealth appointments than with in-person appointments, the former could encourage more preventive medicine usage. Patients, likewise, feel that they are getting more personalized care with telehealth appointments since they report during in-person appointments that their physicians do not even look at them – only at their computer screens. These cases, along with other factors, might cause a surge of usage that helps to improve healthcare outcomes in the future.

Online appointments offer a superior quality of care for a lot of patients, particularly rural ones, as described earlier. With online appointments, patients can pick which provider they want, and they can even be miles away and still get one that meets their precise healthcare needs.

Finally, with online appointments, patients can merely pick the timeframe that works best for them, so, scheduling is easy. Whilst that also can happen with regular in-person appointments, the patient now doesn’t have to wait hours or longer to see their doctor, all they have to do is log in at their appointment time and see their doctor.

Still, whilst telehealth has a huge possibility, it remains pretty new, so several challenges have to be solved – one is protecting patient information online.

Providers have to safeguard their patients online to enjoy the advantages of telemedicine

Patient records and data are very sensitive information, which is one of the dominant reasons most data breaches occur in the healthcare industry. Hackers can sell a medical record for thousands of dollars on the black market, and the scammers then buy them and use them to get healthcare and the actual patient is charged with the bills. While this normally happens in traditional in-person appointments, a lot of experts believe it can also occur in online appointments, so, the healthcare providers have to safeguard their patients’ information while they are in an online appointment too.

Luckily, RightPatient comes with lots of great experience in protecting patient data as well as avoiding medical identity theft in real-time.

One of the top touchless patient ID platforms utilized by many healthcare providers, RightPatient detects patients via facial recognition and averts scammers from trying to pass as the real patient during the registration process and beyond.

RightPatient can be used during telehealth appointments – so it is perfect for protecting your patient’s information as well as stopping identity theft during virtual visits. Patients only need to take a picture of themselves and a picture ID like their driver’s license – RightPatient takes it from there.

Is your facility ready to safeguard your patients’ info and stop medical identity theft in real-time?

Improving Patient Outcomes Has to Be the Main Concern since In-Person Visits Are Back

July 15, 2021/6636 views / 0 Comments/in BLOG, COVID-19, healthcare, Patient Data, Patient Identification, Patient Outcomes, Patient Safety /by Matt Gibson

Luckily, it looks like the COVID-19 pandemic may be ending at last. Whilst COVID-19 cases 19 are still occurring, the overall rate has slowed down, thanks to over 326 million Americans getting vaccinated. As restrictions that used to be in place since the beginning of the pandemic start to ease in most states, businesses are gradually opening back up. However, healthcare, which did not close is finally receiving great news – in-person appointments, as well as margins, are going up gradually. Rising patient appointments are not sufficient for caregivers – guaranteeing quality and safety in healthcare facilities is also necessary for improving patient outcomes.

Having said that, let’s look closer at the present condition concerning patient volumes as well as margins, some statistics regarding them, and the reason hospitals must find solutions that can assist them in lowering significant costs, eliminating current issues, and surviving this difficult environment.

Healthcare providers may, at last, be getting a break

After several months of financial losses, along with suffering caused by COVID-19, healthcare providers, finally are opening facilities for in-person visits. Whilst the reaction is sluggish, it is rising steadily regarding patient volumes along with margins, based on research by KaufmanHall – let’s look closer at a few of the stats.

These stats reveal that whilst patient volumes went up, particularly outpatient visits, providers are still ending up with extremely low margins. In May, the median hospital operating margin index was only 2.6 percent, and if you include the federal CARES funding, that was still only 3.5 percent.

Nevertheless, the operating margin climbed 95.2 percent YTD (year-to-date) when compared to Jan to May 2021, and operating EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization) margin improved close to double – 102.4 percent YTD in May, the latter is excluding the CARES aid.

Conversely, when in comparison to pre-COVID-19 periods (Jan to May 2019), the operating margin was down to 20.5 percent YTD without CARES.

Therefore, what do all these numbers really show regarding healthcare providers?

Actually, it is very simple – when health systems and hospitals were able to open up, and when the restrictions eased, that led to rises in their margins in comparison to the shutdown timeframes. Though the figures were lower in comparison to the pre-pandemic time due to patient numbers being quite high then, a few cases were nearer to pre-pandemic levels, said that same report.

Based on these numbers, it is very clear healthcare is improving its numbers, yet hospitals and health systems can’t stop worrying too soon – they must work towards improving patient outcomes.

Providers must deliver their patients a safer atmosphere, carry out telehealth services for people who don’t want to do in-person appointments and decrease issues that may harm patient care. Overall, they must make sure they’re striving to improve healthcare outcomes.

Improving patient outcomes is necessary to mitigate losses

Even while COVID-19 was rampaging, there were a lot of times when it was obvious hospitals needed to work hard towards improving patient outcomes. Incorrect patient information led to repeated lab tests, inappropriate data sharing, sending results to incorrect patients, etc. Regrettably, that is not new, since healthcare providers have always faced these issues, with one of the dominant causes being the wrong identification of patients.

Misidentifying patients impedes patient outcomes

It is very simple – whenever patients get misidentified, they’re assigned an incorrect EHR, and their treatment process is completely wrong from the start. Patients may get asked to do an unneeded or repetitive lab test, and then will most certainly receive incorrect treatment – all of this gets recorded in an incorrect EHR. This all causes detrimental healthcare outcomes, as well as hospital readmissions, plus in some cases, people even die.

Healthcare providers were facing litigation costs already as well as loss of income because of such cases. However, the COVID-19 issue, along with these losses, might be sufficient to make them permanently close their doors. They simply can’t afford to make medical mistakes and jeopardize patient safety.

Luckily, they do not have to – RightPatient can help with that.

RightPatient improves patient outcomes

RightPatient identifies patients correctly from the beginning, and because it is touchless, it offers a hygienic and safe experience for all. Our biometric patient ID platform is used by many reputed healthcare providers like Terrebonne General Medical Center as well as Grady Health, and it protects millions of patients from adverse effects.

Due to COVID-19, hospitals have to do what they can to lower their losses. RightPatient can do this since it improves healthcare outcomes, as well as averts misidentification problems, and improves the facility’s bottom line.